Pregnancy can be one of the most exciting times in your life. But if you have diabetes, it can also be an overwhelming one. Luckily, understanding how diabetes can impact pregnancy and what you can do to limit risks can help you stay healthy and calm during these important months.
What Are the Risks?
A woman who has diabetes and becomes pregnant is at an increased risk for:
- Very low blood sugar levels
- Ketoacidosis from high blood sugar levels, mainly in people with type 1 diabetes.
Both can be life-threatening if left untreated.
A baby born to a woman with diabetes is at an increased risk for:
- Birth defects
- Large size
- Birth injury
- Low blood sugar right after delivery
- Breathing problems
- Stillbirth
It’s true that diabetes can have serious impacts on a pregnancy. Working with your healthcare team before and during pregnancy can help both mom and baby stay well.
Before Pregnancy
If you have diabetes and are thinking about becoming pregnant, you’ll want to make an appointment to see your healthcare provider. This visit will likely focus on diabetes education and steps you can take to start your pregnancy on the right foot.
Getting close to your blood sugar targets prevents health risks for both mom and baby. Diabetes Canada recommends an A1c of <7.0% when planning pregnancy. This A1c target is linked with the lowest risk of complications.
Before becoming pregnant, you’ll also want to start taking a prenatal vitamin with at least 400 mg of folic acid It would also be helpful to speak with your primary care physician prior to pregnancy to discuss any needed adjustments in your diabetes medications.
During Pregnancy
Pregnancy can change how a woman’s body uses blood sugar. An organ called the placenta gives the growing baby nutrients and oxygen. It also makes important hormones. Later in pregnancy, these hormones can block insulin. This means that sugar is blocked from going into the body’s cells. This causes blood sugar levels to rise. Pregnancy can also make low blood sugar levels hard to detect.
Here are steps you can take to stay on track:
- Check your blood sugar. This is a key part of taking good care of yourself and your baby before, during, and after pregnancy. This can mean up to eight checks daily.
- Log details around checks. Keep track of your food, the time of day, exercise, mood, and symptoms related to blood sugar.
- Talk with your provider. Blood sugar goals vary based on your needs. Ask your healthcare team about your specific goals.
- Eat well and exercise. Your needs will be different than pre-pregnancy. A coach can help you develop a nutrition plan to help you balance carbohydrates, protein, and fat.
Diabetes Canada recommends the following blood sugar targets during pregnancy:
- Fasting blood sugar: <5.3 mmol/L
- 1 hour post-meal: <7.5 mmol/L
- 2 hours post-meal: <6.7 mmol/L
- A1c: ≤6.5% (with an amended goal of >6.1% during the third trimester)
Your individual goals may vary. Talk with your doctor about what’s right for you throughout your pregnancy.
Your doctor will monitor your pregnancy closely to help you stay healthy. Prenatal tests may be more frequent for someone with diabetes and can include: fetal movement counting, ultrasound, non-stress testing, biophysical profile, Doppler flow studies, and amniocentesis.
While it can feel like a lot to manage diabetes while you’re pregnant, remember that staying on top of your health will have countless benefits. Your healthcare team can help you navigate this exciting time. Ask questions, be informed, and take comfort in knowing that each step you take now brings you closer to having a healthy baby.