WHAT YOU NEED TO KNOW:

What do I need to know about diabetes and pregnancy? Plan your pregnancy so healthcare providers can help you have a healthy pregnancy and baby. Control your blood sugar levels before and during pregnancy to decrease your risk of health problems. Your healthcare provider may recommend A1c levels less than 6.5% before you get pregnant. During pregnancy, your A1c levels may need to be between 6 and 6.5%.

How can I manage my diabetes during pregnancy?

• Check your blood sugar level. You may need to test your blood sugar level at least 3 times each day. Ask your healthcare providers when and how often you should check your blood sugar. He will tell you what your blood sugar levels should be at different times throughout the day. He may want your blood sugar levels to be 60 mg/dL to 99 mg/dL before meals, at bedtime, and during the night. He may want them to be 100 mg/dL to 129 mg/dL after meals. Your healthcare provider can show you how to use a blood glucose meter to check your levels.
  
  
• Ask about medicines. Some medicines are not safe to take when you are trying to get pregnant or become pregnant. If you have type 2 diabetes and you take diabetes pills, you may need to stop taking them and start using insulin. Insulin is safe to use during pregnancy.
  
  
• Check your blood pressure often. High blood pressure can cause problems with your health and your pregnancy. Blood pressure readings are usually written as 2 numbers. Your systolic blood pressure (the first number) should be between 110 and 129. Your diastolic blood pressure (the second number) should be between 65 and 79.
  
  
• Maintain a healthy weight. The recommended weight gain for women who are overweight is 15 to 25 pounds. The recommended weight gain for women who are obese is 10 to 20 pounds. Your risk of problems such as high blood pressure and premature labor are higher if you are overweight.
  
  
• Do not drink alcohol. Alcohol is dangerous for your unborn baby. Alcohol can also increase your blood sugar levels and make your diabetes more difficult to manage. Ask your healthcare provider for information if you need help to quit drinking alcohol.
  
  
• Help prevent hypoglycemia. Your risk of hypoglycemia is higher during pregnancy because you may not feel the symptoms. This risk is highest during the first trimester. Eat regular meals and snacks to avoid hypoglycemia. Always keep glucose tablets with you in case your blood sugar level gets low. If you do not have glucose tablets, drink milk, juice, or regular soda. Tell your family about the symptoms of hypoglycemia so they can help you if you cannot help yourself. Ask your healthcare provider how to manage hypoglycemia.
  
  
• Help prevent diabetic ketoacidosis (DKA). This is a serious condition that can happen when your blood sugar level gets too high. Pregnancy increases your risk for DKA. The symptoms of DKA include stomach pain, nausea, vomiting, and confusion. Your healthcare provider may suggest that you test the levels of ketones in your urine when your blood sugar level is high. He may also ask you to check your ketones regularly if you are sick.

What do I need to know about nutrition and pregnancy? The amount of calories you need depends on your weight before you got pregnant. Your healthcare provider or dietitian will tell you how many calories you need each day. You may need more calories while you are pregnant. You may need fewer calories if you are overweight.

How much exercise do I need? Exercise can help you keep your blood sugar level steady. Exercise can also help you lose weight if you are overweight. Ask your healthcare provider how much exercise you should get each day. Ask what types of physical activity you can do safely while you are pregnant.

What can I do to have a healthy baby?

• Keep all appointments with your healthcare providers. They will help you manage your diabetes during pregnancy. You may need to see your healthcare provider every 1 to 2 weeks during the first and second trimesters of your pregnancy. As the end of your pregnancy gets closer, you may need to see your healthcare provider each week. During these exams, he may check your eyes, your A1c levels, and how you and your baby are doing.
  
  
• Take folic acid supplements. Start taking folic acid before you get pregnant and continue until you are at least 12 weeks pregnant. Folic acid decreases the risk that your baby will have birth defects. Ask your healthcare provider how much folic acid you should take.
  
  
• Do not smoke. Nicotine is harmful to your baby and makes it more difficult to manage your diabetes. Do not use e-cigarettes or smokeless tobacco in place of cigarettes or to help you quit. They still contain nicotine. Ask your healthcare provider for information if you currently smoke and need help quitting.

How will my diabetes be managed during and after delivery? Healthcare providers will check your blood sugar levels while you are in labor. They will give you insulin or glucose throughout your labor to keep your blood sugar at the right level. Do the following after delivery:

• Go to all follow-up appointments. Healthcare providers will continue to help you manage your diabetes after delivery. Talk with your healthcare provider about birth control options. It is important to prepare for the next pregnancy if you plan to have another child.
  
  
• Take your medicine as directed. If you have type 2 diabetes, you may be able to take your diabetes medicine again. If you have type 1 diabetes, the amount of insulin you need will decrease after you have your baby. There are certain medicines that you may not be able to take if you breastfeed. Ask your healthcare provider when and how often to test your blood sugar level. You may need to check at least 3 times each day.
  
  
• Help prevent hypoglycemia if you breastfeed. Your risk of hypoglycemia is higher if you breastfeed. Your dietitian will help you create a meal plan that works for you. Eat a snack before you breastfeed. Eat regular meals and snacks to keep your blood sugar level steady.

What are the risks of diabetes and pregnancy? You have an increased risk for high blood pressure, premature (early) labor, and miscarriage. A miscarriage is the loss of a fetus before 20 weeks of pregnancy. High blood sugar levels can increase your risk of having a large baby, a baby with birth defects, and stillbirth. Stillbirth is the loss of a fetus (unborn baby) after 20 weeks of pregnancy.

When should I seek immediate care?

• Your blood sugar level is over 200 mg/dL and you have stomach pain, nausea, vomiting, and confusion.
  
  

When should I contact my healthcare provider?

• You are shaky or dizzy.
  
  
• You are sweaty or have a headache.
  
  
• You have questions or concerns about your condition or care.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.