Other complications of diabetes

Screen for complications of diabetes each trimester in women with pre-existing diabetes. More frequent assessment may be needed for women with significant complications.

See Management of complications of diabetes before conception for information about diabetic retinopathy during pregnancy.

For women with diabetic kidney disease, albumin excretion should be assessed each trimester. The patient should be under the care of a renal physician, obstetric medicine physician or obstetrician. See also Management of complications of diabetes before conception.

Women with type 1 and type 2 diabetes are at higher risk of elevated blood pressure, including pre-eclampsia (three to four times the rate in pregnancies of women without diabetes). Achieving glycaemic targets may reduce these rates. For information on use of blood pressure–lowering drugs during pregnancy, see Safety of drugs used for complications of diabetes during pregnancy. All women with pre-existing diabetes during pregnancy should receive aspirin and calcium supplementation for pre-eclampsia prophylaxis from 12 weeks’ gestation; use:

Cardiovascular disease is uncommon in pregnancy, but women with type 2 diabetes or diabetic kidney disease may be at risk, particularly if they have other significant cardiovascular disease risk factors.