Preconception Care for Patients Using GLP-1 Receptor Agonists

Clinical Recommendations

The American Academy of Family Physicians recommends weight optimization through lifestyle modification (diet and exercise) for non-diabetic patients considering pregnancy 1
The American Diabetes Association recommends folic acid supplementation (400 mcg daily, or 4-5 mg for patients with obesity BMI >35) for non-diabetic patients considering pregnancy 1
The American Diabetes Association recommends effective contraception until metabolic optimization is achieved for non-diabetic patients considering pregnancy 2, 3
The American Diabetes Association recommends preconception glycemic optimization with target A1C <6.5% (ideally <6%) to minimize congenital anomalies, preeclampsia, and other complications for patients with diabetes 2, 3, 4
The American Diabetes Association recommends transitioning from GLP-1 RAs to insulin before conception as insulin is the preferred agent with established safety data for patients with diabetes 5, 6, 7
The American Diabetes Association recommends multidisciplinary preconception care including endocrinology, maternal-fetal medicine, and diabetes education to improve outcomes for patients with diabetes 2, 3
The American Diabetes Association recommends considering long-acting reversible contraception for highest efficacy for patients of reproductive age taking GLP-1 RAs 2
The American Diabetes Association recommends maintaining weight loss achieved through any method with lifestyle measures during the pregnancy planning period 8