Preparing for Pregnancy: Managing Diabetes Before Conception

I’ve always known that experiencing pregnancy was something I deeply desired, but I also understood that it would require significant mental and physical preparation. I would be lying if I didn’t admit to questioning whether I was doing enough to prepare my body for pregnancy or if having diabetes would hinder my ability to get pregnant and, if successful, carry a healthy baby to full term.

While I know I'm not the first woman with type 1 diabetes to conceive and deliver a healthy baby, the fears were firmly lodged in my mind. Googling “type 1 diabetes and pregnancy” led down a daunting path of information. Thankfully, I had a supportive and knowledgeable medical team behind me, including my OBGYN and diabetes management teams, who were experienced in managing pregnancy alongside diabetes.  

Given the awareness and the fears that occupied my thoughts, I was fully committed and prepared to take on whatever challenges lie ahead.

Maintaining good blood sugar levels and staying on top of diabetes management is crucial on any given day, but especially during pregnancy. Achieving optimal blood sugar levels before conception was critically important for several reasons, including:

• Planning and preparation – Attaining good control and finding comfort in managing my diabetes with tighter control was a gradual journey that required time. I prioritized time to work with my diabetes management team and make necessary adjustments, which helped to ease my mind as I prepared for pregnancy.
  

• Ensuring a healthy start – Establishing good control before conceiving set the stage for a healthier pregnancy and a better beginning for the baby's life.
  

• Reducing the risk of complications during pregnancy – Poorly controlled blood sugar levels increase the risk of complications during pregnancy, including miscarriage, pre-eclampsia, preterm birth, still birth, and birth defects. While these complications can happen regardless of blood sugar levels, I wanted to take proactive steps to minimize any potential risks to my baby by achieving better control of my diabetes.
  

• Promoting fetal development – High blood sugar levels can negatively impact fetal development, leading to problems with the baby’s heart, brain, spine, and other organs. I wanted to ensure my baby wasn’t already at risk due to my blood sugar levels at the start of pregnancy, so achieving control beforehand was crucial!  
  

• Minimizing maternal health risks – The complications associated with diabetes can worsen during pregnancy, including vision and kidney problems, high blood pressure, heart disease, hypoglycemia (low blood sugars), hyperglycemia (high blood sugars) diabetic ketoacidosis (a serious complication of diabetes), and an increased risk of infections such as UTIs or yeast infections. Achieving better control before conceiving, reduces the likelihood of encountering these complications, although it does not guarantee that they won’t occur. Improving my control before getting pregnant also contributed to enhancing my overall well-being, which better prepared me to manage the physical and emotional challenges of pregnancy alongside diabetes.

As a seasoned diabetic with over 15 years of experience, I generally maintained good control over my diabetes before even considering pregnancy. My A1C was typically below 6, although I did have occasional days of poor control. Nevertheless, I was managing well before contemplating the addition of a baby into my life. However, the rigorous control demanded before and during pregnancy was unparalleled.

I entered this journey fully aware that despite all my preparation, there were no guarantees. Living with diabetes, I knew that unexpected challenges could arise at any moment, and I certainly faced my fair share during pregnancy. Establishing a healthy and safe environment for my baby's growth and development was key from the onset. Before and throughout my pregnancy, I remained committed to doing everything possible to ensure a healthy delivery.

I am incredibly proud of myself for succeeding and for delivery a happy, healthy baby!