How do I install the Pdm Glp1ra Discontinuation Timing skill?

Run npx skillmds@latest add dromlakhani/pdm-glp1ra-discontinuation-timing in your terminal (requires Node.js), paste this page's agent-chat prompt into Claude, Cursor, or any MCP-connected agent, or download the SKILL.md file and copy it into your agent's skills directory.

Is Pdm Glp1ra Discontinuation Timing safe to use?

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Which AI agents work with Pdm Glp1ra Discontinuation Timing?

This skill is tagged as working with Claude Code, Claude.ai, OpenAI Codex. SKILL.md is an open format, so most agents that read a skills directory can load it too.

Is Pdm Glp1ra Discontinuation Timing free to use?

Yes. Installing skills from SkillMD is free, and the skill stays under its author's original license.

Who published Pdm Glp1ra Discontinuation Timing?

dromlakhani (@dromlakhani) published this skill. Their other Agent Skills are listed on their SkillMD profile.

Pdm Glp1ra Discontinuation Timing by dromlakhani

Name: Pdm Glp1ra Discontinuation Timing
Rating: 4.2 (5 reviews)
Author: dromlakhani

Pdm Glp1ra Discontinuation Timing

Recommends discontinuation of GLP-1RA before conception rather than between start of pregnancy and end of first trimester for individuals with type 2 diabetes who are planning pregnancy. Trigger when clinician considers stopping GLP-1RA therapy in a patient with type 2 diabetes who is planning pregnancy or seeking preconception care.

dromlakhani Updated Sep 8, 2026 10 repo stars

File contents

Discontinue GLP-1RA before conception in type 2 diabetes

STEP 1 — Gather Information

Collect pregnancy intention, current GLP-1RA regimen and dosing, contraception method, HbA1c, weight, renal function, and anticipated timing of conception after contraception cessation.

STEP 2 — Rule In / Rule Out

Rule in: patient with type 2 diabetes mellitus currently on a GLP-1RA who is planning pregnancy or seeking preconception care; rule out: patient not planning pregnancy, already pregnant, has type 1 diabetes, or is not on a GLP-1RA.

STEP 3 — Classify or Stratify

Stratify by anticipated conception timing (<1 month, 1–3 months, >3 months) and GLP-1RA half‑life (short‑acting e.g., lixisenatide vs long‑acting e.g., semaglutide) to determine discontinuation window and need for insulin transition.

STEP 4 — Decide

Discontinue GLP-1RA at least 1 month before desired conception for short‑acting agents and 2 months for long‑acting agents; initiate insulin or other pregnancy‑safe antihyperglycemic agent; maintain effective contraception until conception is desired; optimize glycemia to HbA1c <6.5% before conception attempt.

Clinical Guardrails / Mimics / Pitfalls

Do not discontinue GLP-1RA without ensuring effective contraception to avoid hyperglycemia‑related teratogenicity; avoid abrupt cessation leading to weight gain and hyperglycemia; do not delay discontinuation until after pregnancy confirmation; do not neglect active glycemic management after GLP-1RA stop; do not overlook risks of prolonged time off GLP-1RA such as rebound weight gain.

Concrete Clinical Example

A 32‑year‑old woman with type 2 diabetes on semaglutide 1 mg weekly desires pregnancy in the next 3 months and uses condoms. Advise to stop semaglutide now, start basal‑bolus insulin titrated to fasting <95 mg/dL, continue contraception for another month to allow washout, then attempt conception after confirming HbA1c <6.5% and stable weight.

Source: Preexisting Diabetes and Pregnancy: An Endocrine Society and European Society of Endocrinology Joint Clinical Practice Guideline, Endocrine Society, 2025, https://doi.org/10.1210/clinem/dgaf288

---name: pdm-glp1ra-discontinuation-timingdescription: Recommends discontinuation of GLP-1RA before conception rather than between start of pregnancy and end of first trimester for individuals with type 2 diabetes who are planning pregnancy. Trigger when clinician considers stopping GLP-1RA therapy in a patient with type 2 diabetes who is planning pregnancy or seeking preconception care.---# Discontinue GLP-1RA before conception in type 2 diabetes## STEP 1 — Gather InformationCollect pregnancy intention, current GLP-1RA regimen and dosing, contraception method, HbA1c, weight, renal function, and anticipated timing of conception after contraception cessation.## STEP 2 — Rule In / Rule OutRule in: patient with type 2 diabetes mellitus currently on a GLP-1RA who is planning pregnancy or seeking preconception care; rule out: patient not planning pregnancy, already pregnant, has type 1 diabetes, or is not on a GLP-1RA.## STEP 3 — Classify or StratifyStratify by anticipated conception timing (<1 month, 1–3 months, >3 months) and GLP-1RA half‑life (short‑acting e.g., lixisenatide vs long‑acting e.g., semaglutide) to determine discontinuation window and need for insulin transition.## STEP 4 — DecideDiscontinue GLP-1RA at least 1 month before desired conception for short‑acting agents and 2 months for long‑acting agents; initiate insulin or other pregnancy‑safe antihyperglycemic agent; maintain effective contraception until conception is desired; optimize glycemia to HbA1c <6.5% before conception attempt.## Clinical Guardrails / Mimics / PitfallsDo not discontinue GLP-1RA without ensuring effective contraception to avoid hyperglycemia‑related teratogenicity; avoid abrupt cessation leading to weight gain and hyperglycemia; do not delay discontinuation until after pregnancy confirmation; do not neglect active glycemic management after GLP-1RA stop; do not overlook risks of prolonged time off GLP-1RA such as rebound weight gain.## Concrete Clinical ExampleA 32‑year‑old woman with type 2 diabetes on semaglutide 1 mg weekly desires pregnancy in the next 3 months and uses condoms. Advise to stop semaglutide now, start basal‑bolus insulin titrated to fasting <95 mg/dL, continue contraception for another month to allow washout, then attempt conception after confirming HbA1c <6.5% and stable weight.**Source:** Preexisting Diabetes and Pregnancy: An Endocrine Society and European Society of Endocrinology Joint Clinical Practice Guideline, Endocrine Society, 2025, https://doi.org/10.1210/clinem/dgaf288

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