Another very important step in this pathway, is to distinguish co-existing thyroid dysfunction in the woman diagnosed with DM type 1 (T1DM).

Autoimmune thyroid disease is common among reproductive women diagnosed with T1DM. Hypothyroidism is common among individuals with T1DM. Untreated or insufficiently treated hypothyroidism reduces fertility and in the event of pregnancy, increases the risk of miscarriage and impaired fetal brain development. 

So, if a woman is diagnosed with T1DM:

Has thyroid function been investigated? And if thyroid dysfunction is diagnosed, is it properly controlled?