Retinopathy is a disease of the retina that reults in impairment or loss of vision. Most people with diabetes will show signs of retinopathy after 25 years of duration, however only a few progress to the severst form. the most effective treatment for retinpathy is improvement of glycaemic control which will slow progression of the condition. Follow this link to watch a short video on diabetic retinopathy.

Pregnancy can accelerate existinf retinopathy - in fact, if a women improves her glycaemic control too quickly in pregnancy, this can have a negative effect on retinopathy. Therefore, it is extremely important to carry out a full retinal assessment ideally preconceptually or in early pregnancy and then repeat assessments during pregnancy to check for any signs of deterioration.

Diabetic nephropathy is kidney disease caused by diabetes and clinical diagnosis is based on detection of proteinuria in the absence of another obvious cause such as infection. The most effective treatment for nephropathy  in improvement of glycaemic control and careful management of blood pressure which will slow progression of the condition.

Pregnancy can accelerate existing nephropathy. Urinalysis testing preconceptually to detect proteinuria and regular urine testing during pregnancy is recommended. Testing for urinary microalbuminuria would also be recommended.

Insulin is considered the main drug of choice in managing type 1 diabetes and is also often used in treatment of type 2 diabetes. Some insulins are now licensed as safe for use in pregnancy under medical advice.

Often used for type 2 diabetics as an alternative to insulin. Some drugs increase insulin action (example metformin); some drugs increase insulin secretion (sulphonylureas). Most oral antidiabetic drugs are contraindicated in pregnancy, except metformin which has been deemed safe in pregnancy and has been used successfully as an alternative to insulin in women with type 2 diabetes or in gestational diabetes.

Some anti-hypertensivesmay be teratogenic in pregnancy, however, some are considered safe (example: methyldopa). Therefore, if a woman is considering pregnancy, she will need to change to a safe anti-hypertensive medication.

Satins help to control cholesterol levels and have proved excellent in the treatment of diabetes. However, satins are considered unsafe in pregnancy - therefore if a woman is planning pregnancy, she will need to stop statin medication under medical advice.