What precautions should I take if I am diabetic and would like to get pregnant?
There was a time when women with diabetes were discouraged from having children. Today, advances in medicine have made it much safer than in the past for a woman with diabetes to have a baby. However, the most important aspect of a woman with diabetes who wishes to become pregnant is diligent management of her diabetes.
High ketones and blood glucose levels are believed to increase the chances of having birth defects. Because of this, it is important to have your blood glucose under control before becoming pregnant. The first six weeks of pregnancy are critical, as the baby’s organs are first forming. High blood glucose levels during this time greatly increases the odds of having birth defects. Because most women don’t know that they are pregnant until the baby has been growing for two to four weeks, if you are trying to conceive you should make every effort to have your blood glucose levels under control.
Once you are pregnant, it is important to have the right prenatal team at hand. These should incude a doctor, who is trained to care for people with diabetes; an obstetrician who has handled high-risk pregnancies, and who preferably has cared for other pregnant women with diabetes; a pediatrician who knows and can treat special problems that may occur in babies of women with diabetes; a registered dietician who can help change your meal plan as your needs change both during and after your pregnancy.
If you have type 1 diabetes, pregnancy will also affect your insulin treatment plan. During the time that you are pregnant, your body’s need for insulin will increase, especially during the last three months of pregnancy. This increased need for insulin is caused by hormones made by the placenta. These hormones help the baby grow. At the same time, these hormones block the action of the mother’s insulin. As a result, your insulin needs will increase.
If you have type 2 diabetes, you too need to plan ahead as well. If you are taking diabetes pills to control your blood glucose, you may not be able to take them when you are pregnant. The safety of using diabetes pills during pregnancy has not been established, so it is likely that your doctor will have you switch to insulin right away.