Management of Pregestational Diabetes in Pregnancy and Impact on Maternal, Fetal and Childhood Outcomes

The prevalence of pregestational diabetes in pregnancy (such as type 2 diabetes and type 1 diabetes) is increasing. Women with pregestational diabetes remain at increased risk for pregnancy complications such as congenital anomalies, stillbirth, preterm delivery, preeclampsia, cesarean sections, macrosomia, and neonatal hypoglycemia. In addition, the offspring of mothers with pregestational diabetes are at increased risk for long-term metabolic complications such as type 2 diabetes, obesity, and metabolic syndrome. However, the achievement of optimal glycemic control remains challenging due to the risk of hypoglycemia, the need for frequent adjustments of insulin dosing throughout pregnancy, and the risk of hypertensive disorders and excessive gestational weight gain. More research is needed on the optimal management strategies for pregestational diabetes in pregnancy (including novel technologies to improve glycemic control, prevention of preeclampsia, management of hypertension in pregnancy, dietary advice, and gestational weight gain targets) and its impact on short-and long-term outcomes in women and their children.

This research topic aims to give an updated overview of the current management strategies of pregestational diabetes in pregnancy, including management of glycemic control, blood pressure control, and weight gain as well as dietary advice, screening for diabetes complications, prevention of maternal and fetal complications, and impact on the long-term childhood and maternal outcomes. In addition, it also aims to identify research gaps and stimulates research on strategies to improve metabolic control in pregnancy and the short-and long-term complications in mother and offspring. This research topic focuses specifically on pregestational diabetes in pregnancy (mainly type 1 diabetes, type 2 diabetes, and monogenetic forms of diabetes) and this excludes therefore gestational diabetes.

Topic Editors welcome all article types (except case reports and animal studies), particularly original research and review articles (including narrative reviews) evaluating pregestational diabetes in pregnancy. This includes articles focusing on, but not limited to:

• glycemic control and management strategies including novel technologies such as continuous glucose monitoring and closed-loop insulin delivery systems;

• maternal, fetal, and long-term childhood outcomes;

• diabetes complications;

• blood pressure control;

• dietary advice and gestational weight gain;

• Peer support and educational tools (including applications).





COI: Katrien Benhalima reports research funding and receipt of study devices from Medtronic for the investigator-initiated CRISTAL study, receipt of study devices from Dexcom, consulting fees from Astrazeneca and Lilly, and she served on the speaker bureau for Novo Nordisk, AstraZeneca and Mundipharma.

Lene Ringholm reports that she is participating in a clinical study on the use of insulin in pregnant women with pre-existing diabetes in collaboration with Novo Nordisk; no personal honorarium is involved.

Aoife Egan has no competing interests.

Anne Vambergue has received speaker honoraria from Eli Lilly, Novo Nordisk, Roche, Abbott, Sanofi, MSD, Lifescan, Ascensia, AstraZeneca and served on advisory board panels for Roche, Diabeloop, Eli Lilly, and AstraZeneca.