References
Diabetes Mellitus: Preconception management in primary care

Abstract
Women with diabetes experience adverse risks to their health and the health of their foetuses during pregnancy. This article draws upon research to help primary care nurses advise and care for patients who fall into this category
Diabetes mellitus is associated with adverse risks to both pregnant women and their foetuses. These risks include; congenital malformations, stillbirth and miscarriage. The infant is also at risk of developing diabetes mellitus and other health issues in the future. This article provides an overview of diabetes mellitus and pregnancy. Addressing the importance of preconception management and the role general practice nurses have in increasing favourable outcomes, through improving preconception management in primary care. Discussing integrating primary and secondary care to enable continuity of care. Analysing the research on the impact health care professionals conducting educational interventions has on patient's pregnancy outcomes. As well as the use of conventional and digital methods to provide health education on preconception care.
Diabetes Mellitus is a metabolic and chronic disease, which is identified by elevated blood glucose levels. These elevated blood glucose levels can result in developing macrovascular and microvascular complications (World Health Organization, 2023). The two main types of diabetes mellitus are type 1 and type 2, the most prevalent type is Type 2 Diabetes Mellitus (hereafter referred to as T2DM) (World Health Organization, 2023). Without insulin replacement in Type 1 Diabetes Mellitus (T1DM), death will occur within weeks or days (National Institute for Health and Care Excellence, 2022).
The National Institute for Health and Care Excellence (NICE) provides guidelines for managing preconception and diabetes mellitus. Under these guidelines, NICE advises providing women with diabetes mellitus with the requisite information, support and advice to mitigate the adverse risks to mother and foetus that are associated with diabetes mellitus and pregnancy (National Institute for Health and Care Excellence, 2020). These risks include; miscarriage, stillbirth, perinatal death, congenital malformations, neural tube defect, neonatal hypoglycaemia, blood glucose control affected by nausea and vomiting (National Institute for Health and Care Excellence, 2020). The infant may also be large for their gestational age, resulting in labour inductions, birth traumas, shoulder dystocia, caesarean section and instrumental deliveries (National Institute for Health and Care Excellence, 2020). Monitoring through an early ultrasound scan at approximately 7 weeks gestation is crucial (Guy's and St Thomas NHS Foundation Trust, 2022). The infant is also at risk of developing diabetes mellitus in the future (National Institute for Health and Care Excellence, 2020).
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