We thank the authors for appreciating the importance of our study and their comments. The commentary pointed out to an important maternal risk associated with preexisting diabetes mellitus (DM) in particular the potential for deterioration of DR. In recognition of the importance of this risk, all preconception care guidelines included the need to screen for and treat microvascular complications of DM in the preconception period. We did not elaborate on every maternal and fetal risks associated with preexisting DM in the introduction and discussion because the objectives of our study were to identify the rate of preconception counseling, the level of preconception care knowledge, and the rate of unplanned pregnancies among the participants. In addition, there is a paucity of data on the fetal-maternal outcomes of preexisting DM from our region.
Again we thank the authors for their commentary. We hope that the discussion will stimulate further research on all aspects of preexisting DM including preconception care, especially in the developing countries that harbor 81.1% of patients with DM around the world, aiming at improving pregnancy outcomes.
1. Mahmud M, Mazza D. Preconception care of women with diabetes: A review of current guideline recommendations BMC Womens Health. 2010;10:5
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2. IDF Diabetes Atlas. 2015Last accessed on 2016 Dec 137th ed Available from: http://www.diabetesatlas.org