Some medicines, such as statins are not safe during pregnancy and women with diabetes should be advised about these when planning for pregnancy.

"Angiotensin-converting enzyme inhibitors and angiotensin-II receptor antagonists should be discontinued before conception or as soon as pregnancy is confirmed. Alternative antihypertensive agents suitable for use during pregnancy should be substituted"

"Statins should be discontinued before pregnancy or as soon as pregnancy is confirmed" (NICE Clinical Guidelines, 2015)

 

During pregnancy, insulin is the safest diabetes medication, however, the type and amount needed may change so a personalised insulin plan should be discussed with your patient. Women with type 2 diabetes are often started on insulin prior to coneption to achieve optimal glycaemic control. Always refer women wo their specialist pre-pregnancy care team.

‘I’ve only been told the second time I went [for clinic appointment], and they said ‘‘Oh, by the way, if you’re planning to get pregnant, you know, you have to go on insulin’’. So I thought that’s… I could have got pregnant all that time before!’ (Spence et al., 2010)

Note: All other medications should be reviewed. Go Folic! is a useful website about the importance of taking folic acid preconception. You can access the website here.

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