Diabetes: Preparing for Pregnancy

Topic Overview

If you are a woman with type 1 or type 2 diabetes who is planning to become pregnant, meet with your doctor. Your doctor will want to talk to you about your A1c goal, your medicine for diabetes, your weight, and getting enough folic acid. Your doctor will want to make sure that you are up to date with immunizations. And you'll want to have your cholesterol, thyroid, eyes, and blood pressure checked to see if you need treatment changes.

Your diabetes puts your developing baby at risk for birth defects. This is especially true if you don't keep your blood sugar in your target range during the early part of pregnancy. And during pregnancy, your high blood sugar can cause your baby to be very large. This will make delivery hard for both of you. After delivery, your baby is more likely to have jaundice. High blood sugar during your pregnancy causes your baby to make extra insulin. After delivery, your baby may continue to make too much insulin and be at risk for low blood sugar.

Many women find that they have low blood sugar in early pregnancy. Then later in pregnancy, they develop more resistance to insulin. To keep your blood sugar levels within a target range, you may need to adjust how much insulin you need from day to day. And you'll want to be more careful about healthy eating, especially if you have morning sickness and/or food cravings. You will want to test your blood sugar more often to find out about the ways in which your pregnancy changes how insulin, food, activity, and stress affect your blood sugar.

If you have type 2 diabetes, ask your doctor about the best medicine to take during your pregnancy. This may be insulin. Not all diabetes medicines are safe during pregnancy. If you don't take medicine, you will want to monitor your blood sugar frequently. To reduce your risk for high blood pressure during pregnancy (preeclampsia), your doctor may recommend that you take low-dose aspirin during the second and third trimesters of your pregnancy. And all women who are planning to be pregnant should check with a doctor about the safety of prescription and over-the-counter medicines, vitamins, herbs, and supplements.