If you have diabetes — either type 1 or type 2 — and you're thinking about having a baby, you might worry about possible risks. To put your mind at ease, start preparing. Managing your blood sugar levels and making healthy lifestyle choices before pregnancy is good for your health and can give your baby a healthier start too.
Start with a checkup
The first step in preparing for pregnancy is to talk to your health care provider.
He or she might recommend:
- Changing medications. If you take diabetes medication besides insulin, you might need to switch to something that's safer for use in pregnancy or make other changes to your diabetes treatment plan before you conceive. If you also have high blood pressure, your blood pressure medications may need to be changed because some blood pressure drugs aren't recommended during pregnancy.
- Treatment for certain conditions. If you have high blood pressure, signs of eye disease or other diabetes complications that could be aggravated by pregnancy, you might need treatment before you get pregnant.
- Seeing specialists. Your health care provider might suggest scheduling preconception appointments with a high-risk obstetrician, a diabetes educator, a registered dietitian or other specialists.
Focus on blood sugar management
Managing your blood sugar is key for avoiding diabetes complications. And, when you're preparing for pregnancy, blood sugar management becomes more important than ever.
Your health care provider will recommend that you reach a specific hemoglobin A1C level before pregnancy. A1C is a blood test that gives your doctor an idea of your blood sugar levels during the past two to three months. The American Diabetes Association generally recommends a pre-pregnancy A1C of 6.5%.
Your baby's brain, spinal cord, heart and other organs begin forming soon after conception, even before you know you're pregnant. If your blood sugar isn't well controlled during the earliest days of pregnancy, your risk of miscarriage and your baby's risk of birth defects — particularly those affecting the brain, spinal cord and heart — increase.
Your health care provider will help you establish your target blood sugar range. He or she will also evaluate your diabetes treatment plan and consider any changes that might improve it. The goal is to keep your blood sugar level as close to normal as safely possible.
Technology can help
You'll need to check your blood sugar multiple times throughout the day. You can do this by pricking your finger and drawing a drop of blood to test with a glucose meter, or you may choose to rely on newer technology. Continuous glucose monitors are devices that track blood sugar throughout the day, letting you know what your blood sugar level is without having to prick your finger. These devices rely on a tiny sensor that's injected underneath the skin temporarily.
Eat a healthy diet
Your diabetes diet probably already includes plenty of fruits, vegetables and whole grains. You can eat those same foods while you're preparing for pregnancy. If you're having trouble keeping your blood sugar in your target range or you want to lose weight before pregnancy, consult a registered dietitian. A dietitian can help you customize your meal plan to meet your pre-pregnancy needs.
Your health care provider will also likely recommend taking a daily prenatal vitamin beginning before conception to make sure you get enough vitamins, especially folic acid. Folic acid is important for preventing neural tube birth defects, such as spina bifida.
Physical activity is another important part of living well with diabetes. During your preconception appointment, get your doctor's OK to exercise. Then choose activities you enjoy, such as walking, swimming or stationary biking, and make them part of your daily routine.
Aim for at least 150 minutes a week of moderate aerobic activity — based on the Department of Health and Human Services guidelines for exercise during pregnancy. If you haven't been active for a while, start slowly and build up gradually.
Remember that physical activity affects blood sugar. Check your blood sugar level before and after any activity, especially if you take insulin. You might need to eat a snack before exercising to help prevent low blood sugar. If you're using an insulin pump, you might need to adjust the basal rate for exercise.
Patience pays off
Until your health care provider gives you the green light for pregnancy, remember to use a reliable method of birth control. A healthy pregnancy is worth the wait.