If you are planning pregnancy, think you are pregnant or are confirmed to be pregnant, let your diabetes team know right away so they can help you with proper management.
Preconception Counseling:
• Pregnancy and healthy pregnancy is possible with diabetes and is possible any time
• Achieving glucose levels as near normal as safely possible (HbA1c < 6.5%) to reduce risk of birth defects, preeclampsia, large babies, preterm birth
o Common birth defects affect the baby’s spinal cord and heart
• If you are sexually active and do not desire pregnancy, use of effective contraception is essential (e.g., birth control pills, condoms, IUDs, contraceptive implants, injectable contraception). Your endocrinologist can help you facilitate confidential access or direct you to who can if needed.
• Insulin needs change during pregnancy. Pregnancy care for those with diabetes should be managed in a multidisciplinary clinic which usually includes an endocrinologist, high risk obstetrician, registered dietician, and diabetes educator.
• If you are on medications for complications of diabetes (specifically for diabetic nephropathy or kidney disease or hyperlipidemia/high cholesterol), the medication may be harmful to the baby. Early discussion can ensure you are on medications with the least potential for harm.
References:
American Diabetes Association Professional Practice Committee; 15. Management of Diabetes in Pregnancy: Standards of Medical Care in Diabetes—2022. Diabetes Care 1 January 2022; 45 (Supplement_1): S232–S243.