Managing preexisting diabetes during pregnancy

In the United States, about 9 out of 100 women – 9 percent – have diabetes. Diabetes is a condition in which your body has too much sugar in the blood. Preexisting diabetes, called type 1 or type 2 diabetes, means you have diabetes before you get pregnant. This is different from gestational diabetes, which is a kind of diabetes that some women get during pregnancy.

When you have diabetes, your body doesn’t make enough insulin or can’t use insulin well, so you end up with too much sugar in your blood. This can cause serious health problems, like heart disease, kidney failure and blindness. High blood sugar can be harmful to your baby during the first few weeks of pregnancy when his or her brain, heart, kidneys and lungs begin to form. It’s really important to get treatment for diabetes to help prevent health problems.

If it’s not managed well, diabetes can cause these complications during pregnancy:

Preeclampsia: This is when a pregnant woman has high blood pressure and signs that some of her organs, like her kidneys and liver, may not be working properly. Signs of preeclampsia include having protein in the urine, changes in vision and severe headaches.

Premature birth: This is birth before 37 weeks of pregnancy. Premature babies are more likely to have health problems at birth and later in life.

Birth defects: These include heart defects and birth defects of the brain and spine called neural tube defects (NTDs). Birth defects change the shape or function of one or more parts of the body.

Having a very large baby (more than 9 pounds): Weighing this much makes your baby more likely to get hurt during labor and birth. You may need to have a cesarean birth (C-section) to keep your baby safe. Large babies are more likely to be obese or have diabetes later in life.

Miscarriage and stillbirth: Miscarriage is when a baby dies in the womb before 20 weeks of pregnancy. Stillbirth is the death of a baby in the womb after 20 weeks of pregnancy.

If you have diabetes, plan ahead so you’re as healthy as you can be before you get pregnant. Here’s what you can do:

  • Manage your diabetes even if you’re not planning to get pregnant. If you’re thinking about having a baby, get your diabetes under control 3 to 6 months before you start trying to get pregnant.
  • Use birth control until your diabetes is under control and you’re ready to get pregnant.
  • Take a multivitamin with 400 micrograms of folic acid in it every day. If you take it before pregnancy and during early pregnancy as part of healthy eating, it may help protect your baby from neural tube defects.
  • Tell your provider about any medicine you take to make sure it’s okay to take when you do get pregnant. Your provider may want to change some medicines before you get pregnant if they’re not safe for you and your baby.
  • Eat healthy foods and do something active every day.
  • Meet with medical specialists who can help you manage your diabetes and any complications that arise during pregnancy. These doctors include a perinatologist who treats women with high-risk pregnancies and an endocrinologist who treats women with diabetes and other health conditions.

If you have diabetes, your healthcare provider will want to see you often during pregnancy so he or she can monitor you and your baby closely to prevent problems or catch them before they get serious.

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