Pre-existing (type 1 and type 2) diabetes in pregnancy

The prevalence rates of both type 1 and type 2 diabetes mellitus are increasing in the UK. These rates are resulting in a higher number of women with pregnancy complicated by pre-existing diabetes being seen in maternity clinics. Specifically, there is a continuing marked increase in the number of women with type 2 diabetes and pregnancy. Confidential Enquiry into Maternal and Child Health (CEMACH) has recently reported findings from a large study of pregnancy outcome in women with type 1 and type 2 diabetes. We review the current understanding of diabetes in pregnancy, and discuss the CEMACH findings and current and future developments in the delivery of pre-conception and diabetes care in established pregnancy in the UK.