Pregnancy Tracker: 19 weeks
Size of the Baby: Weighs just over ½ pound
Biggest Obstacle: Figuring out my increased insulin needs!
The single most important factor to having a healthy pregnancy with preexisting diabetes is to P-L-A-N. Since many of your baby's vital organs are formed very early, it's crucial to have good blood glucose control during the first trimester and the three months prior to conception.
Each woman is different, and each person's diabetes has its own unique qualities, so it's important to discuss your specific healthcare concerns with a diabetes and pregnancy specialist before conceiving. However, for all diabetic mothers-to-be, there are many consistent factors to consider with your doctor. This list provides a general outline of the questions a diabetic woman may want to discuss with her doctor before conceiving.
1. What should my HbA1c level be and for how many months prior to conceiving?
Generally, around 6 percent is the HbA1c number doctors will want their patients to achieve for at least 3 months before giving the green light to try to get pregnant. Some doctors may want to see this level of control exhibited over a longer period of time. Early on in my pregnancy journey (about a year prior) an endocrinologist told me to get my A1c under 6.5%. However, my high risk OB, who specializes in diabetes during pregnancy, wanted me below 6%.
2. What should my pre-meal and postprandial blood sugar targets be?
The numbers I have been working with are:
Pre-meal: 60-90 mg/dl
Postprandial (1 hour): not above 140 mg/dl
Postprandial (2 hours): not above 120 mg/dl
Fasting: 90 mg/dl
Be sure to discuss any concerns you have about "hypoglycemia unawareness" with your doctor if you've experienced this condition. The target blood sugars for pregnant women (and those attempting to conceive) are quite low and may put some individuals at risk for severe hypoglycemic episodes.
3. Do I have any health concerns that we should address before I conceive? What risks do preexisting diabetes complications pose to my health and the health of my child?
These questions can only be answered by your doctor and require specialized treatment. Complications to your kidneys, eyes, and nerves are the most common for diabetics, and should be considered prior to conception.
4. What level of exercise should I perform during pregnancy?
If you have an established workout routine, you'll want to discuss how long you can continue at your current intensity. If you don't participate in regular activity, pregnancy is not the time to start extreme training; however, light exercise could be beneficial to controlling weight gain, managing blood sugars, and keeping fit for the strain on labor.
5. As a diabetic, must I have a cesarean delivery?
The rate of cesarean delivery in the general population has risen in the last few decades, and women with preexisting diabetes typically have c-sections at a higher rate than women with low-risk pregnancies. However, this does not have to be the case for you, and you should discuss this with your doctor. The most important aspect of delivery is whether you and your baby are healthy and happy, so you should consider all possibilities with your doctor.
6. Are there minerals and vitamins I need while attempting to conceive?
My prenatal vitamins include higher levels of folic acid, iron, calcium, and other minerals that aid in my own health and the health of my baby. Be sure to discuss the dosage amounts of these vitamins with your doctor, because they may differ for some people -- for example if you've had a history of anemia.
Published On: August 16, 2007