Five ways to prepare for pregnancy when you have diabetes

Diabetes management is essential for a healthy pregnancy.

Pregnancy isn’t always planned. But when you have diabetes, planning for your newest addition to the family is crucial for a healthy pregnancy and baby.

Getting your diabetes under control before you become pregnant reduces risks for both you and your baby.

“High blood sugar can cause harm to your developing baby during those first few critical weeks and increase the risk of birth defects,” says Michael Krew, MD, director of Maternal-Fetal Medicine at Akron Children’s. “Having uncontrolled diabetes also puts mom at an increased risk for serious complications during pregnancy and delivery.”

Thankfully, planning ahead with a prepregnancy plan, getting support and managing your blood sugar levels with a healthy eating plan and exercise routine greatly reduces these risks.

If you’re thinking about starting — or adding to — your family, schedule an appointment with your diabetes team and continue using birth control until you’re as close as possible to your blood sugar goals.

How can diabetes affect my baby?

During the first few weeks of pregnancy — when many women don’t even realize they’re pregnant — your baby is developing vital organs including the brain, heart, kidneys and lungs. High blood sugar levels during this critical time can increase the risk of birth defects, miscarriage and other serious complications such as:

• Premature birth
• Higher-than-normal newborn weight
• Low blood sugar levels in baby
• Newborn injury during vaginal delivery

Because of complications, a Cesarean delivery and intensive care for your newborn may be necessary.

The good news is there are steps you can take now to prepare for pregnancy (link to preconception tips blog) and help greatly reduce risks to deliver a healthy baby.

Develop a prepregnancy plan with your diabetes team

The first important step is to schedule an appointment with your diabetes team at least six months before trying to get pregnant. Your provider can talk to you about how diabetes affects pregnancy and the baby, and together you can develop a pre-pregnancy plan to reduce risks.

Talk to your provider about what specific blood sugar and A1C target goals should be. It’s important to make sure your blood sugar target and A1C are as near normal as possible for at least three months before trying to get pregnant.

“When you’re planning to get pregnant, your target blood sugar levels may change,” says Dr. Krew. “Changes to hormones and your body during pregnancy will affect the amount of insulin you need.”

Your provider may recommend adjusting your meal plan, physical activity and/or medications to better control your diabetes. And you’ll need to check your blood sugar more often to make sure you’re staying as close to your target range as possible.

Also, talk to your doctor about keeping other conditions under control, such as high blood pressure or cholesterol, to protect your baby.

Your provider also may recommend other checkups, such as vision and kidney tests, to avoid worsening conditions like retinopathy or preeclampsia during pregnancy.

Review medications with your provider

Review any prescription, over the counter and supplements you’re taking with your provider. Some may not be recommended for pregnancy, and you’ll need time to transition to safer options. If that’s not possible, your provider may refer you to a maternal-fetal medicine specialist for further evaluation.

Your provider will recommend switching from most glucose-control medicines to insulin therapy. And if you’re already taking insulin, your provider may recommend changing the type, amount or how often you’re taking it.

In addition, ask your doctor about other medications or supplements you should add. It’s recommended all women start taking 400 micrograms of folic acid at least three months prior to conception. However, if you have diabetes, your provider will likely recommend a higher dose of folic acid, which is only available by prescription.

Women with diabetes have an even higher risk of neural tube defects (problems caused by incomplete development of the brain or spinal cord), such as spina bifida, and other pregnancy complications. Getting enough folic acid in early pregnancy can lower these serious risks.

Eating healthy foods helps you maintain good blood sugar levels before and during pregnancy.

Schedule an appointment with a dietitian

If you’re not already seeing a dietitian, now’s a good time to start. A dietitian can help you adjust your diet plan for pregnancy. Good nutrition not only nourishes your body before and during pregnancy, but it also helps you maintain a healthy weight and manage your blood glucose.

Reach for plenty of fruits, vegetables, whole grains, low-fat dairy and lean proteins. Good sources include dark leafy greens, turkey and fish, tofu and low-fat cheeses and yogurt. At the same time, limit sugary treats, highly processed and fried foods to maintain a balanced diet.

A dietitian can help you review meal plans that include options you actually want to eat and can easily incorporate into your daily diet.

Stay active

It’s important to make exercise a regular part of your daily routine — whether you’re trying to get pregnant or not. But when you have diabetes, it’s even more crucial.

Exercise not only helps you manage weight, but it also improves blood sugar control by increasing insulin sensitivity. Not to mention, it helps build muscle, flexibility and stamina — all the things required for carrying — and delivering — a baby.

Aim for 30 minutes of physical activity five or more days a week, such as brisk walking, swimming, strength training or yoga.

Quit smoking and using other harmful substances

There’s no better time than now to quit smoking and using other harmful substances. You’ll improve your health — and your baby’s. Smoking is dangerous for your health and increases the risk of many pregnancy complications, especially if you have diabetes.

And vaping is not a safer alternative for smoking. Vape juice contains nicotine and heavy metals that are toxic.

In addition, smoking marijuana or chewing edibles is not safe during pregnancy, even if purchased from a legal dispensary. Marijuana use during pregnancy can cause harm to your developing baby’s brain.

If you’re planning for pregnancy and have diabetes, know you’re not alone. Your diabetes team is here to support you and ensure a healthy pregnancy and baby.

“Just because you have diabetes, doesn’t mean you can’t have a healthy pregnancy,” says Dr. Krew. “Planning ahead, getting support and strong blood sugar management before and during pregnancy greatly reduce risks for both mom and baby.”