I am a diabetic and I want to have a baby, is it safe?

Women with diabetes shoud not be discouraged to have babies.

If you are planning to have a baby, it is critically important that you discuss your decision with your treating doctor.

You will also need to be followed up jointly by a doctor who looks after pregnant women and a doctor who treats diabetes

Planning for the woman with diabetes before pregnancy

Women with diabetes who are considering pregnancy are strongly urged to achieve excellent blood glucose control before conception.

Ideally, the blood glucose level should be monitored for three to six months before pregnancy. This is often achieved by switching to insulin.

Hyperglycemia (high glucose level in blood) can increase the risk of a miscarriage or of birth defects in the baby.

When women have maintained strict blood glucose control prior to conceiving and during the first trimester, the incidence of malformations is much lower than in women with diabetes who did not.

Insulin and Diabetes Pills

If you are taking diabetes pills to control your blood glucose, you may not be able to take them when you are pregnant.

Because the safety of using diabetes pills during pregnancy has not been established, your doctor will probably have you switch to insulin right away.

Aim for near-normal glucose levels

The most essential thing you must do is to get your blood glucose levels as close to normal as possible.

During the first three months of pregnancy, the baby is developing rapidly and this is the time during which malformations can occur if glucose levels are high.

The key to a healthy pregnancy for a woman with diabetes is keeping blood glucose (sugar) in the target range both before she is pregnant and during her pregnancy. To do this, you need a diabetes treatment plan that keeps meals, exercise, and insulin in balance.

This plan will change as you change with pregnancy. You will also need to check your blood glucose often and keep a record of your results. With your blood glucose in the target range and good medical care, your chances of a trouble-free pregnancy and a healthy baby are almost as good as they are for a woman without diabetes.

Good Prenatal Care

For the best prenatal care, have a team that includes:

- a doctor, trained to care for people with diabetes, who has cared for pregnant women with diabetes

- an obstetrician who handles high-risk pregnancies and has cared for other pregnant women with diabetes

- a pediatrician (children's doctor) or neonatologist (doctor for newborn babies) who knows and can treat special problems that can happen in babies of women with diabetes

- a registered dietitian who can change your meal plan as your needs change during and after pregnancy

- a diabetes educator who can help you manage your diabetes during pregnancy

Checking Your Blood Glucose

Blood checks will help you keep your blood glucose on target.

Check your blood glucose levels at the times your diabetes team advises; this may be up to eight tests daily and will probably include after-meal checks.

- Write down your results

- Keep notes on your meal plan and exercise

- Make changes in your meal plan and insulin only with the advice of your diabetes team

Pregnancy and Food

During pregnancy you and your dietitian or doctor may need to change your meal plan to avoid problems with low and high blood glucose levels.

This is the most important reason for keeping track of your blood glucose results.

Pregnancy and Exercise

Exercise, especially for people with type 2 diabetes, is a key part of diabetes treatment.

Just as you need to get your blood glucose under control before getting pregnant, it's best to get fit before you get pregnant.

Discuss your exercise plans with your diabetes team.

After your baby arrives, your body begins to recover from the hard work of pregnancy and delivery.

Some new mothers have better blood glucose control in the first few weeks after delivery. For many, it's a period of odd blood glucose swings. Not being able to predict how your body will act may leave you puzzled and upset.

Delivery

As your due date nears, your doctors will study your health and that of your growing baby. Then, you and the team will discuss the best time and method for delivery.

Your baby may be delivered vaginally or by Caesarean section: your obstetrician will decide what is safest for you and for your baby.

Breastfeeding

Breastfeeding is good for women with diabetes, but it may make your blood glucose a little harder to predict.

During the first weeks at home with baby, you are likely to be tired, stressed from lack of sleep, and off schedule. Odd sleep patterns increase the danger of napping through a snack or mealtime. Low blood glucose is a real danger.

It's important for your baby's safety to avoid blood glucose reactions that could confuse you. For all of the above reasons, it is important to check your blood glucose often during this time. And your records of your blood glucose levels will help you and your team adjust your insulin dose.

To help prevent low blood glucose levels due to breastfeeding:

- Plan to have a snack before or during nursing

- Drink enough fluids (plan to sip a glass of water or a caffeine-free drink while nursing)

- Keep something to treat low blood glucose nearby when you nurse, so you don't have to stop a feed to treat low blood glucose levels

Women who breastfeed use more calories. You will need to work with your doctor and dietitian to adjust your meal plan while you are nursing.

With baby's arrival, your focus turns to caring for your little one. But keep in mind that to take good care of your baby you need to take good care of yourself. Stick to your habits that helped you keep your blood glucose levels on target during pregnancy.