Discontinuation of GLP-1 receptor agonists suggested before conception rather than between start of pregnancy and end of first trimester
By Elana Gotkine HealthDay Reporter
FRIDAY, July 18, 2025 (HealthDay News) — In a joint clinical practice guideline issued by the Endocrine Society and European Society of Endocrinology, recommendations are presented for pregnancy care in individuals with preexisting diabetes mellitus (PDM). The guidelines were published online July 14 in the Journal of Clinical Endocrinology & Metabolism to coincide with presentation at ENDO 2025, the annual meeting of the Endocrine Society, held from July 12 to 15 in San Francisco.
Jennifer A. Wyckoff, M.D., from the University of Michigan in Ann Arbor, and colleagues developed recommendations for the care of individuals with PDM before, during, and after pregnancy.
The authors suggest asking a screening question about pregnancy intention for individuals with diabetes mellitus who have the possibility of becoming pregnant, with contraception suggested when pregnancy is not desired. Discontinuation of glucagon-like peptide-1 receptor agonists is suggested before conception — rather than between the start of pregnancy and the end of the first trimester — in individuals with type 2 diabetes mellitus (T2DM). Routine addition of metformin is not suggested in pregnant individuals with T2DM already on insulin. Either a carbohydrate-restricted diet (<175 g/day) or usual diet (>175 g/day) is suggested during pregnancy in individuals with PDM. Use of a continuous glucose monitor (CGM) or self-monitoring of blood glucose is suggested in pregnant individuals with T2DM. For individuals with PDM using a CGM, use of a single 24-hour CGM target <140 mg/dL is not suggested in place of standard-of-care pregnancy glucose targets. A hybrid closed-loop pump is suggested rather than an insulin pump with CGM for individuals with type 1 diabetes mellitus who are pregnant.
“We developed these guidelines as diabetes rates are rising among women of reproductive age and very few women with diabetes receive proper preconception care,” Wyckoff said in a statement.
Several authors disclosed financial ties to the pharmaceutical industry; two authors disclosed ties to Dexcom.
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