title: Management of pregnancy in women with type 1 diabetes mellitus: guidelines of the French-Speaking Diabetes Society (Société francophone du diabète [SFD]).
abstract: OBJECTIVE
  The clinical guidelines reported by the French-Speaking Diabetes Society (Société francophone du diabète) include updated recommendations for preconceptual planning and care in the management of pregnancy in women with type 1 diabetes mellitus (T1DM).
  
  
  METHODS
  The working group included diabetologists, as well as an obstetrician, a nurse and a dietician. A review of the literature was performed using PubMed and Cochrane databases. Guidelines published by foreign diabetes societies were also consulted.
  
  
  RESULTS
  In women with T1DM, pregnancy increased the risks of hypoglycaemia, diabetic ketoacidosis, pregnancy-induced hypertension, infections and worsening of diabetic microvascular disease. Moreover, T1DM during pregnancy had an impact on the embryo and the fetus, and may have increased the risk of spontaneous miscarriages, malformations, premature births, and fetal and neonatal complications. However, intensive glycaemic control and preconceptual care have been shown to decrease the rate of fetal demise and malformations. Also, the use of insulin analogues during pregnancy is now regarded as safe. Tight glucose control and frequent follow-up are recommended throughout pregnancy in women with T1DM. Their obstetric management should take place in a maternity hospital with an appropriate perinatal environment and in close collaboration with diabetologists.
  
  
  CONCLUSIONS
  Pregnancy planning and adequate management during pregnancy are mandatory for improving the outcomes of women with T1DM.
authors.affiliation: Department of Paediatric Endocrinology-Diabetology, Robert-Debré Hospital, AP-HP, 48, boulevard Sérurier, 75019 Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Bismuth
authors.forename: C
authors.initials: C
authors.lastname: Bouche
authors.forename: C
authors.initials: C
authors.lastname: Caliman
authors.forename: J
authors.initials: J
authors.lastname: Lepercq
authors.forename: V
authors.initials: V
authors.lastname: Lubin
authors.forename: D
authors.initials: D
authors.lastname: Rouge
authors.forename: J
authors.initials: J
authors.lastname: Timsit
authors.forename: A
authors.initials: A
authors.lastname: Vambergue
mesh_terms: D000022:Abortion, Spontaneous / Q000517:prevention & control; D001786:Blood Glucose / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D016883:Diabetic Ketoacidosis / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D005260:Female; D005602:France; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000188:drug therapy*; D047928:Premature Birth / Q000517:prevention & control
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin