As the incidence of diabetes continues to increase, the incidence of combined type 1 or type 2 diabetes in pregnancy is on the rise. The effects of pre-pregnancy diabetes on the mother and child are serious, and the extent of the effects is very closely related to the condition of diabetes and the control of blood glucose after pregnancy. High blood sugar before and early in pregnancy can easily affect embryonic cells and fetal development, leading to an increase in the occurrence of fetal malformations, especially during the first to eighth weeks of pregnancy, when elevated blood sugar can easily lead to serious fetal malformations, fetal abortion and spontaneous abortion. The rising blood sugar of pregnant women in the middle and late stages of pregnancy will lead to the accumulation of islet cells in the developing fetus, thus inducing fetal hyperinsulinemia, excessive fetal growth and the formation of giant babies, and increasing the chance of obesity and diabetes in adulthood after birth. At the same time, the chance of complications such as hypertension, infection and ketoacidosis increases significantly in diabetic patients with unsatisfactory glycemic control. Therefore, the glycemic management of pre-pregnancy diabetic patients should be strengthened to maintain normal blood glucose before and during pregnancy, so as to ensure that those with diabetes can successfully pass through pregnancy to obtain a healthy fetus. To ensure that people with diabetes can have a healthy baby without aggravating their own condition and by following the treatment plan designed for you by your doctor, most women with gestational diabetes can successfully manage their condition to have a healthy pregnancy. To achieve this goal the following should be taken into account: What should I do before pregnancy if I have diabetes? If you have diabetes before pregnancy, you should first plan your pregnancy and see an endocrinologist and an experienced obstetrician before planning your pregnancy for blood glucose and glycosylated hemoglobin (HbA1c) testing, fundus examination, urine microalbumin testing and renal function tests, and for diabetes grading, so that your doctor can assess whether you are fit to become pregnant and the timing of your pregnancy, and whether you need special treatment before pregnancy. If diabetes mellitus with proliferative retinopathy requires laser treatment before pregnancy can occur. Diabetes mellitus with severe nephropathy is not suitable for pregnancy if there is already a large amount of proteinuria, reduced kidney function or severe hypertension. Blood glucose should be closely monitored before pregnancy to ensure that it is close to normal before pregnancy. If blood glucose is greater than normal, actively control it to the normal range. At the same time, it is recommended to change from oral hypoglycemic drugs to insulin before pregnancy. Women with pre-pregnancy diabetes have a serious impact on the mother and child after pregnancy, and the degree of impact is very closely related to the condition of diabetes and the control of blood glucose after pregnancy. Pre-pregnancy diabetic patients should preferably consider the issue of childbirth when the disease is in remission, blood sugar is maintained at normal levels and there are no clinical symptoms. In addition, oral folic acid or multivitamins containing folic acid should be taken before and during early pregnancy to reduce the occurrence of fetal malformations. What is the standard of blood sugar control before pregnancy? Pre-meal glucose: 70-105mg/dl (3.9-5.8mmol/L), 2 hours post-meal glucose <140mg/dl (5.0-7.8mmol/L). No severe hypoglycemia or nocturnal hypoglycemia. HbA1c target within normal range (<6%), or as close to normal as possible (<7%). What should I do if my blood sugar is high before and during pregnancy? If the blood sugar is high before pregnancy, contraception should be continued and the blood sugar should be controlled normally before planning pregnancy. Many studies have shown that:Among the many oral hypoglycemic drugs, the dimethyldiphenhydramine class does not increase the incidence of fetal malformation belongs to FDA, class B. It is safe to apply in early pregnancy, but the long-term safety of applying this class of drugs in middle and late pregnancy lacks evaluation and is not recommended for routine application. Those who apply other oral hypoglycemic drugs for treatment before pregnancy should stop using oral hypoglycemic drugs and switch to insulin for blood glucose control. The management of blood glucose during pregnancy is the same as that of gestational diabetes, and the principles of treatment include: reasonable diet, appropriate exercise and insulin. Of course, type 1 diabetic patients with high blood glucose fluctuations during pregnancy are prone to hypoglycemia and ketoacidosis, and exercise is not recommended to control blood glucose. In addition, blood glucose should be closely monitored after pregnancy under the guidance of clinicians to prevent the occurrence of hypoglycemia. Maternal and child monitoring during pregnancy Blood glucose macrospectrum at least once a week, i.e., 7 times/day blood glucose monitoring; before and after three meals and at bedtime. As gestational weeks progress, especially, after 20 weeks of gestation, insulin dosage may need to be increased due to the development of insulin resistance induced by pregnancy. Color ultrasonography around 22 weeks of gestation to rule out fetal anomalies. Intrauterine monitoring of the fetus needs to be intensified after 32 weeks of gestation to detect intrauterine hypoxia in time and to dynamically evaluate the rate of fetal growth and development. At the same time, breastfeeding is encouraged to reduce insulin use. Of course, insulin can be applied during breastfeeding but many oral hypoglycemic drugs are not suitable for breastfeeding patients.