Interactive diabetes case 11: A 34-year-old pregnant patient with type 2 diabetes – A2

ANSWER — Incorrect.

Intensive insulin therapy in this patient will not reduce the risk of congenital malformations. Fetal organogenesis is nearly complete at seven weeks of gestation. Counseling and planning before pregnancy are essential in women of childbearing age who have diabetes so that conception occurs when the patient has achieved glycemic goals. Unfortunately, this is the exception rather than the rule in women with diabetes.

Intensive therapy of diabetes early in pregnancy reduces the risks of spontaneous abortion, fetal macrosomia (and its complications, including birth trauma to mother and child), neonatal hypoglycemia, and other neonatal complications (including hypocalcemia, hyperbilirubinemia, polycythemia, and respiratory distress).

This patient had access to medical care but did not take advantage of it until she was already pregnant. Women of childbearing age with diabetes often have inadequate access to medical care, especially women in certain ethnic groups with a high prevalence of type 2 diabetes including those with Hispanic ethnicity.

Return to the beginning to try again. (See "Interactive diabetes case 11: A 34-year-old pregnant patient with type 2 diabetes".)