If you’re like me, when you were first diagnosed with diabetes you wanted to learn all
you could about the disease and how your life would change. My first thought was,
“how is diabetes going to affect my chances of getting pregnant and having a healthy
baby?” I had only been married six months when I was diagnosed with Type 2 and
we just decided that we would start trying to conceive.
Since then I have been spending every free minute I have trying to find out as much
as I can about pregnancy and diabetes. The following is what I have read from many
different sources and is just a small amount of what is out there. Although I have tried
to include the most essential information in this article I encourage women with
diabetes who are trying to conceive to learn as much as you can before getting
pregnant.
First of all it is essential to establish healthy habits and good blood glucose control
before you become pregnant. All of your baby’s organs are formed during the first 8
weeks of pregnancy. This is before many women even know they are pregnant. It is
best to have a full physical and evaluation of your blood glucose control before you
even begin trying to conceive. The general risks for pregnant women with type 2
diabetes include miscarriage, stillbirth, macrosomia (birth weight over nine pounds),
traumatic delivery, hypertension or preeclampsia, and infant disorders such as
breathing difficulties, jaundice and heart problems.
Although having diabetes means additional risks for you and your baby, it is still
possible to have a healthy pregnancy. If you can keep your blood glucoselevels and
blood pressure normal, it is likely you will have just as normal a pregnancy as other
women in your age group. Some women should carefully consider whether or not
pregnancy is right for them especially those with serious diabetes related problems.
Pregnancy can make severe cardiovascular disease, kidney failure or crippling
gastrointestinal neuropathy worse, or lead to life-threatening conditions such as a
stroke or heart attack.
If you are taking medication to help control your diabetes, talk with your doctor about
alternatives, as some drugs such as sulfonylureas could potentially cause birth
defects. Most doctors recommend switching to insulin before you become pregnant.
Also, check with your doctor about medications that you are taking for other conditions
as they may not be safe to use during pregnancy.
Before you get pregnant
1. Schedule a pre-pregnancy visit with your health care team. Your doctor will
perform a complete physical exam. You will be checked for high blood pressure, heart
disease, kidney disease, nerve disease, and eye disease. It is critical to treat these
problems before you consider pregnancy.
2. Visit your eye doctor. Untreated diabetic retinopathy can worsen during pregnancy.
3. Make sure you are able and willing to keep your blood glucose levels as close to
normal as possible. “In one study, women who practiced tight control reduced the risk
of birth defects to only 1 percent, compared to 10 percent for those who began
intensive therapy after the pregnancy had begun.” If you have type 1, intense
management means a program of several insulin injections per day and testing your
blood glucose level six to eight times per day. If you have type 2, you may need to
begin insulin therapy and test your blood glucose level two to three times each day.
4. Talk with your doctor to find alternatives for your medications that shouldn't be used
in pregnancy. Adjusting to a different medicine will be easier to do before you start
trying to conceive especially if you need to switch to insulin.
5. Get your A1C level checked. Most doctors recommend that it is less than 7% before
you become pregnant. The risk of deformities in your baby goes way up if your blood
sugar levels are too high.
6. Take folic acid supplements before you start trying to conceive. Folic acid will help
prevent spinal defects in your baby.
7. For women with type 2 diabetes, weight can also play a part in having a healthy
pregnancy. Getting down to a normal weight before you get pregnant is recommended
and will benefit you as well as your baby.
Check this out!
One site that I found in my search and recommend to diabetic women trying to
conceive or who are already pregnant is www.diabeticmommy.com . One thing I like
about this site is that there is a forum where you can talk to other women and get first
hand advice on what it is like to be pregnant with diabetes. There are also links to
even more resources on this site.
References:
1.Rosenthal, M. Sara. The Type 2 Diabetes Sourcebook for Women. New York: McGraw-Hill, 2005.
2.Touchette, Nancy. The Diabetes Problem Solver. American Diabetes Association, Port City Press, 1999.
