Family planning with preexisting diabetes
Many women living with diabetes, especially those who were diagnosed as young children, might have heard or even been told that they may not be able to have children one day, or if they did, extreme complications for themselves and the baby were likely. That however is the furthest thing from the truth! With the right planning, healthy, successful pregnancies are the norm rather than the exception. Just look at our growing group of Sugar Mommas!
First things first. When living with pre-existing diabetes, it is important to get your ducks lined up when planning your pregnancy. Check our our recommendations:
Set yourself up with a great medical team!
Who does this include?
Endocrinologist
Obstetrician (OB)
Diabetes and Pregnancy Team
Registered Dietician (RD)
Certified Diabetes Educator (CDE)
Perinatologist (A doctor specializing in high risk pregnancy)
Some hospitals have clinics specifically focused on diabetes and pregnancy and programs like Sweet Success in California. Find out if there is one near you!
Come prepared with questions!
Take charge of your healthcare. Talk to your partner or other significant persons in your life and develop a list so you are confidently prepared to maximize your appointment. As doctors can unfortunately be limited by time , be sure to prioritize your questions to ensure the big ones get answered. If you run out of time, ask if the medical office uses an online messaging system to get back to you on the others or if they can provide other printed or online resources ! If possible it's great to have your partner, spouse, or even a good friend come along to the appointment. This is a big journey you are about to embark on and it goes a long way to have a support system at home and among friends! Plus there will be a lot of information coming your way and an extra set of ears will definitely come in handy.
Suggested questions include:
What should my A1C be preconception?
How long should I be under control before I try to conceive?
What are my blood pressure goals?
Are there any blood tests that I should have done before getting pregnant?
Who will be helping with insulin dose adjustments—OB team or Endocrinologist? How do these two communicate?
What should my blood glucose targets be before and after meals?
Speaking of meals—what about diet in pregnancy? Is there a certain amount of carbohydrates I should be targeting on a daily basis?
When should I contact my OB team following a positive pregnancy test?
Plan to have these common tests done!
Our Medical Advisory Board suggests the following common tests are completed during family planning stages. The results of these tests can offer your medical team important information to ensure your care is best tailored to your needs. Additionally, while these tests are likely familiar to you as a person with pre-existing diabetes, the ranges for targeted results differ for some during family planning and pregnancy as those ranges are associated with higher likelihood of positive outcomes and minimized risk.
Hemoglobin A1C
This blood test gives an understanding of the average blood glucose level for roughly the past three months. Preconception A1C is recommended to be less than 7.0%, and ideally should be aimed to be 6.5% or less, if possible to achieve without significant hypoglycemia (low blood glucose).
Urine microalbumin
Urine check for protein leakage. This test is to make sure your kidneys are in good function.
Thyroid (TSH / T4 Free)
These tests look at thyroid production. Pregnancy increases demand on thyroid production making it important to be in a healthy range preconception.
Schedule your eye exam
Be sure to schedule an eye exam preconception. If you have an underlying eye complication from diabetes, discuss risks and monitoring frequency during the pregnancy with your doctor.
Check your supplements
Folic Acid, a B vitamin, helps to form the neural tube in the early stages of pregnancy and can help to prevent certain birth defects. Ideally, you will want to be taking 400 micrograms a day of Folic Acid for 1-2 months prior to becoming pregnant. As such, the CDC recommends that all females of reproductive age proactively take this supplement. If you haven’t been taking Folic Acid and find out you are pregnant, be sure to start as soon as you can.
Check the box!
Are you thinking how helpful this article would be if it was translated to a checklist that you could print it off, fill in each item as you completed it, and customize it to your own journey? Hey, us too! Grab the free printable checklist to support you in your preconception planning.
