Preparing for pregnancy with diabetes

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Going into a pregnancy as a woman with pre-existing diabetes may seem daunting, but taking good care of yourself before you’re even get pregnant – and throughout your pregnancy – can reduce your risks of complications.

If you are diabetic and planning to get pregnant, it is recommended that you visit a doctor that specializes in high-risk pregnancies for a preconception visit, said Debbie Michels, a registered nurse and certified diabetes educator at St. Elizabeth’s Maternal-Fetal Center in Edgewood, KY.

With the proper care and monitoring, a diabetic mother can minimize the possible risks.

“We like to see hemoglobin A1C at less than 6 when they conceive – which is the normal range – at the beginning of pregnancy when all development is occurring,” Michels said. “That helps avoid birth defects in the baby such as heart problems, neurological problems or stillbirth. The rate of miscarriage increases with uncontrolled diabetes.”

Since gestational diabetes develops later in pregnancy and is not a pre-existing condition, the risk for birth defects is low. There are complications that can occur with poorly controlled gestational or pre-existing diabetes, including a large baby, which may lead to birth injuries from a more difficult delivery.

“In general, you need to be as healthy as you can be,” Michels said. “A healthy weight, good blood pressure, normal blood sugar and start a prenatal vitamin with folic acid as soon as you are trying to get pregnant.”

The American Diabetes Association lists some of the possible risks to the diabetic mother and to her baby if blood glucose levels are too high during pregnancy.

 

Risks for the baby

  • Premature delivery
  • Miscarriage
  • Birth defects (not usually a risk for women with gestational diabetes)
  • Macrosomia (having a large baby)
  • Low blood glucose at birth (hypoglycemia)
  • Prolonged jaundice (yellowing of the skin)
  • Respiratory distress syndrome (difficulty breathing)

Risks for the mother

  • Worsening of diabetic eye problems
  • Worsening of diabetic kidney problems
  • Infections of the urinary bladder and vaginal area
  • Preeclampsia (high  blood pressure  usually with  protein  in the  urine)
  • Difficult delivery or cesarean section

 

Target blood glucose goals before getting pregnant

  • Premeal (before eating): 60-119  mg/dl
  • 1 hour after meals: 100-149 mg/dl

 

diabetes during pregnancy