Pre-existing Diabetes and Pregnancy

Have you been looking for information on pregnancy and diabetes? If so, there’s a good chance you’re already familiar with gestational diabetes—that is, diabetes initially diagnosed mid-pregnancy. However, that doesn’t mean there’s no connection between other forms of diabetes and pregnancy. As recently as the mid-20th century, women who had type 1 diabetes were discouraged from having children at all.

Diabetes management has progressed by leaps and bounds since those days, but you’ll still need to take a few precautions to ensure your pregnancy goes smoothly. Keep reading for a rundown of everything you should know about pre-existing diabetes and pregnancy.

About diabetes

Before learning more about managing diabetes during pregnancy, take a minute to brush up on the fundamentals of this disease:

What is Type 1 diabetes? 

This type of diabetes is thought to be an autoimmune disease. That means it occurs when your immune system misidentifies healthy pancreas cells as outside invaders. Since the cells targeted by the immune system are responsible for generating insulin, the body cannot create insulin on its own when this happens.

What is Type 2 diabetes?

In contrast, type 2 diabetes involves increased insulin resistance. While people with type 2 diabetes can still generate their own insulin, their cells are less capable of using it efficiently. Currently, type 2 diabetes is the single most common form of diabetes in the world.

What are Diabetes Symptoms?

Unmanaged type 1 and type 2 diabetes can have symptoms like:

• Frequent urination 
• Excess thirst and hunger 
• Fatigue 
• Blurred vision 
• Cuts/sores that don’t heal as they should 
• Dry skin 
• Infections 

Diabetes Risk factors 

While the risk factors for type 1 diabetes are poorly understood, known risk factors for this disease include family history and age (it is most commonly seen in children and teenagers). Type 2 diabetes risk factors include:

• Prediabetes 
• Extra weight 
• Low levels of physical activity 
• Age (over 45), EVENTHOUGH WE ARE SEEING MORE AND MORE TYPE 2 CASES IN YOUNGER PEOPLE 
• A history of gestational diabetes 
• Having given birth to a baby weighing nine pounds or more 
• Race (Alaska Native, American Indian, Black, or Hispanic/Latino) 
• A family history of type 2 diabetes 
• Polycystic ovary syndrome 

How can my diabetes affect me during pregnancy? 

Pregnancy comes with a variety of hormonal changes, and these shifts can affect your blood sugar levels. As a result, you might need to make temporary changes to your diabetes management plan – even if you’ve been living with this condition for years. That could include changes to your:

• Medication 
• Exercise routine 
• A Healthy Meal Plan  

Furthermore, you may have to make further alterations as you approach your due date.

How can diabetes affect my baby?

Your child’s organs (including their brain, lungs, heart, and kidneys) will begin to form in the first eight weeks of your pregnancy. At this crucial stage, high glucose levels in your bloodstream could cause trouble for your baby—including potential congenital disabilities.

High blood sugar levels at other points in your pregnancy can also affect your baby’s health. Elevated glucose levels can increase the odds that your child will be born prematurely, overweight, or with low blood sugar or breathing problems immediately after birth. Along with that, high glucose levels can make it more likely that you will have a stillborn baby or miscarriage.

What tests will check my baby’s health during pregnancy? 

To ensure your child stays healthy throughout your pregnancy, you’ll receive tests like ultrasounds and blood tests. For more information about prenatal testing, talk to your healthcare team.

How can I prepare for pregnancy if I have diabetes?

Maintaining a healthy blood sugar level before and during your pregnancy is the key to keeping yourself and your baby healthy throughout this process. To pursue this goal, you’ll want to put together a diabetes healthcare team if you don’t already have one.

Some people you may want to include on this team are:

• A medical doctor specializing in diabetes, such as an  endocrinologist 
• An obstetrician with diabetes experience 
• A diabetes educator who can help you deal with this disease 
• A nurse practitioner to provide natal care 
• A registered dietitian who can help you build a healthy meal plan  
• Specialists focusing on diabetes-related problems (including heart disease, kidney disease, and vision issues) 
• A psychologist or social worker who can help you deal with the stress associated with pregnancy and diabetes management 

Tips on working with your healthcare team during pregnancy.

Once you’ve put your healthcare team together, you’ll be ready to tackle the challenges of managing type 1 diabetes and pregnancy (or type 2 diabetes and pregnancy) head-on. At this point, your priorities should include:

Getting a checkup 

When you know you’re pregnant (or if you are planning to become pregnant soon), your first step should be getting a thorough checkup. Your doctor should look out for complications like:

• High blood pressure 
• Nerve damage 
• Eye disease 
• Heart/blood vessel disease 
• Thyroid disease 
• Kidney disease 

Avoiding tobacco and alcohol 

Smoking is harmful to everyone, but it’s especially dangerous for people with diabetes – and pregnant women. Tobacco use can make you more likely to experience diabetes complications like eye, heart, and kidney disease. And like diabetes, smoking can increase your odds of having a stillborn or premature baby. If you currently smoke or use tobacco products, talk to your healthcare team about strategies for quitting.

In addition, you should steer clear of alcohol during pregnancy (regardless of whether you have diabetes). Alcohol can affect your pregnancy and result in lifelong health issues for your child.

Creating a pregnancy-friendly diabetes diet 

Even if you already have a diabetes diet, you may need to make some adjustments due to your pregnancy. Ask your dietician about what you should eat while pregnant, how much food you should consume, and what weight you should target. With that information, you’ll be able to safely adapt your meal plan to each stage of your pregnancy.

Getting physical activity 

Anyone with diabetes can benefit from exercise. Physical activity can make it easier for you to:

• Reach your target blood glucose level 
• Control your cholesterol and blood pressure 
• Enjoy countless other health benefits 

Try to get at least half an hour of exercise five days a week before your pregnancy, and work with your healthcare team to prepare a pregnancy-friendly exercise regimen.

Taking medicines, vitamins, and supplements 

While you should take medicines as prescribed when managing diabetes, some drugs are not considered safe for use by pregnant women. If you become pregnant, make sure your doctor is aware of the medicines you take for diabetes and other conditions. They’ll be able to tell you which medications you should pause and what you can safely replace them with.

Insulin is commonly prescribed as a treatment for type 1/type 2 diabetes during pregnancy. Even if you already take insulin, you might need to adjust your dosage or schedule to fit your body’s changing needs. As part of this, your insulin needs may decrease during the first trimester; however, they may double or triple later in your pregnancy.

In addition to keeping an eye on your medicine-related needs, you’ll want to start taking folic acid at least a month before your pregnancy. Look for a supplement or multivitamin containing at least 400 mcg of folic acid. When you become pregnant, increase your daily dosage to 600 mcg. Also, talk to your healthcare team about any other vitamins or supplements that may be useful during your pregnancy.

What do I need to know about blood glucose testing before and during pregnancy?

Like many other aspects of diabetes management, your blood sugar testing schedule may shift while you are pregnant. As part of this, you could have to check your blood sugar levels more often during your pregnancy. If you haven’t had to check these levels on a daily basis before, there’s a good chance that you’ll need to start doing so. Additionally, you may need to check for ketones if your blood sugar levels are particularly high. Talk to your healthcare team about the right blood glucose testing schedule for you.

Target blood glucose levels before pregnancy 

Your everyday blood sugar targets may change when you’re getting ready for pregnancy. Your healthcare team can help you figure out what target levels you should aim for at this time. Be sure to record these levels whenever you check your blood sugar and present this information to your healthcare team to track the effectiveness of your diabetes treatment plan.

Target blood glucose levels during pregnancy 

For most pregnant women with diabetes, the recommended daily glucose targets are:

• Before meals, before bed, and overnight: 95 or lower 
• An hour after meals: 130-140 or lower 
• Two hours after meals: 120 or lower 

These numbers may vary based on your own situation, so be sure to ask your healthcare team what levels you should aim for. If you are dealing with type 1 diabetes, you may have higher target numbers to reduce your risk of hypoglycemia.

Let US MED help you with pregnancy and diabetes

Taking care of yourself and your baby while pregnant can be difficult for anyone, and it should come as no surprise that managing diabetes along with this can complicate matters. Fortunately, if you work closely with your healthcare team, you can significantly reduce your risk of diabetes-related pregnancy problems.

Along with the tips listed in this article, a great way to reduce pregnancy-related stress is to have a reliable source of any diabetes supplies you may need. US MED is proud to provide free priority shipping for these supplies, and we’re backed by an A+ Better Business Bureau rating. Choose US MED for your continuous glucose monitors, diabetes testing supplies, insulin pumps, and any other supplies you’re looking for!