Healthy pregnancy with diabetes is absolutely possible. Planning and close monitoring help protect both parent and baby.
What to know
- Types in pregnancy:
- Preexisting diabetes: Type 1 or Type 2 present before conception.
- Gestational diabetes (GDM): first recognized during pregnancy.
- Why tight control matters:
- High glucose early raises risk of miscarriage and birth defects; later it increases risks of large baby, birth complications, preeclampsia, and newborn low blood sugar.
- Typical glucose targets in pregnancy (individualize with your clinician):
- Fasting/pre‑meal: ≤95 mg/dL (≤5.3 mmol/L)
- 1‑hour post‑meal: ≤140 mg/dL (≤7.8 mmol/L)
- 2‑hour post‑meal: ≤120 mg/dL (≤6.7 mmol/L)
- Insulin is the preferred therapy if meds are needed; many non‑insulin diabetes drugs are paused or switched when trying to conceive or once pregnant.
Take action
- Preconception (ideal: ≥3 months before trying):
- Aim for an A1c as close to normal as safely possible (often <6.5%) to reduce birth‑defect risk.
- Review all meds: switch off teratogenic drugs (e.g., some BP meds, statins) and align diabetes therapy for pregnancy.
- Start folic acid (at least 400 mcg/day; some need more per clinician).
- Screen and treat diabetes complications (eyes, kidneys); optimize thyroid if needed.
- During pregnancy:
- Nutrition: regular meals/snacks with balanced carbs; include fiber/protein to steady glucose.
- Monitoring: frequent checks or CGM; share weekly data with your team.
- Insulin: doses often rise as pregnancy progresses; titrate with clinician.
- Additional care: aspirin 81 mg from late first trimester for preeclampsia prevention if recommended; monitor BP/weight; schedule anatomy scan and fetal growth checks.
- Postpartum:
- Insulin needs drop quickly after delivery—review doses to prevent lows.
- If GDM: get a 75‑g OGTT at 4–12 weeks postpartum; repeat diabetes screening every 1–3 years.
- Breastfeeding supports maternal glucose/weight; watch for hypoglycemia if on insulin.
Talk to your obstetric and diabetes team about
- Safe glucose targets and how/when to adjust insulin.
- Which non‑insulin meds (if any) are appropriate before/during pregnancy.
- Aspirin use, BP goals, and eye/kidney monitoring schedule.
- Birth plan, neonatal hypoglycemia prevention, and postpartum screening.
Quick glossary
- GDM: gestational diabetes, usually resolves after birth but signals future diabetes risk.
- Preeclampsia: pregnancy‑related high BP with organ effects; needs close monitoring.
- OGTT: oral glucose tolerance test used to diagnose GDM and screen postpartum.
Safety note
Persistent high readings, ketones, reduced fetal movement, severe headache/visual changes, or BP spikes need urgent evaluation.