Before you get pregnant
Uncontrolled high blood sugar levels raise the risk of birth defects and miscarriage. This is why planning for a baby is so important.Most women don't know they're pregnant until a few weeks after a baby is conceived. During these early weeks of pregnancy, as the baby's organs are forming, high blood sugar can damage the baby's heart, brain, and spine.
The American Diabetes Association recommends you have good blood sugar control for at least 3 to 6 months before you get pregnant. If you're thinking about getting pregnant:
- See your doctor. Tell him or her you are planning a pregnancy. Discuss whether you need any changes in your medicines or treatment plan.
- Ask your doctor about your target blood sugar ranges and A1C tests. Discuss exercise before and during pregnancy. It can help control blood sugar. But it's important to know that some types of exercise are not recommended in pregnancy. And your medical situation will affect your doctor's exercise recommendations in pregnancy.
- Ask your doctor if you will need an obstetrician who specializes in high-risk pregnancies as that kind of doctor will know about the complications of pregnancy in someone with diabetes. Also ask about a registered dietitian or diabetes educator for help with meal planning and managing your blood sugar.
- Make sure you have everything you need to monitor your blood sugar at home. Keep track of your blood sugar readings so you can discuss them with your doctor.
- It's best to go into your pregnancy being fit. Ask your doctor about the risks of exercise if you have high blood pressure or eye, heart, kidney, nerve, or blood vessel problems.
Once you're expecting
The excitement and hormone changes that come with pregnancy can make it harder to manage your blood sugar. Don't make any changes to your diabetes care without first talking to your doctor:
- If you have type 1 diabetes, you may need more insulin, especially in the last few months of pregnancy. Your doctor can help you manage this.
- If you have type 2 diabetes and take diabetes pills, you will likely have to stop the pills and start taking insulin right away. Experts disagree whether it's safe to take diabetes pills during pregnancy.
- You'll need to check your blood sugar more often. Write down the results. Include notes on your meals and exercise.
- Talk to your doctor before making any changes in your meal plans or exercise.
- Talk to your doctor about how much weight you should gain during your pregnancy. Do not try to lose weight while you are pregnant.
After the baby arrives
Your focus will be on your new little one, but don't forget to take care of yourself. Your blood sugar could go up and down as your body readjusts to its non-pregnant state and you get used to a new routine. If you decide to breast-feed, that also will affect your blood sugar.- Get plenty of shut-eye. Lack of sleep raises your risk of low blood sugar.
- Don't skip meals and snacks. Breast-feeding moms need more calories.
- Drink lots of fluids.
- Keep snacks on hand for low blood sugar emergencies.
References
- American Diabetes Association. Standards of medical care in diabetes - 2010. Diabetes Care. 2010;33(1):s11-s61.
- Slocum JM. Preconception counseling and type 2 diabetes. Diabetes Spectrum. 2007;20:117-123.
- American Diabetes Association.