The Power of Small Conversations: Bridging the Gap Between Diabetes and Pregnancy Planning

Despite the established importance of preconception counselling among women with pre-existing diabetes, many Canadian women of this demographic continue to report inadequate medical planning of pregnancy. Primarily due to the teratogenic effects of hyperglycemia in the early weeks of pregnancy, minimizing the risk of adverse pregnancy outcomes requires a proactive approach toward medical optimization before conception. Primary care providers are well placed to provide preconception counselling to reproductive age women with pre-existing diabetes to alert them to the importance of pregnancy planning. This counselling may not necessarily require dedicated visits but may take the form of simple check-ins and key messages interspaced between other interactions. Herein we discuss the importance and challenges of preconception counselling among women with pre-existing diabetes and provide a pragmatic approach to the delivery of preconception counselling among primary care providers.