{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T22:40:58Z","timestamp":1787784058260,"version":"build-2784847793"},"reference-count":82,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2015,2,3]],"date-time":"2015-02-03T00:00:00Z","timestamp":1422921600000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:p>The numbers of women of childbearing age with pregestational diabetes mellitus (diabetes existing before pregnancy) are increasing, primarily because more patients are developing type 2 diabetes at younger ages. The teratogenicity associated with hyperglycemia in early pregnancy is well documented, and tight glucose control minimizes the risk of congenital malformation. Preconception planning is essential; thus contraception that does not worsen complications of diabetes is desirable. In addition, because contraceptives are not 100% effective, the treatment of elevated blood glucose levels, hypertension, and dyslipidemia in these women requires consideration of unplanned pregnancy. We summarized the literature to aid clinicians in choosing individualized treatment that minimizes risk in case pregnancy occurs and maximizes benefit in preventing the complications of diabetes. In women with well\u2010controlled diabetes without vascular disease, all contraceptive methods are safe. Intrauterine devices are recommended due to their minimal effects on risk factors for diabetic complications and their lack of reliance on patient adherence for efficacy. Among insulins, the insulin analogs\u2014insulin lispro, insulin aspart, and insulin detemir\u2014offer patients greater convenience than regular insulin and <jats:styled-content style=\"fixed-case\">NPH<\/jats:styled-content> insulin, and they are safe in case of unplanned pregnancy. Of the noninsulin agents, glyburide and metformin are the safest during pregnancy, but many of the other agents pose minimal risk as long as they are withdrawn during early pregnancy. The risks and benefits of angiotensin\u2010converting enzyme inhibitors in women with compelling indications must be weighed individually. In hypertensive patients at a high risk for unplanned pregnancy, nifedipine should be considered due to literature supporting its safety during early pregnancy. Pravastatin is recommended for women with dyslipidemia who are using effective contraception because there have been no reports of birth defects with this statin when used during early pregnancy in humans and animals.<\/jats:p>","DOI":"10.1002\/phar.1535","type":"journal-article","created":{"date-parts":[[2015,2,3]],"date-time":"2015-02-03T00:58:59Z","timestamp":1422925139000},"page":"158-174","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Pharmacologic Management of Types 1 and 2 Diabetes Mellitus and Their Complications in Women of Childbearing Age"],"prefix":"10.1002","volume":"35","author":[{"given":"Mimi","family":"S. Mukherjee","sequence":"first","affiliation":[{"name":"MCPHS University Worcester Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie A.","family":"Coppenrath","sequence":"additional","affiliation":[{"name":"MCPHS University Worcester Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bree A.","family":"Dallinga","sequence":"additional","affiliation":[{"name":"Edward M. Kennedy Community Health Center Framingham Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,2,3]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc08-9020"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.4158\/EP.17.S2.1"},{"key":"e_1_2_8_4_1","first-page":"33","volume-title":"A core curriculum for diabetes education: diabetes in the life cycle and research","author":"Homko CJ","year":"2001"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(11)90608-5"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198105283042204"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767050903550881"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000156301.11939.56"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/13625180802382604"},{"key":"e_1_2_8_10_1","doi-asserted-by":"crossref","first-page":"53","DOI":"10.3109\/13625187.11661695.1996","article-title":"Contraception guidance in women with pre\u2010existing disturbances in carbohydrate metabolism","volume":"1","author":"Peterson K","year":"1996","journal-title":"Eur J Contracept Reprod Health Care"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2012.11.001"},{"key":"e_1_2_8_12_1","unstructured":"Janssen Pharmaceuticals 2012"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2013.03.004"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.3109\/13625187.2010.502583"},{"key":"e_1_2_8_15_1","doi-asserted-by":"crossref","unstructured":"Merck 2013","DOI":"10.22233\/20412495.0413.6"},{"key":"e_1_2_8_16_1","unstructured":"Bayer Pharmaceuticals 2014"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-200606000-00055"},{"issue":"1","key":"e_1_2_8_18_1","first-page":"158","article-title":"OC practice guidelines: minimizing side effects","volume":"42","author":"Darney PD","year":"1997","journal-title":"Int J Fertil Womens Med"},{"key":"e_1_2_8_19_1","unstructured":"Pfizer 2013"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181af68b2"},{"key":"e_1_2_8_21_1","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1055\/s-0037-1613379","article-title":"Obesity: risk of venous thrombosis and the interaction with coagulation factor levels and oral contraceptive use","volume":"89","author":"Abdikkahi M","year":"2003","journal-title":"Thromb Haemost"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d6423"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000149155.11912.52"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(01)03275-7"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2012.05.012"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(72)90296-7"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2011.02.009"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2010.01.014"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2011.03.008"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1080\/09513590600624317"},{"key":"e_1_2_8_31_1","first-page":"CD003990","article-title":"Hormonal versus non\u2010hormonal contraceptives in women with diabetes mellitus type 1 and type 2","volume":"3","author":"Visser J","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_32_1","unstructured":"Department of Reproductive Health World Health Organization.Medical eligibility criteria for contraceptive use 4th ed. 2009. Available fromhttp:\/\/whqlibdoc.who.int\/publications\/2010\/9789241563888eng.pdf. Accessed February 8 2014."},{"key":"e_1_2_8_33_1","volume-title":"Drugs in pregnancy and lactation: a reference guide to fetal and neonatal risk","author":"Briggs GG","year":"2011"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/94.5.255"},{"issue":"2","key":"e_1_2_8_35_1","first-page":"803","article-title":"Congenital anomaly rate in offspring of mothers with diabetes treated with insulin lispro during pregnancy","volume":"46","author":"Wyatt JW","year":"2004","journal-title":"Diabet Med"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc06-1887"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.08.005"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ogc.2007.03.003"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-2264"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/649070"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1517\/13543784.13.9.1103"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.18.11.1446"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(91)90421-M"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200010193431601"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(94)90078-7"},{"key":"e_1_2_8_46_1","first-page":"497","article-title":"Pregnancy outcome following exposure to orlistat, ramilpril, glimepiride in a woman with metabolic syndrome","volume":"26","author":"Kalyoncu NI","year":"2005","journal-title":"Saudi Med J"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0707193"},{"key":"e_1_2_8_48_1","unstructured":"Bayer Healthcare Pharmaceuticals 2011"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-200204001-00009"},{"key":"e_1_2_8_50_1","first-page":"42","article-title":"Effectiveness of acarbose in the control of glucose tolerance worsening in pregnancy","volume":"68","author":"Z\u00e1rate A","year":"2000","journal-title":"Ginecol Obstet Mex"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.reprotox.2008.08.001"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.reprotox.2004.11.003"},{"key":"e_1_2_8_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.reprotox.2004.02.014"},{"key":"e_1_2_8_54_1","unstructured":"Boehringer Ingelheim 2013"},{"key":"e_1_2_8_55_1","unstructured":"Takeda Pharmaceuticals 2013"},{"key":"e_1_2_8_56_1","unstructured":"Janssen Pharmaceuticals 2013"},{"key":"e_1_2_8_57_1","unstructured":"Bristol\u2010Myers Squibb 2014"},{"key":"e_1_2_8_58_1","volume-title":"Antihypertensive drug therapy for mild to moderate hypertension during pregnancy (Cochrane Review)","author":"Abalos E","year":"2010"},{"key":"e_1_2_8_59_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMe068089"},{"key":"e_1_2_8_60_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.112.196352"},{"key":"e_1_2_8_61_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa055202"},{"key":"e_1_2_8_62_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-009-0620-0"},{"key":"e_1_2_8_63_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d5931"},{"key":"e_1_2_8_64_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.reprotox.2011.02.008"},{"key":"e_1_2_8_65_1","doi-asserted-by":"publisher","DOI":"10.1002\/phar.1212"},{"key":"e_1_2_8_66_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(96)70307-1"},{"key":"e_1_2_8_67_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.reprotox.2008.05.065"},{"key":"e_1_2_8_68_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.111.00833"},{"key":"e_1_2_8_69_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.284427"},{"issue":"2","key":"e_1_2_8_70_1","first-page":"337","article-title":"KDIGO clinical practice guideline for the management of blood pressure in chronic kidney disease","volume":"2","author":"Kidney disease: improving global outcomes (KDIGO) blood pressure work group","year":"2012","journal-title":"Kidney Int"},{"key":"e_1_2_8_71_1","unstructured":"American Heart Association.Cardiovascular disease and diabetes. Available from:http:\/\/www.heart.org\/HEARTORG\/Conditions\/Diabetes\/WhyDiabetesMatters\/Cardiovascular-Disease-Diabetes_UCM_313865_Article.jsp. Published July 5 2012. Updated January 31 2013. Accessed March 28 2014."},{"key":"e_1_2_8_72_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc14-S014"},{"key":"e_1_2_8_73_1","first-page":"S0735","article-title":"2013 ACC\/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines","volume":"13","author":"Stone NJ","year":"2013","journal-title":"J Am Coll Cardiol"},{"key":"e_1_2_8_74_1","first-page":"75","article-title":"What precautions should we use with statins for women of childbearing age?","volume":"55","author":"Patel C","year":"2006","journal-title":"J Fam Pract"},{"key":"e_1_2_8_75_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.20181"},{"key":"e_1_2_8_76_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacl.2011.08.005"},{"key":"e_1_2_8_77_1","doi-asserted-by":"publisher","DOI":"10.1038\/ncpendmet1066"},{"key":"e_1_2_8_78_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.smj.0000208120.73327.db"},{"key":"e_1_2_8_79_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2007.01.003"},{"key":"e_1_2_8_80_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.159.16.1893"},{"key":"e_1_2_8_81_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)13636-7"},{"key":"e_1_2_8_82_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)16895-5"},{"key":"e_1_2_8_83_1","volume-title":"National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011","author":"Centers for Disease Control and Prevention","year":"2011"}],"container-title":["Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fphar.1535","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fphar.1535","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/phar.1535","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T13:47:47Z","timestamp":1761054467000},"score":1,"resource":{"primary":{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/10.1002\/phar.1535"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,2]]},"references-count":82,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2015,2]]}},"alternative-id":["10.1002\/phar.1535"],"URL":"https:\/\/doi.org\/10.1002\/phar.1535","archive":["Portico"],"relation":{},"ISSN":["0277-0008","1875-9114"],"issn-type":[{"value":"0277-0008","type":"print"},{"value":"1875-9114","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,2]]},"assertion":[{"value":"2015-02-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}