ABSTRACT
The prevalence of pregestational diabetes mellitus is increasing, particularly in minority populations. Diabetes mellitus (DM) is defined as a metabolic abnormality characterized by elevated circulating glucose. The diagnoses of diabetes and impaired glucose tolerance outside of pregnancy are established on the basis of formal laboratory criteria. Often asymptomatic, but classic symptoms of uncontrolled diabetes are polydipsia, polyuria, and polyphagia. The prevalence of pregestational DM continues to increase in many high-income countries. Obesity, hypertension, advanced maternal age, non-white race, family history, and metabolic syndrome, among others are associated risk factors for diabetes. It is always important to consider the effect of maternal disease on pregnancy and, conversely, the effect of pregnancy on maternal end organs, especially because pregestational diabetes affects the micro- and macrovascular systems. Diabetic retinopathy is the leading cause of blindness in reproductive years. The care of the pregestational diabetic patient is best instituted in the preconception period.
