Preexisting Diabetes and Pregnancy: What You Should Know
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Living with diabetes is already a challenge, but pregnancy brings extra planning and care. If you have type 1 or type 2 diabetes before pregnancy, you have what experts call preexisting diabetes. This can affect both your health and your baby’s health, but with the right steps you can still have a healthy pregnancy. Here is simple guidance based on the latest expert recommendations.
Plan Before You Conceive
Planning ahead is the most important thing you can do. Experts strongly suggest that every woman with diabetes who could become pregnant should be asked about her pregnancy plans during routine doctor visits. If you are not ready for pregnancy, reliable contraception is key. If you do want to become pregnant, talk to your care team early so you can improve your blood sugar levels and overall health before you conceive. This planning, known as preconception care, can lower the risk of miscarriage and birth defects.
Manage Your Blood Sugar Early and Often
Keeping blood sugar in a healthy range before and during pregnancy is crucial. Aim for fasting levels under 95 mg/dL, one hour after meals under 140 mg/dL, and two hours after meals under 120 mg/dL. Some people use a continuous glucose monitor (CGM), while others use a standard finger-prick meter. Both methods are acceptable. What matters most is frequent monitoring and making adjustments with the help of your care team.
Review Your Medications
If you are on certain diabetes medications like GLP-1 receptor agonists, your doctor may recommend stopping them before you try to conceive. If you already use insulin, experts do not recommend adding metformin during pregnancy unless there is a special reason. Always speak to your doctor before making any changes, because stopping some medicines suddenly can cause blood sugar spikes.
Focus on Healthy Eating and Activity
There is no strict rule for how many carbohydrates you should eat, but both very low and very high carb intake can be harmful. Most women with diabetes during pregnancy can follow their usual balanced diet while monitoring blood sugar levels. Eating plenty of vegetables, lean protein, whole grains, and healthy fats, along with gentle daily exercise like walking, can make a big difference.
Plan Delivery and Postpartum Care
Women with preexisting diabetes may need to deliver a little earlier than others, often around 38 weeks, depending on individual risk factors. After birth, you still need support. Blood sugar management continues to be important while you recover and if you are breastfeeding. Postpartum care is also a chance to plan for future pregnancies and adjust your diabetes treatment as needed.
Takeaway
Pregnancy with diabetes takes extra preparation, but it is absolutely possible to have a healthy baby and stay healthy yourself. Start planning early, keep your blood sugar in range, work closely with your care team, and don’t be afraid to ask questions. The more you prepare, the smoother your pregnancy journey will be.