Preexisting Diabetes and Planning Pregnancy

Many people believe that getting pregnant when they already have diabetes is not possible because of the struggles women in the past may have faced, which preceded more modern treatments, monitoring tools, and knowledge. Today, however, being diabetic does not mean that your pregnancy is destined for struggle, complications, or miscarriage. That said, you do need to be proactive in your diabetes care prior to pregnancy to optimize you and your baby's health and prevent possible complications, like birth defects.

If you want to "try," 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 (by 7 weeks). Other potential risks include low blood glucose in your baby at birth, a large baby, and a baby born with difficulty breathing or yellowing of the skin (jaundice).

There are also risks to you as a mother being pregnant and having diabetes like worsening of your 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 preeclampsia, a dangerous medical condition that causes high blood pressure and swelling.

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.

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.

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.