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Q&A: I have diabetes. What should I know before getting pregnant?

I have diabetes. What should I know before getting pregnant?

Re: I have diabetes. What should I know before getting pregnant?

The Bump Expert

Just as it should be before and after having a baby, your number-one priority during pregnancy if you're diabetic should be regulating your blood glucose levels. You've probably already gotten this talk from your doctor about how eating nutritious foods, exercising regularly, and consistently monitoring your blood-glucose levels will help keep you healthy, but once you’re pregnant, you'll really need to be on top of it. So here's the rundown on some things to keep in mind:

Before you become pregnant, a preconception checkup is a must. Here, your doc can diagnose and treat any illnesses related to your diabetes. She may also give you meal and exercise plans, as well as info on upping your folic acid intake (which will help prevent neural tube defects).

Once you become pregnant, you'll likely need to increase your insulin dose. Your doc will also need to keep a closer eye on you and may run some extra tests on top of the ones normally performed during routine prenatal visits. Be aware that your baby also has an increased risk for the following conditions:

- Miscarriage and stillbirth

- Hydramnios (can lead to preterm labor and delivery)

- Preeclampsia (can lead to seizures and kidney/liver problems in mother; may require early delivery)

- Respiratory distress syndrome (can make it harder for baby to breathe after birth)

- Skeletal, heart, and brain birth defects (linked to high blood-glucose levels when baby is developing)

- Macrosomia (high glucose levels throughout pregnancy can make baby grow too large, which may make vaginal delivery difficult)

Now that we’ve covered the scary bits -- don't stress -- you can absolutely have a healthy baby as long as your doctor creates a prenatal care plan that works for you -- and you stick to it!

Colleen Canney

Q&A: I have diabetes. What should I know before getting pregnant?

The Bump Expert's answer covers all the medical aspects you need to be concerned about. I am a type 1 diabetic and am in my 8th month. My A1c has been 5.7% throughout my pregnancy. My advice is to get your A1c to around 6% before you get pregnant and commit yourself to exercising and testing your blood sugars ~ 10-12 times a day while pregnant. I eat everything I pretty much want but have kept my blood sugar levels in control by bolusing correctly and making adjustments to my basal rates as my requirements have changed (at 7.5 months my insulin daily requirements increased by around 60% - usually at around 28 weeks diabetic women's daily requirements change). You need to keep detailed records of your blood sugar levels, insulin dosing, exercise so you can react quickly to patterns of low and high blood sugars at certain times of the day. I would recommend you wear a pump with a continuous glucose monitoring addition if your insurance will cover it or you can afford to purchase it yourself. I use the paradigm medtronic pump. During the first 8 weeks of your pregnancy, be careful not to run high blood sugars levels by eating carb laden foods and simple sugars - this is when the baby's organ development occurs and when sugar can cause birth defects. I have found exercise to be my greatest friend - it has kept me from gaining too much weight and has helped keep my blood sugars low. Lastly, make sure you have a competent team taking care of you - endocrinologist, dietician and perinatologist. It's hard work I know, but the rewards of having an easy healthy pregnancy far outweigh the sore fingers and 9 months of feeling like everything revolves around your diabetes. Good luck!

louisesharabi |

Q&A: I have diabetes. What should I know before getting pregnant?

Definitely get your blood sugar levels in check (if you can) before conceiving. I have type 2 diabetes, and switched to insulin during my 16th week. But, because my sugar levels weren't in great control before I got pregnant, I was at the doctor every two weeks until 24 weeks, and then every week until 30 weeks, when I started going twice a week. This was not easy to do and still work full time, but my baby was my priority. I told myself that every time I wanted something that would send my sugar levels skyrocketing. Which is more important, the ice cream sundae or my healthy baby? When Nathaniel was born, he did have some issues, but he was perfectly healthy and was certainly smaller than the average diabetic baby, weighing in at 6lbs 6 oz. He is a very healthy 9 month old now, and we are looking forward to trying for number 2 later this year. It can be done, but you must commit yourself to being healthy for the baby's sake, if not your own.

hijoi |

Q&A: I have diabetes. What should I know before getting pregnant?

My aunt was a diabetic, and I've heard - and seen firsthand - that diabetic moms create really big babies whose blood sugar plummets after birth. No matter how carefully you regulate your sugar levels (which is very important throughout pregnancy), it's still very possible to have this happen, so you should prepare for this possibility - and that of a c-section because of the baby's size - now. Luckily a bottle of sugar water soon after delivery will fix the second problem.

Scooby1970 |

Q&A: I have diabetes. What should I know before getting pregnant?

I've had type 1 diabetes for 20 years now. My husband and I were worried about the effects of the diabetes on my pregnancy long before we tried for a child. We talked to both my OB and my diabetes dr about what should be done. Both doctors strongly suggested that any diabetic woman get blood sugars in wonderful control before concieving. I had my A1c at 6 and blood sugars are checked every 3 hrs or so! I'm very consious about all things diabetic related when it comes to my baby! Awareness is very crutial part of being diabetic and pregnant....Good luck!

bjevans |