Having A Healthy Baby - Pregnancy And Diabetes: Diabetes

Content provided by the Faculty of the Harvard Medical School

Having a healthy baby

Women with diabetes who strictly control their blood sugar before conception and during pregnancy can substantially improve their chances of having a healthy baby. It's imperative that blood sugar levels and HbA1c be kept as close to normal as possible throughout the pregnancy. In the early stages of fetal development, this can help prevent birth defects, and in the last trimester, it will reduce the chance of the fetus growing too large.

Because glucose control by the mother early in pregnancy is so crucial to the health of the baby, it is important to achieve near-normal glucose control before you become pregnant. This requires advance planning. Ideally, most women with diabetes will have good glucose control and won't need major adjustments in their diabetes treatment plan in preparation for a pregnancy. However, women who have not been able to reduce their glycosylated hemoglobin readings to 7% or less (the target range for women with diabetes who are not pregnant) may require treatment adjustments before trying to become pregnant.

The increased monitoring, medical visits, and cost of supplies that go along with a diabetic pregnancy are also good reasons to plan ahead. You may want to check with your insurance provider to find out what it will cover.

If you become pregnant, it's important to have frequent contact with your medical team, which will include an obstetrician. You'll have ultrasound tests to monitor the growth and development of the fetus and more frequent glycosylated hemoglobin tests to evaluate your blood sugar control. Blood sugar and HbA1c goals during pregnancy are even more stringent than when you are not pregnant. You will probably be asked to check blood sugars both before meals and two hours after eating. Your doctor may recommend other tests to screen for possible abnormalities in the fetus. A dietitian will also adjust your diet to ensure that the fetus receives proper nutrition and that you get the calories you need. You'll need to adjust your insulin doses often, especially in the last trimester, since insulin requirements can increase dramatically toward the end of pregnancy. Getting enough exercise will be just as important as before pregnancy, and women who are heavy will have to watch that their weight gain isn't excessive.

Last updated:	January 23, 2007