Background: Preconception planning can reduce complications in pregnancy with type 1 diabetes. However, high periconception HbA1C is not uncommon and increases maternal and fetal risks. Due to limited data regarding preconception counseling, questions about education and contraception use were added to the 2022 T1DX-QI survey.

Methods: The annual T1DX-QI survey was conducted August-September 2022 with a site response rate of 94% of 50 sites: 33 pediatric (66%), 17 adult (34%). Respondents answered questions relating to clinic resources and practices. Response data was cleaned and summarized.

Results: Most sites report discussing contraception (74%) and pregnancy planning (72%) once a year or more. Of pediatric sites, 42% report always asking about menstruation history compared to 6% of adult sites. Only 12% of adult and 6% of pediatric sites have a formal preconception counseling protocol. Only 12% of adult and 9% of pediatric sites estimated that >80% of their patients of childbearing potential were using contraception, and all sites estimated that <60% had a HbA1C under 7%.

Conclusions: Though most sites report discussing contraception and pregnancy planning, estimated rates of formal counseling programs, contraception use and attaining goal HbA1C remain low. QI efforts are needed to determine rates of preconception counseling and implement best practices to improve pregnancy outcomes.


G.O'malley: Research Support; Dexcom, Inc., Abbott Diabetes, Tandem Diabetes Care, Inc., Omnipod, Eli Lilly and Company. M.Basina: None. R.Fallurin: None. C.J.Levy: Advisory Panel; Dexcom, Inc., Research Support; Abbott Diabetes, Dexcom, Inc., Insulet Corporation, Tandem Diabetes Care, Inc., T1D Exchange. T1dx-qi collaborative: n/a. S.J.Ogyaadu: None. C.Levister: Research Support; Dexcom, Inc., Tandem Diabetes Care, Inc., Abbott Diabetes. N.Rioles: None. H.Hardison: None. A.J.Roberts: None. S.Accacha: None. I.Guttmann-bauman: None. F.Vendrame: Consultant; Eli Lilly and Company.


The Leona M. and Harry B. Helmsley Charitable Trust

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at