Women with type 1 diabetes during pregnancy can be very detrimental to both mother and baby. Pregnancy itself increases the risk of complications from type 1 diabetes and may also increase the risk of adverse pregnancy outcomes, which can cause miscarriage, congenital malformations, pre-eclampsia, and may even affect the health of the child.
Women in pregnancy are also treated slightly differently, with more stringent glucose control goals during pregnancy compared to the general patient population. In general, blood glucose targets are 3.3 to 5.3 millimoles per liter (mmol/L) fasting, <7.8 millimoles per liter (mmol/L) 1 hour postprandial, <6.7 millimoles per liter (mmol/L) 2 hours postprandial, and glycated hemoglobin control of about 6%. The most important thing to keep in mind during pregnancy is blood glucose monitoring. The recommended frequency of monitoring is 4-7 times/day, including fingertip end blood glucose on fasting, 30 minutes before and 1 or 2 hours after three meals, and adjusting insulin dose according to blood glucose monitoring results.
The only treatment option available during pregnancy is insulin, and short- and intermediate-acting human insulin therapy is usually recommended because these insulins are structurally similar to human, have minimal placental passage, are not teratogenic, and are safe for use during pregnancy.
Overall, it may be a better option for women with type 1 diabetes to consider pregnancy after thorough and thoughtful communication with their physician prior to pregnancy.