Preexisting Diabetes and Planning Pregnancy

If you are diabetic and want to get pregnant, you may be worried about having a more complicated pregnancy. Although you will likely face more challenges in pregnancy than if you did not have diabetes, being diabetic does not mean that your pregnancy is destined for major complications or miscarriage. That said, you do need to be proactive in your diabetes care prior to pregnancy to optimize your health and your baby's and prevent possible complications.

Pregnancy Risks for Women With Preexisting Diabetes

If you are planning a pregnancy, it's strongly recommended that you get blood sugar levels under control three to six months before trying to conceive. This is because there are potential risks to you and your baby if your blood glucose levels are high.

For your baby, these risks ​include miscarriage, premature birth, and birth defects, especially when blood glucose levels are high during the first trimester. This is why it's critical to get your diabetes under control before conceiving—you may not even realize you are pregnant by the time your baby's organs are formed (7 weeks gestation).

Other potential risks of poorly controlled diabetes in pregnancy include low blood glucose in your baby at birth, a large baby, or under certain circumstances, a growth-restricted baby. In addition, your baby may have some difficulty transitioning to breathing, or may develop jaundice.

There are also risks to you as a mother being pregnant and having diabetes. These include worsening of diabetes-related eye or kidney conditions, and a greater risk for having infections, like urinary tract infections.

Another concern for pregnant women with diabetes is an increased risk of developing a hypertensive complication called preeclampsia. This is a serious medical condition that causes high blood pressure and swelling.

Women With Diabetes and Pregnancy Planning

First, talk to your health care provider about your desire to have a baby. Discuss diet, exercise, blood sugar goals, and any medications you are currently taking. Some medications may not be safe during pregnancy or may require dosage adjustment.

Your doctor may refer you to a diabetes educator and/or a dietitian to help you with a meal plan and blood sugar management. In addition, you may also be referred to other diabetes or high-risk pregnancy specialists, such as a perinatologist or an endocrinologist.

When talking to your doctor, ask about a daily multivitamin with folic acid—400 micrograms is a typically recommended amount, but you should find out if this is sufficient for you.

In addition, it's important to educate yourself about diabetes and be prepared. It might be helpful to join a support group of women with diabetes who became pregnant. They may be able to share tips for managing tight blood sugar levels and other tidbits on nutrition and maintaining a healthy weight during pregnancy.

A Word From Verywell

Having diabetes, especially with out-of-control blood sugars, increases the risks of pregnancy. However, with good planning and blood sugar control, the risks can be lowered.

Having diabetes and getting pregnant means that your pregnancy will be labeled high-risk. This sounds scary, but basically, it means that your health care team knows to watch you closely. Your doctor will likely recommend some baseline blood work in addition to your routine prenatal labs. You can expect to have additional ultrasounds to follow your baby's growth and non-stress tests to monitor your baby's well being. Most likely your doctor will also recommend that you deliver a week or two before your actual due date.

Talk to your doctor if you have existing diabetes-related complications or other health problems that may prevent or complicate pregnancy. In addition, if you are already pregnant, seek out prenatal care as soon as possible to help lower the risks for you and your baby.