March of Dimes
Preexisting Diabetes
 
What you need to know:
About 1 in 100 women of childbearing age has diabetes before pregnancy. Pregnancy is considered risky for women with diabetes because of the increased risk of miscarriage, stillbirth and birth defects in their babies. However, with good preconceptional care and careful monitoring of their blood sugar, most women with preexisting diabetes can look forward to healthy pregnancies and healthy babies.


What you can do:
It is important for women with preexisting diabetes to see a health care provider before trying to get pregnant and to establish good blood sugar control before and during pregnancy. This will reduce the risk of birth defects in the baby. Women who take oral medications to control blood sugar will need to switch to insulin before conceiving and during pregnancy. Women with preexisting diabetes should also talk to their health care provider about taking a multivitamin and folic acid before conception and during early pregnancy, to help prevent serious birth defects of the brain and spinal cord.
 
 

Having a Healthy Pregnancy with Diabetes

Pregnancy is considered risky for the 1.85 million U.S. women of childbearing age who have diabetes. But women with preexisting diabetes are almost as likely as women without the disorder to have a healthy baby—as long as their blood sugar levels remain normal before and throughout pregnancy.

Women with poorly controlled diabetes in the early weeks of pregnancy are two to four times more likely than women without diabetes to have a baby with a serious birth defect, such as a heart defect or a neural tube defect. They also have an increased risk of miscarriage and stillbirth as well as increased risk of having a very large baby (10 pounds or more), which makes vaginal delivery more difficult and puts the baby at risk for injuries during birth.

If you have diabetes and you want to have a baby, you should see your doctor before you plan to conceive and establish good blood sugar control. If you have good blood sugar control around the time of conception, your risk of having a baby with a birth defect is nearly the same as that of women without diabetes.

If you take oral medications to control your diabetes, you'll need to use insulin instead, both before and during pregnancy, as these oral medications may cause birth defects. You should take a multivitamin. Your doctor also may increase your daily dosage of folic acid above the recommended 400 micrograms that all women planning pregnancy should take to help reduce the risk of birth defects.

You'll need frequent prenatal visits to adjust your diet and insulin as pregnancy progresses, and you'll need to check your blood sugar levels at home several times a day. To learn more, contact the American Diabetes Association at 1-800-DIABETES or www.diabetes.org.
  
  © 2008 March of Dimes Foundation. All rights reserved. The March of Dimes is a not-for-profit organization recognized as tax-exempt under Internal Revenue Code section 501(c)(3). Our mission is to improve the health of babies by preventing birth defects, premature birth, and infant mortality.