Women with type 1 diabetes can successfully conceive and have healthy children. However, they need to be especially careful to control their blood glucose levels and work closely with their doctor. Here is a list of plans to follow when a person with diabetes is pregnant.
Start preparing early
Before conception, you should start taking prenatal vitamins and make an appointment with your endocrinologist for preconception testing. Most birth defects occur within the first 4 weeks of pregnancy, and many women don’t even know they’re pregnant at that time,” said Dr. Florence Brown, an endocrinologist and co-director of the Joslin-Beth Israel Pregnancy Program in Boston, USA. Testing for glycated hemoglobin (HbA1c) levels is critical. “When HbA1c is below 6.5%, the risk of birth defects in children is not different from the general population,” Brown said.
However, it is worth noting that when HbA1c is elevated, the child’s risk of birth defects is elevated, as is the risk of preeclampsia (the risk of developing high blood pressure during pregnancy). Also, if there are complications such as retinopathy or kidney disease, your doctor may want to screen prophylactically for these problems before conception.
Tight control of blood glucose
When you are pregnant, you need to keep your blood glucose strictly within your target range: 60-99 mg/dl fasting and 100-130 mg/dl one hour after a meal. you need to eat fiber-rich foods, keep your intake of processed foods to a minimum, and planning three meals a day and three extra meals in advance should help.
Also, insulin must be given 10 minutes before a meal, rather than starting it after a meal, and the amount of insulin needed may vary dramatically. Your doctor or diabetes educator can provide guidance about insulin dosing.
Be alert for hypoglycemia
When blood glucose starts to gradually drop to dangerous levels, some warning signs may be noticed, such as dizziness or shaking. But when accustomed to keeping blood sugar tightly in the target range, the body loses its normal response to fluctuations in blood sugar levels, which means it may not know that blood sugar has dropped to dangerous levels, Brown said. The solution: more frequent blood glucose testing. If you still can’t detect a drop in blood glucose levels, you may need a continuous blood glucose monitor to warn you at the right time.
Get a regular prenatal visit
An ultrasound should be performed at the first prenatal visit, and a level 2 (i.e., deep) ultrasound should be performed later in pregnancy to check the baby’s spinal cord, heart, and other organs. Ultrasound is also performed in late pregnancy to determine fetal growth and development.
Consult your doctor
- Does my current medical condition allow for pregnancy? If not, what do I need to do to prepare for conception?
- Who should provide my obstetric care?
- How should I make insulin dosage adjustments during pregnancy? What should I do if I need extra help between tests?
- Should I stop or change any medications?
- How should I monitor my blood glucose during pregnancy?
- How should I monitor my blood glucose during pregnancy?