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Women with Diabetes: Your Guide to Pregnancy

My Checkups

Pregnancy can make some diabetes-related health problems worse. Your health care provider can talk with you about how pregnancy might affect any problems you had since before pregnancy. If you plan your pregnancy enough in advance, you may want to work with your health care provider to arrange for treatments, such as laser treatment for eye problems, before you get pregnant. Your diabetes-related health conditions can also affect your pregnancy.

“I check my urine every morning for ketones. That’s one of the things I do to keep my baby and myself safe and healthy.”

Have a complete checkup before you get pregnant or at the start of your pregnancy. Your doctor should check for:

You’ll also get regular checkups throughout your pregnancy to check your blood pressure and average blood glucose levels and to monitor the protein in your urine.

Smoking

Smoking can increase your chance of having a stillborn or premature baby. Smoking is also especially harmful for people with diabetes. If you smoke, talk with your health care provider about how to quit.

My Meal Plan

If you don’t already see a dietitian, now would be an excellent time to start. Your dietitian can help you learn what to eat, how much to eat, and when to eat. Together, you’ll create a meal plan tailored to your needs, usual schedule, food preferences, medical conditions, medications, and physical fitness routine.

Many women need changes in their diet, such as extra calories and protein, during pregnancy. You might need to see your dietitian every few months during pregnancy as your needs change. Eating a well-balanced diet helps ensure that you and your baby are healthy.

How Much to Eat

“My dietitian helped me include my favorite foods in my meal plan.”

Talk with your dietitian about how many servings to have at each meal and snack. Your dietitian can also provide advice about portion sizes. Your meal plan will be based on how many calories you need for pregnancy and your goals for weight gain during the pregnancy. For most women whose weight is in the normal range before pregnancy, gaining 25 to 35 pounds is recommended. If you’re underweight or overweight at the start of your pregnancy, your weight goal may differ. For overweight women, the recommended weight gain is no more than 15 pounds.

“Eating small meals and snacks throughout the day helps keep my blood glucose under control.”

Vitamin and Mineral Supplements

Your health care team will tell you whether you need to take a vitamin and mineral supplement before and during pregnancy. Many pregnant women need supplements because their diets don’t supply enough of the following important vitamins and minerals:

  • iron—to help make extra blood for pregnancy and for the baby’s supply of iron
  • folic acid—to prevent birth defects in the brain and spinal cord
  • calcium—to build strong bones

Alcoholic Beverages

You should avoid alcoholic beverages while you’re trying to get pregnant and throughout pregnancy. When you drink, the alcohol also goes to your baby. Alcohol can lead to serious, lifelong problems for your baby.

You can keep track of what you eat and drink using My Daily Food Record. Your food records can help you and your health care team see whether your diabetes care plan is working.

Artificial Sweeteners

Artificial sweeteners can be used in moderate amounts. If you choose to use sweeteners, talk with your dietitian about how much to have.

My Physical Activity Routine

Daily physical activity can help you reach your target blood glucose levels. It can also help you reach your blood pressure and cholesterol target levels, relieve stress, improve muscle tone, strengthen your heart and bones, and keep your joints flexible. Talk with your health care team about moderate physical activity, such as walking or swimming. Consider whether you have any health problems and which exercises would be best for you. Your health care team may advise you to avoid exercises that increase your risk of falling, such as downhill skiing.

A sensible goal for most women is to aim for 30 minutes or more of activity, most days of the week. If you’ve been active before pregnancy, you may be able to continue with a more moderate version of your usual exercise routine. But if you haven’t been active, start with an activity such as walking. Vigorous physical activity, such as walking briskly, can lead to low blood glucose. Pregnant women sometimes do not have the typical signs of low blood glucose.

“I wasn’t very active before I got pregnant. But my doctor said that walking every day would be safe and good for me and my baby.”

My Medications

Medications for Diabetes

During pregnancy, the safest diabetes medication is insulin. Your health care team will work with you to make a personalized plan for your insulin routine. If you’ve been taking diabetes pills to control your blood glucose levels, you’ll need to stop taking them. Researchers have not yet determined whether diabetes pills are safe for use throughout pregnancy. Instead, your health care team will show you how to take insulin.

If you’re already taking insulin, you might need a change in the kind, the amount, and how or when you take it. The amount of insulin you take is likely to increase as you go through pregnancy because your body becomes less able to respond to the action of insulin, a condition called insulin resistance. Your insulin needs may double or even triple as you get closer to your delivery date. Insulin can be taken in several ways. Your health care team can help you decide which way is best for you.

Other Medications

Some medications are not safe during pregnancy and should be discontinued before you get pregnant. Tell your health care provider about all the medications you currently take, such as those for high cholesterol and high blood pressure. Your provider can tell you which medications to stop taking.

Changes in My Daily Routine

Sick Days

When you’re ill, your blood glucose levels can rise rapidly. Diabetic ketoacidosis, a dangerous condition for you and your baby, can occur. Talk with your health care team about what you should do if you get sick. Be sure you know

  • what to do if you’re nauseated or vomiting
  • how often you should check your blood glucose
  • how often you should check your urine or blood for ketones
  • when you should call your health care provider

Being Away from Home

When you’re away from home—for several hours or for a longer trip—you’ll want to be prepared for problems. Make sure you always have the following with you:

“When I’m not feeling well, I check my blood glucose more often than usual. I know that being sick can make my blood glucose level go too high.”

  • a snack or a meal
  • food or drinks to treat low blood glucose
  • your diabetes medicines and supplies
  • your blood glucose meter and supplies
  • your glucagon kit
  • your health care team’s phone numbers for emergencies

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