When a woman with type 2 diabetes who is not pregnant requires a drug to reduce her blood glucose levels, the oral glucose-lowering drug metformin is the first choice (1,2). Maternal diabetes around the time of conception and during the 1st trimester of pregnancy increases the risk of miscarriage, fetal malformations and perinatal death. The higher the HbA1c level, the greater the risk (3-5). Whether it started before or during pregnancy, maternal diabetes increases the risk of gestational hypertension, pre-eclampsia, perinatal death, and obstetrical complications associated with high birthweight (3-6).
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