Feb 15, 2014 - LETTER. Should women with diabetic nephropathy considering pregnancy continue ACE inhibitor or angiotensin II receptor blocker therapy ...
Diabetologia (2014) 57:1082–1083 DOI 10.1007/s00125-014-3188-x
LETTER
Should women with diabetic nephropathy considering pregnancy continue ACE inhibitor or angiotensin II receptor blocker therapy until pregnancy is confirmed? Gareth Lewis & Alexander P. Maxwell
Received: 30 November 2013 / Accepted: 21 January 2014 / Published online: 15 February 2014 # Springer-Verlag Berlin Heidelberg 2014
To the Editor: We read with interest the article by Tennant et al [1], which highlights the increased risk of fetal and infant death in women with pre-existing diabetes. The magnitude of these risks increases with HbA1c concentrations above 49 mmol/mol, and women with diabetes and a history of retinopathy have twice the incidence of fetal or infant death. The findings of Tennant et al support the need for not only good glycaemic control but also more intensive pre-pregnancy counselling for the women in higher risk categories. Women who have diabetic nephropathy (persistent albuminuria and/or estimated glomerular filtration rate
