A Product Warning Label to Encourage Prepregnancy Control of Diabetes

Jeffrey S. Greenspoon, MD; B. Roz Morgan, RN, MPA, CDE
JAMA. 1991;266(16):2225. doi:10.1001/jama.1991.03470160057031.
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To the Editor.  —Despite physician awareness of the benefits of preconception glycemic control of diabetes mellitus, many diabetic women of childbearing age are either unaware or unmotivated to optimize control of their diabetes before becoming pregnant. The benefits of preconception glycemic control, including a reduction in the risk of fetal anomalies to that of a normal nondiabetic population1,2 and a significant decrease in the rate of spontaneous abortion3,4 have been well established. Implementing a plan to encourage universal prepregnancy diabetes control should be a major priority.We propose a straightforward and inexpensive tactic to improve compliance with preconception diabetes control programs: put a warning label regarding pregnancy and birth defects on the equipment that diabetic patients routinely use for their daily care. The devices and supplies to be labeled could include insulin syringes, glucose meters, blood glucose monitoring strips, lancets, finger-pricking devices, and urine glucose test strips. The


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