Diabetes is a disease caused by problems with insulin. Insulin helps glucose get from the blood into the body’s cells where it can be converted into energy. We often refer to pregnant women who had diabetes before they became pregnant as having a “combined diabetes pregnancy”. When our bodies do not make enough insulin or have difficulty with normal feedback regulation, our blood glucose has difficulty getting into our cells for energy and stays in the bloodstream. The result is an increase in the amount of glucose in the blood. Over time, high levels of glucose can cause damage to the body and lead to serious health problems, such as cardiovascular disease, visual impairment and kidney disease. If a woman with diabetes has poor blood sugar control prior to pregnancy, she is at increased risk for diabetes-related problems. The risk of certain complications is also increased. For example: birth defects in the baby, hypertension, excess amniotic fluid (which can trigger preterm delivery), and giant babies (which can make delivery more difficult and cesarean delivery more likely). If the mother’s blood sugar is poorly controlled during pregnancy, then the baby may have respiratory distress, hypoglycemia, and jaundice. Of course most babies will be born healthy, but a small number will require special hospital care. For the prevention of this condition, pregnant women can reduce the risk of associated problems through proper preconception prenatal planning and controlling the level of diabetes. For women with diabetes, it is best to get advice from a doctor before pregnancy and to give a truthful and detailed account of the condition. Because it is important to control blood sugar levels before pregnancy, certain organs of the baby develop in the first 8 weeks of pregnancy and high blood sugar can cause defects during this period, but the pregnant woman does not even know she is pregnant until the 8th week of pregnancy. The control of blood sugar is usually for medication, diet and improvement of exercise. During pregnancy, women with a combined diabetic pregnancy should have more frequent prenatal checkups, manage their diet and exercise appropriately. Monitoring of blood glucose is especially important. Of course, medications may also be used to control blood sugar. The glycosylated hemoglobin test will help us understand our blood glucose control over the past 4-6 weeks and can track our blood glucose control in some ways. During pregnancy, people with diabetes sometimes experience hypoglycemia. Sometimes this is due to not having enough energy intake, such as not eating a particular meal or not eating on time, or because of too much exercise. If a pregnant woman has symptoms of hypoglycemia, such as dizziness, shaking, sudden hunger, sweating, weakness, etc., it is important to tell her family and seek medical attention. A good, healthy, balanced diet is an important part of self-management for pregnant women during pregnancy. The growth and development of the baby is dependent on what the pregnant woman eats. For women with diabetes, diet is even more important. Not thinking about eating or not eating properly may lead to high and low blood sugar levels. Exercise is an effective measure to keep blood sugar levels within the normal range and has many benefits, including weight control, increased energy, sleep, reduced back pain, and reduced bloating and constipation. Medication-wise, insulin is not known to affect the fetus, which means it does not cause birth defects. If insulin was already used before pregnancy, then the amount of insulin used may increase during pregnancy. It may even be changed from oral to subcutaneous injections. Diabetes can have an impact on labor and delivery. Generally women with combined diabetes pregnancies go into labor earlier than their due date. After labor, it is very important to monitor blood glucose levels, even once an hour. If necessary, intravenous insulin will be given. If the pregnant woman is using an insulin pump, she can continue using it during labor. For breastfeeding, a mother with diabetes does not have to worry about the quality of her breast milk. On the contrary, breast milk is very good nutrition for the baby. Moreover, breastfeeding will help the mother’s body to recover, the uterus to rejuvenate, and the weight loss during pregnancy gain.