Health Library I Have Diabetes. Should I Get Pregnant Now?From Healthwise

You may want to have a say in this decision, or you may simply want to follow your doctor’s advice. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Key points in making your decision

Here are some things to consider if you have diabetes and are thinking about getting pregnant:

• Is your blood sugar in a normal or near-normal range? Women with diabetes who want to get pregnant should have blood sugar levels as close to normal as possible before they get pregnant. This lowers the chance of birth defects, miscarriage, and other problems. Check your blood sugar throughout the day to see if it is in a near-normal range. If not, consider using birth control until your blood sugar is in that range.
• Do you take pills to treat diabetes? Your doctor may have you switch to insulin or take a different pill before you get pregnant. If you are changing to insulin or a new pill, make sure that the medicine is controlling your blood sugar before you try to get pregnant.
• Do you take insulin? Talk to your doctor before you try to get pregnant to see if you need to change your dose or how you take it (such as through an insulin pump or as shots). If you figure out the right dose of insulin to take before you get pregnant, you are less likely to have problems with high and low blood sugar during your pregnancy.
• Do you take medicine to treat other problems? Talk to your doctor before you get pregnant to see if you need to stop or change your medicine.
• Do you have complications from diabetes, such as eye or kidney disease? If you do, being pregnant can make some of these problems worse. Also, high blood pressure can create problems for you and affect your baby's growth during pregnancy.
• Do you have other children? If so, how did the diabetes affect your pregnancy?
• Do you take a folic acid supplement? Taking a daily multivitamin or prenatal vitamin with folic acid reduces the chance of having a baby with a birth defect.

What should you do before you get pregnant when you have diabetes?

You can have a healthy pregnancy if your blood sugar is in a normal or near-normal range before you get pregnant and you don't have high blood pressure or problems from diabetes, such as kidney disease. Keeping your blood sugar at a normal level lowers your risk of birth defects, miscarriage, and other problems. Experts recommend keeping blood sugar levels as close to normal as possible—called tight control—for 3 to 6 months before you get pregnant. To do this, get plenty of exercise, eat healthy foods, lose weight if you need to, and take medicine if your doctor prescribes it.

For more information, see:

Planning for pregnancy when you have diabetes

What should you talk to your doctor about?

Medicines

It's important to let your doctor know if you are thinking about getting pregnant. If you take pills to treat your diabetes, your doctor may want to switch you to insulin or to a new pill before you get pregnant. And if you take insulin, your doctor may need to change the dose or how you take it, such as through an insulin pump or as shots. You also need to let your doctor know about any medicine you take to treat other health problems. He or she may have you stop or change your medicine before you get pregnant if you are taking any medicines that could harm your baby.

Screening

When you have diabetes, you need to see your doctor regularly to check for problems from the disease. It's especially important to do this before you get pregnant. Screening tests include:

• An eye exam to look for signs of retinopathy.
• Blood and urine tests to look for kidney damage.
• Blood pressure checks. High blood pressure can cause problems with the mother and the baby. When blood pressure is very high, the placenta may not work well and the doctor may need to deliver the baby early.
• Blood sugar level tests. Your doctor will talk to you about keeping your blood sugar in a normal or near-normal range at all times before and during your pregnancy.

What are the risks from getting pregnant when your diabetes is not controlled?

Uncontrolled diabetes increases the risk of problems for both the baby and the mother.

Risks for the baby include:

• Birth defects.
• Early (premature) birth.
• Jaundice.
• Low blood sugar.
• Larger-than-normal size at birth, which can cause shoulder and other problems in the infant.
• Smaller-than-normal size at birth caused by high blood pressure, kidney disease, or problems with the placenta.
• Death, although this is not common now that more women use insulin to control their blood sugar.

Risks for the mother include:

• Miscarriage.
• Kidney damage if creatinine levels are above 2.0 mg/dL.
• High blood pressure during pregnancy.
• Eye problems during pregnancy that may get better after the baby is born.

For more information, see the topics:

• Type 2 Diabetes: Living With the Disease
• Type 1 Diabetes: Living With the Disease

Your choices are:

• Try to get pregnant now.
• Don't try to get pregnant now.

The decision whether to try to get pregnant when you have diabetes takes into account your personal feelings and the medical facts.

These personal stories may help you make your decision.

Use this worksheet to help you make your decision. After completing it, you should have a better idea of how you feel about trying to get pregnant now. Discuss the worksheet with your doctor.

Circle the answer that best applies to you.

*NA=Not applicable

Use the following space to list any other important concerns you have about this decision.

What is your overall impression?

Your answers in the above worksheet are meant to give you a general idea of where you stand on this decision. You may have one overriding reason to try or not try to get pregnant now.

Check the box below that represents your overall impression about your decision.

Return to the topics:

• Type 1 Diabetes: Living With the Disease
• Type 2 Diabetes: Living With the Disease

Author:	Merrill Hayden	Last Updated: February 5, 2008
Medical Review:	Caroline S. Rhoads, MD - Internal Medicine Kirtly Jones, MD - Obstetrics and Gynecology
© 1995-2008 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. This information does not replace the advice of a doctor. Healthwise disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.