Pregnancy When You Have Type 1 Diabetes

Prior to the use of insulin in 1922, it could be hazardous for women with diabetes to get pregnant. Now many women with diabetes type 1 are having babies without complications and leading a healthy life. Knowing what to expect and how to take proper care is essential when you get pregnant and have diabetes type 1.

• You should properly control your diabetes before, during, and after pregnancy. If your blood sugar is poorly controlled it can lead to problems for you and your baby including birth defects, early or pre-term birth, and low blood sugar. If your diabetes is not well-controlled the baby could be extra large and you might need to have a caesarian delivery. It takes a woman longer to recover after a c-section. A pregnant woman may also develop high blood pressure (preeclampsia), a problem that must be watched closely by your doctor.
• Taking certain steps before you get pregnant can help prevent problems such as health complications and birth defects. Schedule a visit to talk to your doctor prior to getting pregnant. Discuss the effects diabetes has already had on your body. Review ways to control your blood sugar and change medications if necessary. If you are overweight the doctor might recommend shedding a few pounds before getting pregnant to help keep your blood sugar in control.
• Once you become pregnant schedule regular appointments with your health care team. Women with type 1 diabetes must see the doctor more often than women without diabetes. Visiting your health care team regularly can help to prevent potential problems.
• Work with your doctor or a dietitian to create a healthy meal plan when you are pregnant. A dietitian or diabetes nurse practitioner can help you learn how to choose the right foods. This ensures you and your baby get essential nutrients while you keep your blood sugar levels in check.
• Talk to your health care team about exercising while you are pregnant. Most pregnant women with type 1 diabetes are advised to exercise at least 30 minutes a day and 5 days a week. Moderate-intensity exercises may include swimming, walking, yoga, cycling and stretching.
• Discuss insulin and diabetes with your doctor to help keep your blood sugars under control. Insulin is considered a safe medication when you are pregnant. Many women with type 1 diabetes require up to 4-6 insulin injections daily. Inquire about using an insulin pump during pregnancy to avoid radical blood sugar fluctuations. You may inquire about a continuous glucose monitor system as well.
• Be ready to treat low blood sugar quickly by having glucose tablets or hard candy available at all times. Talk to your family, friends and co-workers about how they can help if your blood sugar plummets. Monitor your blood sugar frequently and report the results to your health care team. Your doctor may want to adjust your insulin, food intake and exercise based on the results.
• Schedule tests and exams throughout your pregnancy to check your well-being and the health of the baby. These exams might include an eye exam to check for retinopathy, blood pressure monitoring, and kidney function monitoring as well as tests to check the baby such as ultrasound, screening for birth defects, and fetal monitoring.
• Risk factors such as increased blood sugar levels, preeclampsia, nephropathy or worsening retinopathy as well as a baby that is larger or smaller than normal make the doctor decide to schedule the date of delivery. This is done by inducing labor or having a cesarean delivery.
• Once your baby arrives, it is important to maintain regular doctor appoints to ensure your health is stable. Risks for the mother may include breathing problems, lower blood sugar levels, low calcium levels, jaundice, heart problems, and excessive red blood cells (polycythemia). Talk to your pediatrician about any potential risks your infant could face in the future. With proper care you and your baby will be healthy.

An increasing number of women with type 1 diabetes have successful pregnancies and maintain optimum well-being. Proper planning plays a major role in your health and the health of your baby. Maintain proper lifestyle habits and visit your health care team on a regular basis before, during and after pregnancy.