Diabetes Before Pregnancy

Although it is more common for a woman to develop Gestational Diabetes during pregnancy, 1-2% of pregnant women already have a Type 1 or Type 2 diabetes diagnosis. This is called Pregestational, or preexisting, diabetes.

It has been called “one of the most challenging medical complications of pregnancy,” by ACOG due to the need for frequent monitoring and adjustment of medications, as well as the potential for maternal and fetal complications. It is especially critical for women with preexisting diabetes to have their blood sugar under control before they conceive. This is because the first two months of pregnancy is when the organs of the baby start to form, and blood sugar that is not in control can affect those organs, causing serious birth defects in the developing baby.

The CDC outlines seven tips for women who currently have diabetes to keep in mind when planning to get pregnant or are already pregnant. Those include:

1. Plan for Pregnancy
   Before getting pregnant, see your doctor. The doctor needs to look at the effects that diabetes has had on your body already, talk with you about getting and keeping control of your blood sugar, change medications if needed, and plan for frequent follow-up. If you are overweight, the doctor might recommend that you try to lose weight before getting pregnant as part of the plan to get your blood sugar under control.

2. See Your Doctor Early and Often
   During pregnancy, a woman with diabetes needs to see the doctor more frequently. Together, you and your doctor can work to prevent problems early.

3. Eat Healthy Foods
   Eat healthy foods from a meal plan made for a person with diabetes. A dietitian can help you create a healthy meal plan. A dietitian can also help you learn how to control your blood sugar while you are pregnant.
   To Find a Dietitian:
   American Dietetic Association
   1–800–877–1600
   www.eatright.orgexternal icon (click on “Find an Expert”)

4. Exercise Regularly
   Exercise is another way to keep blood sugar under control. It helps to balance food intake. After checking with your doctor, you can exercise regularly before, during, and after pregnancy. Get at least 30 minutes of moderate-intensity physical activity at least five days a week. This could be brisk walking, swimming, or actively playing with children.
   Learn more about physical activity during pregnancy »

5. Take Pills and Insulin as Directed
   If diabetes pills or insulin are prescribed by your doctor, take them as directed in order to help keep your blood sugar under control.

6. Control and Treat Low Blood Sugar Quickly
   Keeping blood sugar well controlled can lead to a chance of low blood sugar at times. If you are taking diabetes pills or insulin, it’s helpful to have a source of quick sugar, such as hard candy, glucose tablets or gel, on hand at all times. It’s also good to teach family members and close co-workers or friends how to help in case of a severe low blood sugar reaction.

7. Monitor Blood Sugar Often
   Because pregnancy causes the body’s need for energy to change, blood sugar levels can change very quickly. Check your blood sugar often, as directed by your doctor. It is important to learn how to adjust food intake, exercise, and insulin, depending on the results of your blood sugar tests.
   Learn how to take control of your diabetes »

If you are diabetic and considering starting or adding to your family, please make an appointment with your doctor before you start trying to ensure proper management of diabetes before and during your pregnancy.