MamasHealth.com Home Diabetes and Pregnancy Baby's health Daily glucose levels Diabetes and pregnancy Pregnancy guide Links News Pre-Diabetes Email Mama	Women with Diabetes: Your Guide to Pregnancy You have type 1 diabetes or type 2 diabetes and you are pregnant or hoping to get pregnant soon. You can learn what to do to have a healthy baby. You can also learn how to take care of yourself and your diabetes before, during, and after your pregnancy. Pregnancy and new motherhood are times of great excitement, worry, and change for any woman. If you have diabetes and are pregnant, your pregnancy is automatically considered a high-risk pregnancy. Women carrying twins—or more—or who are beyond a certain age are also considered to have high-risk pregnancies. High risk doesn’t mean you’ll have problems. Instead, high risk means you need to pay special attention to your health and you may need to see specialized doctors. Millions of high-risk pregnancies produce perfectly healthy babies without the mom’s health being affected. Special care and attention are the keys. Taking Care of Your Baby and Yourself Keeping your blood glucose as close to normal as possible before you get pregnant and during your pregnancy is the most important thing you can do to stay healthy and have a healthy baby. Your health care team can help you learn how to use meal planning, physical activity, and medications to reach your blood glucose goals. Together, you’ll create a plan for taking care of yourself and your diabetes. Pregnancy causes a number of changes in your body, so you might need to make changes in the ways you manage your diabetes. Even if you’ve had diabetes for years, you may need changes in your meal plan, physical activity routine, and medications. In addition, your needs might change as you get closer to your delivery date. “I took good care of my diabetes before and throughout my pregnancy. And now I have a healthy little girl!” How Diabetes Can Affect You and Your Baby High blood glucose levels before and during pregnancy can: worsen your long-term diabetes complications, such as vision problems, heart disease, and kidney disease increase the chance of problems for your baby, such as being born too early, weighing too much or too little, and having low blood glucose or other health problems at birth increase the risk of your baby having birth defects increase the risk of losing your baby through miscarriage or stillbirth However, research has shown that when women with diabetes keep blood glucose levels under control before and during pregnancy, the risk of birth defects is about the same as in babies born to women who don’t have diabetes. If your blood glucose level is too high, then your baby also gets too much glucose. Glucose in a pregnant woman’s blood passes through to the baby. If your blood glucose level is too high during pregnancy, so is your baby’s glucose level before birth. Your Diabetes, Before and During Your Pregnancy As you know, in diabetes, blood glucose levels are above normal. Whether you have type 1 or type 2 diabetes, you can manage your blood glucose levels and lower the risk of health problems. A baby’s brain, heart, kidneys, and lungs form during the first 8 weeks of pregnancy. High blood glucose levels are especially harmful during this early part of pregnancy. Yet many women don’t realize they’re pregnant until 5 or 6 weeks after conception. Ideally, you will work with your health care provider to get your blood glucose under control before you get pregnant. If you’re already pregnant, see your health care provider as soon as possible to make a plan for taking care of yourself and your baby. Even if you learn you’re pregnant later in your pregnancy, you can still do a lot for your baby’s health and your own. The checklist below can help you make a plan for a safe and healthy pregnancy. More information on each topic then follows. Your health care team can help you with tasks that are difficult for you. Tackle one thing at a time to keep from being overwhelmed. My Diabetes Care Plan for Pregnancy Things I can do to get ready for a healthy pregnancy and continue to do during my pregnancy Planning Ahead I’ll get my diabetes under control 3 to 6 months before I try to get pregnant. If I’m already pregnant, I’ll see my health care provider right away. My Health Care Team I’ll make sure I have the right team of health care providers. I’ll meet with members of my team. My Blood Glucose Levels I’ll set goals with my health care team for my daily blood glucose levels. I’ll set a goal with my health care team for my A1C test result. I’ll learn how and when to check my blood glucose on my own. I’ll learn what to do if my blood glucose is too low. I’ll make sure my family or friends know how to give me glucagon for low blood glucose. I’ll learn what to do if my blood glucose is too high. My Ketone Levels I’ll learn how and when to check my urine or blood for ketones. I’ll learn what to do if I have ketones in my urine or blood. My Checkups I’ll get the recommended checkups and laboratory tests for blood pressure eye disease heart and blood vessel disease nervous system disease kidney function thyroid disease average blood glucose level—the A1C test Smoking If I smoke, I’ll quit. My Meal Plan I’ll see a dietitian or diabetes educator about what, when, and how much to eat. I’ll ask whether I need vitamin and mineral supplements and will take them as directed. I’ll skip alcoholic beverages. My Physical Activity Routine I’ll talk with my health care team about what physical activities are safe for me. I’ll make a plan with my health care team for regular physical activity. My Medications I’ll talk with my health care team about my diabetes medications—what kinds, how much, how to take them, and when to take them. I’ll talk with my health care team about my other medications—what to keep taking and what to stop taking. Changes in My Daily Routine I’ll make a plan for taking care of myself when I’m ill—what to do about food, insulin, blood glucose testing, and ketone testing. I’ll make a plan for what I need to have with me when I’m away from home—for several hours or for a longer trip. Planning Ahead Before you get pregnant, talk with your health care team about your wish to have a baby. Your team can work with you to make sure your blood glucose levels are on target. If you have questions or worries, bring them up. If you’re already pregnant, see your doctor right away. My Health Care Team Regular visits with health care providers who are experts in diabetes and pregnancy will ensure you get the very best care. Your team may include: a medical doctor who specializes in diabetes care, such as an endocrinologist or a diabetologist. You will continue to need monitoring and advice on glucose control throughout your pregnancy and after. an obstetrician-gynecologist, or “OB/GYN,” who has managed pregnancies of women with diabetes. Ask for a referral if your current gynecologist does not also deliver babies, as not all gynecologists do. When calling around to find an OB/GYN, ask about experience with women with diabetes. Maternal-fetal medicine specialists, also called perinatologists, have special training to take care of women with high-risk pregnancies. You will see your OB/GYN regularly throughout your pregnancy. “I’m working with my health care team to take good care of myself and my diabetes. We’re doing all we can to make sure I have a healthy baby and a safe pregnancy. It’s not always easy, but I’m so motivated!” a nurse educator or nurse practitioner, who provides prenatal care and advice on managing diabetes. a registered dietitian to help with meal planning. A good diet—for glucose control and nutrition—has never been more important than now. The phrase “You’re eating for two” is not about quantity as much as food choices. specialists who diagnose and treat diabetes-related complications, such as ophthalmologists and optometrists for vision problems, nephrologists for kidney disease, and cardiologists for heart disease. If you are already experiencing complications from diabetes, you’ll need those conditions monitored throughout your pregnancy as well. a social worker or psychologist to help you cope with stress, worry, and the extra demands of pregnancy. You may already have this kind of support, or you may suddenly need it. If anxiety mounts, do not hesitate to mention your uneasiness to your OB/GYN. Ask for a referral if you need more help working through issues. a pediatrician—a doctor who cares for children. You might want to ask friends, family, or your health care team for recommendations. Many pediatricians visit their newest patients at the hospital soon after their arrival. a neonatologist—a doctor who cares for newborn babies. The hospital will assign a neonatologist if urgent care for your baby is needed at the hospital. You are the most important member of the team. Your health care providers can give you expert advice. But you’ll be responsible for the day-to-day actions needed to keep your diabetes under control.
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