Preparing for Pregnancy With Type 1 Diabetes
Growing up with type 1 diabetes, my doctor always stressed the importance of planning ahead if I wanted to have a child. Pregnancy can be very joyful, but it can also be a time of anxiety, uncertainty, and stress—especially for women with type 1 diabetes, a chronic condition in which the body doesn’t produce insulin, a hormone that helps regulate glucose levels. High glucose levels can cause complications for both the mother and the baby during pregnancy, and that’s why it's crucial to plan a pregnancy in advance.1
As I continued living my life, I always kept my doctor’s advice and the planning aspect in the back of my mind. When it came time for my partner and I to start thinking about the future—and the potential of adding a little human to our lives—I had no shortage of questions about my diabetes and pregnancy: What should my hemoglobin A1c (the measurement of your average glucose level over a three-month period) be before conceiving and throughout pregnancy? What are the risks to the developing fetus if my glucose level goes too high or too low? What will I eat when all those pregnancy cravings hit? And that was just the tip of the iceberg!
If you also live with T1D, you can relate to the fact that no day is the same managing this 24/7 condition. Just when you think you have things under control, diabetes throws you a curve ball. Don’t let this deter you from planning a pregnancy, though.
Here are some things that were helpful on my journey if you’re thinking about becoming pregnant.
Depend on your healthcare team
Before conceiving, it's important to connect with your current diabetes healthcare team or assemble a new one. They’ll help you develop a plan for managing your diabetes leading up to conception and throughout pregnancy.
Perhaps you’re wondering who should be a part of this team? I found that having an endocrinologist as well as an obstetrician, who specialized in high-risk pregnancies and type 1 diabetes, was very helpful. Before becoming pregnant, I would keep a list of questions to ask my endo at our regular appointments, so I’d have a better sense of what would make the journey a little smoother. I also had regular touch points with a dietician and diabetes nurse educator because my insulin dosages and food intake were constantly changing. Someone else to consider is a therapist as you’ll probably feel overwhelmed at times and it can be really cathartic to vent.
I quickly learned that it takes a village to prepare for a pregnancy with T1D, and you’ll feel more confident with these professionals by your side. They’ve helped several other women successfully manage their pregnancies and deliver their little bundles of joy safely. They’re here to help you, too.
Dial in your glucose levels
Glucose levels can fluctuate a lot during pregnancy2 due to hormones—trust me! It’s important to keep an eye on them before conception to reduce the risk of complications for the developing fetus.3 I learned that a baby’s major organs develop during the first trimester4, so I kept a close eye on my glucose levels and went for bloodwork regularly. My ideal A1c target was below 6.0%. Connect with your diabetes team to decide what’s best for you.
Your healthcare team may recommend technology that can help you better achieve your targets, for example a continuous glucose monitor (CGM) and an insulin pump, if you’re not already using one. For me, Omnipod DASH®, my tubeless insulin pump, was a game-changer. I loved how easy it was to tweak my basal rates, insulin to carb ratios and insulin sensitivity factor—all of which were constantly changing in pregnancy! Using the Dexcom CGM* made it easier to share my diabetes data with my healthcare teams so we could make informed decisions together. I really couldn’t imagine my pregnancy without these two devices!
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Find ways to de-stress
With all the time and research that goes into planning a pregnancy with type 1 diabetes, you may feel overwhelmed. I definitely did, and I quickly discovered that I needed an outlet to keep my mind at ease. Although it’s important to prepare both emotionally and physically for the journey ahead, it’s also important to focus on YOU! Try to be kind to yourself along the way and remember that “perfection” doesn’t exist. Find something that you love to do—whether it’s going for a walk to a local coffee shop or going to a yoga class—and do it regularly to de-stress. It’ll help keep your mind, body and soul balanced and happy.
Many women living with type 1 diabetes—myself included—have had safe pregnancies and healthy babies. A bit of preconception planning will help make the process that much smoother. While managing T1D leading up to and throughout pregnancy may seem daunting, you have the power to do whatever you put your mind to!
2https://www.cdc.gov/diabetes/library/features/type-1-and-pregnancy.html
4https://www.jdrf.org/t1d-resources/living-with-t1d/pregnancy/