Pregnant women who have diabetes before getting pregnant have special health concerns, such as keeping blood glucose (sugar) levels in good control, managing diabetes medicines, adjusting meal plans, and exercising regularly.
Meeting with your health care provider before becoming pregnant is very important to ensuring a healthy pregnancy. Your diabetes health care provider can help you determine if your diabetes is controlled well enough for you to stop your birth control method. A blood test called the glycosylated hemoglobin test (HbA1c) can help your health care provider evaluate how well your diabetes has been controlled over the past 6 to 12 weeks. This test is used along with home glucose monitoring to make treatment adjustments.
Having other medical tests before you become pregnant can help your diabetes health care provider monitor your health and prevent the development of diabetes-related complications during pregnancy. Some of the tests your health care provider might order include:
A pre-conception counseling appointment with your health care provider is another important step in preparing for pregnancy. Pre-conception counseling helps educate women so they can be physically and emotionally prepared – and healthy – for pregnancy. A pre-conception appointment usually includes:
Smoking during pregnancy affects you and your baby’s health before, during, and after your baby is born. The nicotine (the addictive substance in cigarettes), carbon monoxide, and numerous other poisons you inhale from a cigarette are carried through your bloodstream and go directly to your baby. Smoking while pregnant will:
Smoking may increase the risk of having an ectopic pregnancy placental problems (placenta previa or placenta abruption) and vaginal bleeding. Second and third hand smoke exposure can also be harmful. During pregnancy, drinking alcohol can cause miscarriage, preterm birth and stillbirth. Stop drinking if you suspect you are pregnant. Excessive drinking can lead to fetal alcohol syndrome, a pattern of birth defects that includes mental retardation, as well as cardiovascular, skeletal, and facial abnormalities.
Good blood glucose control means keeping blood glucose levels within the ideal range 70 - 100 mg/dl (3.9 – 5.6 mmol/L) before meals, less than 140 mg/dl (7.8 mmol/L) two hours after eating, and 100-140 mg/dl (5.6 – 7.8 mmol/L) before bedtime snack), as well as balancing meals, exercise, and diabetes medicines.
Good blood glucose control is important before becoming pregnant because many women do not even know they are pregnant until the baby has been growing for two to four weeks. High blood glucose levels early in the pregnancy (before 13 weeks) can cause birth defects.
Good blood glucose control is just as important during pregnancy because high blood glucose levels can increase the risk of miscarriage and can increase your risk of developing diabetes complications.
If you take insulin to control your diabetes, your health care provider can tell you how to adjust your medicine. Generally, your body will require more insulin during pregnancy, especially during the last three months of pregnancy.
If you take oral medicines to control your diabetes, your health care provider might switch your medicine to insulin during pregnancy, since certain oral medicines could harm the developing baby.
During pregnancy, you and your healthcare provider should work together to adjust your meal plan. Changing your meal plan will help you avoid problems with low and high blood glucose levels. Your meal plan will also be adjusted to include more calories for your growing baby.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition.
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