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Diabetes Health Centre
Pregnancy |
Pregnancy with Type 1 or Type 2 Diabetes
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It is important to have a complete check-up before a pregnancy - including an eye exam - to ensure you are in good health.
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This next section is for women who wish to become pregnant, or are already pregnant, and are living with type 1 or type 2 diabetes. Click here for information about gestational diabetes (diabetes that develops during pregnancy).
You can have a healthy baby if you have type 1 or type 2 diabetes. The key is to obtain optimal blood glucose levels before and during pregnancy. This will require more work on your part but every new mother we've talked to says it's worth it!
Planning with your doctor before you become pregnant is vital. Speak to your doctor about your plans at least 3 months before trying to conceive. A team approach is used at our Centre, where you can see a nurse and dietitian at each preconception visit. With the support of a team, the right formula for your healthy pregnancy will be developed.
Most women do not know that they are pregnant until approximately 5-6 weeks into the pregnancy. During this time the fetus' organs and spinal cord are developing and ideal blood glucose control is important to reduce the baby's risk for birth defects. Rates of spontaneous abortion and stillbirth are similar to women without diabetes but rise in women whose diabetes is poorly controlled. For these reasons, it is best to start working on the following goals about 3 months before conception:
- Achieve an A1C below 7 percent, and, if possible, below 6 percent.
This blood test determines your average blood glucose for the past 2-3 months. A1C levels above this are associated with increased risks of miscarriages and fetal abnormalities.
- Obtain an "ideal" blood glucose level
On a day-to-day basis, obtaining "ideal" blood glucose levels is your goal.
Your doctor or diabetes educator will work closely with you to help you
attain this goal. For most women, this means focusing more than ever on
their diabetes management to achieve a successful balance between insulin,
food and activity. You will need to start testing your blood glucose at
least 4 times a day.
- Have your eyes and kidneys checked
Your eyes and kidneys need to be assessed prior to, as well as during, pregnancy. Pregnancy can affect eye and kidney complications. Women with significant protein in the urine before pregnancy are at risk for high blood pressure during pregnancy.
- Have a medical exam
You need medical examinations by an endocrinologist (a diabetes specialist) prior to and during your pregnancy.
- Take a folic acid supplement
Take a folic acid supplement of 0.4-1mg daily prior to pregnancy to reduce the risk of a neural tube defect in the baby. This should be increased to 4mg daily if a neural tube defect occurred in a previous pregnancy, or if there is a family history of neural tube defects. A neural tube defect is an abnormality affecting the spinal column or the brain. Taking folic acid throughout your pregnancy may have other beneficial effects.
It is important to discuss this with your doctor beforehand.
- Take a prenatal multivitamin daily
If you are taking a multivitamin, limit your intake to one per day to avoid excess intake of vitamin A (less than 10,000 IU of vitamin A daily).
Again, your doctor will advise you on what is best for you.
- Switch to insulin if appropriate
If you have type 2 diabetes and take pills to control your diabetes, your doctor will suggest switching to insulin before you become pregnant.
Managing diabetes during pregnancy and after
Along with the joys of pregnancy, come some challenges that can affect the woman with diabetes at various times throughout her pregnancy. The following is some helpful information as it relates to each trimester (approximately each three-month time period) of your pregnancy. You can also learn more about the stages of pregnancy in our Pregnancy Health Centre
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