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!"so see#
$hat % nee& to kno' a(o)t *ating an& Dia(etes
$hat % nee& to kno' a(o)t Ph+sica" !ctivit+ an& Dia(etes
,+pog"+cemia
The Dia(etes Dictionar+ ,ome # Dia(etes !-. /ist of Topics an& Tit"es # For $omen
'ith Dia(etes# 0o)r 1)i&e to Pregnanc+

For Women
with
Diabetes:
Your Guide
to
Pregnancy
On this page:
%ntro&)ction
Taking 2are of 0o)r
Ba(+ an& 0o)rse"f
0o)r Dia(etes3 Before
an& D)ring 0o)r
Pregnanc+
2hecking 0o)r Ba(+4s
,ea"th D)ring
Pregnanc+
!(o)t /a(or an&
De"iver+
!fter 0o)r Ba(+
!rrives
For 5ore %nformation
5+ Dai"+ B"oo&

1")cose 6ecor&
5+ Dai"+ Foo& 6ecor&
5+ Dai"+ Ph+sica"
!ctivit+ 6ecor&
Introduction
0o) have t+pe 7 or t+pe 8
&ia(etes an& +o) are pregnant
or hoping to get pregnant soon9
0o) can "earn 'hat to &o to
have a hea"th+ (a(+9 0o) can
a"so "earn ho' to take care of
+o)rse"f an& +o)r &ia(etes
(efore3 &)ring3 an& after +o)r
pregnanc+9
For more information a(o)t
&ia(etes3 see Your Guide to
Diabetes: Type 1 and Type 23
'hich is a"so avai"a("e from the
Nationa" Dia(etes %nformation
2"earingho)se (ND%29 See
:$here can % get more
information a(o)t &ia(etes; for
contact information9
Pregnanc+ an& ne' motherhoo&
are times of great e<citement3
'orr+3 an& change for an+
'oman9 %f +o) have &ia(etes
an& are pregnant3 +o)r
pregnanc+ is a)tomatica""+
consi&ere& a high-risk
pregnanc+9 $omen carr+ing
t'ins=or more=or 'ho are
(e+on& a certain age are a"so
consi&ere& to have high-risk
pregnancies9 ,igh risk &oesn4t
mean +o)4"" have pro("ems9
%nstea&3 high risk means +o)
nee& to pa+ specia" attention to
+o)r hea"th an& +o) ma+ nee&
to see specia"i>e& &octors9
5i""ions of high-risk

pregnancies pro&)ce perfect"+
hea"th+ (a(ies 'itho)t the
mom4s hea"th (eing affecte&9
Specia" care an& attention are
the ke+s9
?Top@
Taking Care o Your !aby
and Yourse"
Keeping +o)r ("oo& g")cose as
c"ose to norma" as possi("e
(efore +o) get pregnant an&
&)ring +o)r pregnanc+ is the
most important thing +o) can
&o to sta+ hea"th+ an& have a
hea"th+ (a(+9 0o)r hea"th care
team can he"p +o) "earn ho' to
)se mea" p"anning3 ph+sica"
activit+3 an& me&ications to
reach +o)r ("oo& g")cose goa"s9
Together3 +o)4"" create a p"an
for taking care of +o)rse"f an&
+o)r &ia(etes9
Pregnanc+ ca)ses a n)m(er of
changes in +o)r (o&+3 so +o)
might nee& to make changes in
the 'a+s +o) manage +o)r
&ia(etes9 *ven if +o)4ve ha&
&ia(etes for +ears3 +o) ma+
nee& changes in +o)r mea" p"an3
ph+sica" activit+ ro)tine3 an&
me&ications9 %n a&&ition3 +o)r
nee&s might change as +o) get
c"oser to +o)r &e"iver+ &ate9

:% took goo& care of m+
&ia(etes (efore an& thro)gho)t
m+ pregnanc+9 !n& no' % have
a hea"th+ "itt"e gir"A;

#ow Diabetes Can $ect You
and Your !aby
,igh ("oo& g")cose "eve"s
(efore an& &)ring pregnanc+
can
'orsen +o)r "ong-term
&ia(etes comp"ications3
s)ch as vision pro("ems3
heart &isease3 an&
ki&ne+ &isease
increase the chance of
pro("ems for +o)r (a(+3
s)ch as (eing (orn too
ear"+3 'eighing too
m)ch or too "itt"e3 an&
having "o' ("oo&
g")cose or other hea"th
pro("ems at (irth
increase the risk of +o)r
(a(+ having (irth
&efects
increase the risk of
"osing +o)r (a(+
thro)gh miscarriage or
sti""(irth
,o'ever3 research has sho'n
that 'hen 'omen 'ith &ia(etes
keep ("oo& g")cose "eve"s )n&er
contro" (efore an& &)ring
pregnanc+3 the risk of (irth
&efects is a(o)t the same as in
(a(ies (orn to 'omen 'ho
&on4t have &ia(etes9

%f +o)r ("oo& g")cose "eve" is
too high3 then +o)r (a(+ a"so
gets too m)ch g")cose9
1")cose in a pregnant 'oman4s
("oo& passes thro)gh to the

(a(+9 %f +o)r ("oo& g")cose
"eve" is too high &)ring
pregnanc+3 so is +o)r (a(+4s
g")cose "eve" (efore (irth9
?Top@
Your Diabetes% !eore and
During Your
Pregnancy
!s +o) kno'3 in &ia(etes3 ("oo&
g")cose "eve"s are a(ove
norma"9 $hether +o) have t+pe
7 or t+pe 8 &ia(etes3 +o) can
manage +o)r ("oo& g")cose
"eve"s an& "o'er the risk of
hea"th pro("ems9
%f +o) have gestationa" &ia(etes3
see What I need to know about
Gestational Diabetes3 'hich is
a"so avai"a("e from the ND%29
See :$here can % get more
information a(o)t &ia(etes; for
contact information9
! (a(+4s (rain3 heart3 ki&ne+s3
an& ")ngs form &)ring the first B
'eeks of pregnanc+9 ,igh
("oo& g")cose "eve"s are
especia""+ harmf)" &)ring this
ear"+ part of pregnanc+9 0et
man+ 'omen &on4t rea"i>e
the+4re pregnant )nti" 5 or 6
'eeks after conception9 %&ea""+3
+o) 'i"" 'ork 'ith +o)r hea"th
care provi&er to get +o)r ("oo&
g")cose )n&er contro" (efore
+o) get pregnant9
%f +o)4re a"rea&+ pregnant3 see
+o)r hea"th care provi&er as

soon as possi("e to make a p"an
for taking care of +o)rse"f an&
+o)r (a(+9 *ven if +o) "earn
+o)4re pregnant "ater in +o)r
pregnanc+3 +o) can sti"" &o a "ot
for +o)r (a(+4s hea"th an& +o)r
o'n9
The check"ist (e"o' can he"p
+o) make a p"an for a safe an&
hea"th+ pregnanc+9 5ore
information on each topic then
fo""o's9 0o)r hea"th care team
can he"p +o) 'ith tasks that are
&iffic)"t for +o)9 Tack"e one
thing at a time to keep from
(eing over'he"me&9
&y Diabetes Care P"an or
Pregnancy
Things % can &o to get rea&+ for
a hea"th+ pregnanc+ an&
contin)e to &o &)ring m+
pregnanc+
P"anning $head
%4"" get m+ &ia(etes
)n&er contro" C to 6
months beore % tr+ to
get pregnant9
%f %4m a"rea&+ pregnant3
%4"" see m+ hea"th care
provi&er right a'a+9
&y #ea"th Care Team
%4"" make s)re % have the
right team of hea"th care
provi&ers9
%4"" meet 'ith mem(ers
of m+ team9

&y !"ood G"ucose 'e(e"s
%4"" set goa"s 'ith m+
hea"th care team for m+
&ai"+ ("oo& g")cose
"eve"s9
%4"" set a goa" 'ith m+
hea"th care team for m+
!72 test res)"t9
%4"" "earn ho' an& 'hen
to check m+ ("oo&
g")cose on m+ o'n9
%4"" "earn 'hat to &o if
m+ ("oo& g")cose is too
"o'9
%4"" make s)re m+ fami"+
or frien&s kno' ho' to
give me g")cagon for
"o' ("oo& g")cose9
%4"" "earn 'hat to &o if
m+ ("oo& g")cose is too
high9
&y )etone 'e(e"s
%4"" "earn ho' an& 'hen
to check m+ )rine or
("oo& for ketones9
%4"" "earn 'hat to &o if %
have ketones in m+
)rine or ("oo&9
&y Checkups
%4"" get the recommen&e&
check)ps an& "a(orator+ tests
for
("oo& press)re
e+e &isease
heart an& ("oo& vesse"
&isease
nervo)s s+stem &isease

ki&ne+ f)nction
th+roi& &isease
average ("oo& g")cose
"eve"=the !72 test
*moking
%f % smoke3 %4"" D)it9
&y &ea" P"an
%4"" see a &ietitian or
&ia(etes e&)cator a(o)t
'hat3 'hen3 an& ho'
m)ch to eat9
%4"" ask 'hether % nee&
vitamin an& minera"
s)pp"ements an& 'i""
take them as &irecte&9
%4"" skip a"coho"ic
(everages9
&y Physica" $cti(ity +outine
%4"" ta"k 'ith m+ hea"th
care team a(o)t 'hat
ph+sica" activities are
safe for me9
%4"" make a p"an 'ith m+
hea"th care team for
reg)"ar ph+sica" activit+9
&y &edications
%4"" ta"k 'ith m+ hea"th
care team a(o)t m+
&ia(etes me&ications=
'hat kin&s3 ho' m)ch3
ho' to take them3 an&
'hen to take them9
%4"" ta"k 'ith m+ hea"th
care team a(o)t m+
other me&ications=
'hat to keep taking an&

'hat to stop taking9
Changes in &y Dai"y +outine
%4"" make a p"an for
taking care of m+se"f
'hen %4m i""='hat to
&o a(o)t foo&3 ins)"in3
("oo& g")cose testing3
an& ketone testing9
%4"" make a p"an for 'hat
% nee& to have 'ith me
'hen %4m a'a+ from
home=for severa" ho)rs
or for a "onger trip9
P"anning !hea&
!eore +o) get pregnant3 ta"k
'ith +o)r hea"th care team
a(o)t +o)r 'ish to have a (a(+9
0o)r team can 'ork 'ith +o) to
make s)re +o)r ("oo& g")cose
"eve"s are on target9 %f +o) have
D)estions or 'orries3 (ring them
)p9 %f +o)4re a"rea&+ pregnant3
see +o)r &octor right a'a+9
5+ ,ea"th 2are Team
6eg)"ar visits 'ith hea"th care
provi&ers 'ho are e<perts in
&ia(etes an& pregnanc+ 'i""
ens)re +o) get the ver+ (est
care9 0o)r team ma+ inc")&e
a me&ica" &octor 'ho
specia"i>es in &ia(etes
care3 s)ch as an
en&ocrino"ogist or a
&ia(eto"ogist9 0o) 'i""
contin)e to nee&
monitoring an& a&vice
on g")cose contro"
thro)gho)t +o)r

pregnanc+ an& after9
an o(stetrician-
g+neco"ogist3 or
:EBF10N3; 'ho has
manage& pregnancies of
'omen 'ith &ia(etes9
!sk for a referra" if +o)r
c)rrent g+neco"ogist
&oes not a"so &e"iver
(a(ies3 as not a""
g+neco"ogists &o9 $hen
ca""ing aro)n& to fin& an
EBF10N3 ask a(o)t
e<perience 'ith 'omen
'ith &ia(etes9 5aterna"-
feta" me&icine
specia"ists3 a"so ca""e&
perinato"ogists3 have
specia" training to take
care of 'omen 'ith
high-risk pregnancies9
0o) 'i"" see +o)r
EBF10N reg)"ar"+
thro)gho)t +o)r
pregnanc+9

:%4m 'orking 'ith m+
hea"th care team to take
goo& care of m+se"f an&
m+ &ia(etes9 $e4re
&oing a"" 'e can to
make s)re % have a
hea"th+ (a(+ an& a safe
pregnanc+9 %t4s not
a"'a+s eas+3 ()t %4m so
motivate&A;
a n)rse e&)cator or
n)rse practitioner3 'ho
provi&es prenata" care
an& a&vice on managing
&ia(etes9
a registere& &ietitian to

he"p 'ith mea" p"anning9
! goo& &iet=for
g")cose contro" an&
n)trition=has never
(een more important
than no'9 The phrase
:0o)4re eating for t'o;
is not a(o)t D)antit+ as
m)ch as foo& choices9
specia"ists 'ho &iagnose
an& treat &ia(etes-
re"ate& comp"ications3
s)ch as
ophtha"mo"ogists an&
optometrists for vision
pro("ems3 nephro"ogists
for ki&ne+ &isease3 an&
car&io"ogists for heart
&isease9 %f +o) are
a"rea&+ e<periencing
comp"ications from
&ia(etes3 +o)4"" nee&
those con&itions
monitore& thro)gho)t
+o)r pregnanc+ as 'e""9
a socia" 'orker or
ps+cho"ogist to he"p +o)
cope 'ith stress3 'orr+3
an& the e<tra &eman&s
of pregnanc+9 0o) ma+
a"rea&+ have this kin& of
s)pport3 or +o) ma+
s)&&en"+ nee& it9 %f
an<iet+ mo)nts3 &o not
hesitate to mention +o)r
)neasiness to +o)r
EBF10N9 !sk for a
referra" if +o) nee& more
he"p 'orking thro)gh
iss)es9
a pe&iatrician=a &octor
'ho cares for chi"&ren9

0o) might 'ant to ask
frien&s3 fami"+3 or +o)r
hea"th care team for
recommen&ations9 5an+
pe&iatricians visit their
ne'est patients at the
hospita" soon after their
arriva"9
a neonato"ogist=a
&octor 'ho cares for
ne'(orn (a(ies9 The
hospita" 'i"" assign a
neonato"ogist if )rgent
care for +o)r (a(+ is
nee&e& at the hospita"9
You are the most important
mem(er of the team9 0o)r
hea"th care provi&ers can give
+o) e<pert a&vice9 B)t +o)4"" (e
responsi("e for the &a+-to-&a+
actions nee&e& to keep +o)r
&ia(etes )n&er contro"9
5+ B"oo& 1")cose /eve"s
Dai"y !"ood G"ucose 'e(e"s
0o)4"" check +o)r ("oo&
g")cose "eve"s )sing a ("oo&
g")cose meter severa" times a
&a+9 5ost hea"th care provi&ers
recommen& testing at "east fo)r
times a &a+9 !sk +o)r hea"th
care provi&er 'hen +o) sho)"&
check +o)r ("oo& g")cose "eve"s
an& check off the ans'ers )sing
the chart (e"o'9

:% check m+ ("oo& g")cose at
"east fo)r times a &a+9 The
res)"ts sho' 'hether % nee& to
change m+ mea" p"an or ins)"in

to keep m+ ("oo& g")cose on
target9;
% sho)"& check m+ ("oo&
g")cose "eve"s
fasting='hen % 'ake
)p3 (efore % eat or &rink
an+thing
(efore each mea"
7 ho)r after the start of a
mea"
8 ho)rs after the start of
a mea"
(efore (e&time
in the mi&&"e of the
night=for e<amp"e3 at 8
or C a9m9
The &ai"+ goa"s recommen&e&
(+ the !merican Dia(etes
!ssociation for most pregnant
'omen are sho'n (e"o'9 $rite
&o'n the goa"s +o) an& +o)r
hea"th care team have chosen9
Before mea"s an& 'hen +o) 'ake )pP"asma
B"oo& 1")cose
(mgF&/
8 ho)rs after the start of a mea"
Source# !merican Dia(etes
!ssociation9 Preconception care
of 'omen 'ith &ia(etes9
Diabetes Care9
8GGHI8J(S)pp"ement 7#SJ6K
JB9
See the chart (e"o' for goa"s
recommen&e& (+ the !merican
2o""ege of E(stetricians an&
1+neco"ogists9

When
Fasting
Before mea"s
7 ho)r after the start of a mea"
8 ho)rs after the start of a mea"
D)ring the night
Source# !merican 2o""ege of
E(stetricians an& 1+neco"ogists
(!2E1 2ommittee on Practice
B)""etins9 !2E1 Practice
B)""etin N)m(er 6G#
Pregestationa" &ia(etes me""it)s9
Obstetrics and Gynecoloy!
8GG5I7G5(C#6J5K6B59
0o) can keep track of +o)r
("oo& g")cose "eve"s )sing 5+
Dai"+ B"oo& 1")cose 6ecor&9
$rite &o'n the res)"ts ever+
time +o) check +o)r ("oo&
g")cose9 0o)r ("oo& g")cose
recor&s can he"p +o) an& +o)r
hea"th care team &eci&e 'hether
+o)r &ia(etes care p"an is
'orking9 0o) a"so can )se this
form to make notes a(o)t +o)r
ins)"in an& ketones9
The $,C Test
!nother 'a+ to see 'hether
+o)4re meeting +o)r goa"s is to
have an !72 ("oo& test9
6es)"ts of the !72 test sho'
+o)r average ("oo& g")cose
"eve"s &)ring the past 8 to C
months9 $rite the goa" +o) an&

+o)r hea"th care team have
chosen (e"o'9
1oa" for 5+ !72 Test
!merican 2o""ege of E(stetricians an&
1+neco"ogistsSo)rce of
6ecommen&ation
Target
-umbe
r
&y
Goa"
!merican Dia(etes !ssociation
H to
6
per
cen
t=
nor
ma"
*
or
/es
s
tha
n 7
per
cen
t
a(o
ve
the
)pp
er
"im
its
of
nor
ma"
*
No higher than 6 percent

Dia(etes ,ome L Dia(etes ! to . L %ntro&)ction L Treatments L 2omp"ications L Statistics L 2"inica" Tria"s L
ND*P L !'areness an& Prevention L !&&itiona" 6eso)rces L Er&er P)("ications L !(o)t Ms L %nformaciNn en
*spaOo"
2ontact Ms L ,ea"th %nformation
The ND%2 is a service of the Nationa" %nstit)te of Dia(etes an& Digestive an& Ki&ne+ Diseases3 Nationa"
%nstit)tes of ,ea"th9
Nationa" Dia(etes %nformation 2"earingho)se
7 %nformation $a+
Bethes&a3 5D 8GB98KC56G
Phone# 7KBGGKB6GKBJHJ
TT0# 7KB66K569K7768
Fa<# JGCKJCBKH989
*mai"# n&icPinfo9ni&&k9nih9gov
Privac+ L Disc"aimer L !ccessi(i"it+ L PDF versions reD)ire the free !cro(atQ 6ea&erQ
soft'are for vie'ing9
*
Norma" va")es var+ accor&ing to "a(orator+I check 'ith +o)r &octor9
'ow !"ood G"ucose
$hen +o)4re pregnant3 +o)4re at increase& risk of having "o' ("oo& g")cose3 a"so ca""e&
h+pog"+cemia9 $hen ("oo& g")cose "eve"s are too "o'3 +o)r (o&+ can4t get the energ+ it
nee&s9 Ms)a""+ h+pog"+cemia is mi"& an& can easi"+ (e treate& (+ eating or &rinking
something 'ith car(oh+&rate9 B)t "eft )ntreate&3 h+pog"+cemia can make +o) pass o)t9
For more information a(o)t "o' ("oo& g")cose3 see "ypolyce#ia3 'hich is a"so
avai"a("e from the ND%29 See :$here can % get more information a(o)t &ia(etes; for
contact information9
!"tho)gh h+pog"+cemia can happen s)&&en"+3 it can )s)a""+ (e treate& D)ick"+3 (ringing
+o)r ("oo& g")cose "eve" (ack to norma"9 /o' ("oo& g")cose can (e ca)se& (+
mea"s or snacks that are too sma""3 &e"a+e&3 or skippe&
&oses of ins)"in that are too high
increase& activit+ or e<ercise
/o' ("oo& g")cose a"so can (e ca)se& (+ &rinking too m)ch a"coho"9 ,o'ever3
'omen 'ho are tr+ing to get pregnant or 'ho are a"rea&+ pregnant sho)"& avoi&
a"" a"coho"ic (everages9

:% keep a (o< of crackers on m+ (e&si&e ta("e9 %f % have "o' ("oo& g")cose &)ring
the night3 % eat some crackers right a'a+ to (ring m+ ("oo& g")cose (ack )p to
norma"9;
.sing G"ucagon or *e(ere 'ow !"ood G"ucose
%f +o) have severe "o' ("oo& g")cose an& pass o)t3 +o)4"" nee& he"p to (ring +o)r
("oo& g")cose "eve" (ack to norma"9 0o)r hea"th care team can teach +o)r fami"+
mem(ers an& frien&s ho' to give +o) an inRection of g")cagon3 a hormone that
raises ("oo& g")cose "eve"s right a'a+9
#igh !"ood G"ucose
,igh ("oo& g")cose3 a"so ca""e& h+perg"+cemia3 can happen 'hen +o) &on4t have
eno)gh ins)"in or 'hen +o)r (o&+ isn4t a("e to )se ins)"in correct"+9 ,igh ("oo&
g")cose can res)"t from
a mismatch (et'een foo& an& me&ication
eating more foo& than )s)a"
(eing "ess active than )s)a"
i""ness
stress
%n a&&ition3 if +o)r ("oo& g")cose "eve" is a"rea&+ high3 ph+sica" activit+ can make
it go even higher9 S+mptoms of high ("oo& g")cose inc")&e
freD)ent )rination
thirst
'eight "oss
Ta"k 'ith +o)r hea"th care provi&er a(o)t 'hat to &o 'hen +o)r ("oo& g")cose is
too high='hether it happens once in a 'hi"e or at the same time ever+ &a+ for
severa" &a+s in a ro'9 0o)r provi&er might s)ggest a change in +o)r ins)"in3 mea"
p"an3 or ph+sica" activit+ ro)tine9
5+ Ketone /eve"s
$hen +o)r ("oo& g")cose is too high or if +o)4re not eating eno)gh3 +o)r (o&+ might
make chemica"s ca""e& ketones9 Ketones are pro&)ce& 'hen +o)r (o&+ &oesn4t have
eno)gh ins)"in an& g")cose can4t (e )se& for energ+9 Then the (o&+ )ses fat instea& of
g")cose for energ+9 B)rning fat instea& of g")cose can (e harmf)" to +o)r hea"th an& +o)r
(a(+4s hea"th9 ,armf)" ketones can pass from +o) to +o)r (a(+9 0o)r hea"th care
provi&er can teach +o) ho' an& 'hen to test +o)r )rine or ("oo& for ketones9
%f ketones ()i"& )p in +o)r (o&+3 +o) can &eve"op a con&ition ca""e& ketosis9 Ketosis can
D)ick"+ t)rn into &ia(etic ketoaci&osis3 'hich can (e ver+ &angero)s9 S+mptoms of
ketoaci&osis are
stomach pain
freD)ent )rination or freD)ent thirst3 for a &a+ or more
fatig)e
na)sea an& vomiting
m)sc"e stiffness or aching
fee"ing &a>e& or in shock
rapi& &eep (reathing
(reath that sme""s fr)it+
Checking Your .rine or !"ood )etone 'e(e"s
0o)r hea"th care provi&er might recommen& +o) test +o)r )rine or ("oo& &ai"+ for
ketones an& a"so 'hen +o)r ("oo& g")cose is high3 s)ch as higher than 8GG mgF&/9
0o) can prevent serio)s hea"th pro("ems (+ checking for ketones as
recommen&e&9 !sk +o)r hea"th care team a(o)t 'hen to check for ketones an&
'hat to &o if +o) have them9 Then check off the instr)ctions (e"o' an& fi"" in the
("anks9
% sho)"& test m+ )rine or ("oo& for ketones
ever+ &a+ (efore (reakfast
'hen %4m sick
'hen m+ ("oo& g")cose is SSSSSSSSSSSSS or higher
other times# SSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSSS
%f +o) )se an ins)"in inf)sion p)mp3 +o)r hea"th care provi&er might a"so
recommen& that +o) test for ketones 'hen +o)r ("oo& g")cose "eve" is
)ne<pecte&"+ high9
0o)r hea"th care provi&er might teach +o) ho' to make changes in the amo)nt of
ins)"in +o) take or 'hen +o) take it9 Er +o)r provi&er ma+ prefer that +o) ca"" for
a&vice 'hen +o) have ketones9
5+ 2heck)ps
Pregnanc+ can make some &ia(etes-re"ate& hea"th pro("ems 'orse9 0o)r hea"th care
provi&er can ta"k 'ith +o) a(o)t ho' pregnanc+ might affect an+ pro("ems +o) ha& since
(efore pregnanc+9 %f +o) p"an +o)r pregnanc+ eno)gh in a&vance3 +o) ma+ 'ant to 'ork
'ith +o)r hea"th care provi&er to arrange for treatments3 s)ch as "aser treatment for e+e
pro("ems3 (efore +o) get pregnant9 0o)r &ia(etes-re"ate& hea"th con&itions can a"so
affect +o)r pregnanc+9

:% check m+ )rine ever+ morning for ketones9 That4s one of the things % &o to keep m+
(a(+ an& m+se"f safe an& hea"th+9;
,ave a comp"ete check)p (efore +o) get pregnant or at the start of +o)r pregnanc+9 0o)r
&octor sho)"& check for
high ("oo& press)re3 a"so ca""e& h+pertension
e+e &isease3 a"so ca""e& &ia(etic retinopath+
heart an& ("oo& vesse" &isease3 a"so ca""e& car&iovasc)"ar &isease
nerve &amage3 a"so ca""e& &ia(etic ne)ropath+
ki&ne+ &isease3 a"so ca""e& &ia(etic nephropath+
th+roi& &isease
0o)4"" a"so get reg)"ar check)ps thro)gho)t +o)r pregnanc+ to check +o)r ("oo&
press)re an& average ("oo& g")cose "eve"s an& to monitor the protein in +o)r
)rine9
Smoking
Smoking can increase +o)r chance of having a sti""(orn or premat)re (a(+9 Smoking is
a"so especia""+ harmf)" for peop"e 'ith &ia(etes9 %f +o) smoke3 ta"k 'ith +o)r hea"th care
provi&er a(o)t ho' to D)it9
5+ 5ea" P"an
%f +o) &on4t a"rea&+ see a &ietitian3 no' 'o)"& (e an e<ce""ent time to start9 0o)r
&ietitian can he"p +o) "earn 'hat to eat3 ho' m)ch to eat3 an& 'hen to eat9 Together3
+o)4"" create a mea" p"an tai"ore& to +o)r nee&s3 )s)a" sche&)"e3 foo& preferences3
me&ica" con&itions3 me&ications3 an& ph+sica" fitness ro)tine9
5an+ 'omen nee& changes in their &iet3 s)ch as e<tra ca"ories an& protein3 &)ring
pregnanc+9 0o) might nee& to see +o)r &ietitian ever+ fe' months &)ring pregnanc+ as
+o)r nee&s change9 *ating a 'e""-(a"ance& &iet he"ps ens)re that +o) an& +o)r (a(+ are
hea"th+9
#ow &uch to /at

:5+ &ietitian he"pe& me inc")&e m+ favorite foo&s in m+ mea" p"an9;
Ta"k 'ith +o)r &ietitian a(o)t ho' man+ servings to have at each mea" an& snack9 0o)r
&ietitian can a"so provi&e a&vice a(o)t portion si>es9 0o)r mea" p"an 'i"" (e (ase& on
ho' man+ ca"ories +o) nee& for pregnanc+ an& +o)r goa"s for 'eight gain &)ring the
pregnanc+9 For most 'omen 'hose 'eight is in the norma" range (efore pregnanc+3
gaining 85 to C5 po)n&s is recommen&e&9 %f +o)4re )n&er'eight or over'eight at the
start of +o)r pregnanc+3 +o)r 'eight goa" ma+ &iffer9 For over'eight 'omen3 the
recommen&e& 'eight gain is no more than 75 po)n&s9

:*ating sma"" mea"s an& snacks thro)gho)t the &a+ he"ps keep m+ ("oo& g")cose )n&er
contro"9;
0itamin and &inera" *upp"ements
0o)r hea"th care team 'i"" te"" +o) 'hether +o) nee& to take a vitamin an& minera"
s)pp"ement (efore an& &)ring pregnanc+9 5an+ pregnant 'omen nee& s)pp"ements
(eca)se their &iets &on4t s)pp"+ eno)gh of the fo""o'ing important vitamins an&
minera"s#
iron=to he"p make e<tra ("oo& for pregnanc+ an& for the (a(+4s s)pp"+ of iron
fo"ic aci&=to prevent (irth &efects in the (rain an& spina" cor&
ca"ci)m=to ()i"& strong (ones
$"coho"ic !e(erages
0o) sho)"& avoi& a"coho"ic (everages 'hi"e +o)4re tr+ing to get pregnant an&
thro)gho)t pregnanc+9 $hen +o) &rink3 the a"coho" a"so goes to +o)r (a(+9
!"coho" can "ea& to serio)s3 "ife"ong pro("ems for +o)r (a(+9
For more information a(o)t eating an& &ia(etes3 see What I need to know about
$atin and Diabetes3 'hich is a"so avai"a("e from the ND%29 See :$here can %
get more information a(o)t &ia(etes; for contact information9

0o) can keep track of 'hat +o) eat an& &rink )sing 5+ Dai"+ Foo& 6ecor&9 0o)r
foo& recor&s can he"p +o) an& +o)r hea"th care team see 'hether +o)r &ia(etes
care p"an is 'orking9
$rtiicia" *weeteners
!rtificia" s'eeteners can (e )se& in mo&erate amo)nts9 %f +o) choose to )se
s'eeteners3 ta"k 'ith +o)r &ietitian a(o)t ho' m)ch to have9
5+ Ph+sica" !ctivit+ 6o)tine
Dai"+ ph+sica" activit+ can he"p +o) reach +o)r target ("oo& g")cose "eve"s9 %t can a"so
he"p +o) reach +o)r ("oo& press)re an& cho"estero" target "eve"s3 re"ieve stress3 improve
m)sc"e tone3 strengthen +o)r heart an& (ones3 an& keep +o)r Roints f"e<i("e9 Ta"k 'ith
+o)r hea"th care team a(o)t mo&erate ph+sica" activit+3 s)ch as 'a"king or s'imming9
2onsi&er 'hether +o) have an+ hea"th pro("ems an& 'hich e<ercises 'o)"& (e (est for
+o)9 0o)r hea"th care team ma+ a&vise +o) to avoi& e<ercises that increase +o)r risk of
fa""ing3 s)ch as &o'nhi"" skiing9
! sensi("e goa" for most 'omen is to aim for CG min)tes or more of activit+3 most &a+s
of the 'eek9 %f +o)4ve (een active (efore pregnanc+3 +o) ma+ (e a("e to contin)e 'ith a
more mo&erate version of +o)r )s)a" e<ercise ro)tine9 B)t if +o) haven4t (een active3
start 'ith an activit+ s)ch as 'a"king9 Vigoro)s ph+sica" activit+3 s)ch as 'a"king
(risk"+3 can "ea& to "o' ("oo& g")cose9 Pregnant 'omen sometimes &o not have the
t+pica" signs of "o' ("oo& g")cose9
For more information a(o)t ph+sica" activit+ an& &ia(etes3 see What I need to know
about %hysical &cti'ity and Diabetes3 'hich is a"so avai"a("e from the ND%29 See
:$here can % get more information a(o)t &ia(etes; for contact information9

:% 'asn4t ver+ active (efore % got pregnant9 B)t m+ &octor sai& that 'a"king ever+ &a+
'o)"& (e safe an& goo& for me an& m+ (a(+9;
0o) can keep track of +o)r ph+sica" activit+ )sing 5+ Dai"+ Ph+sica" !ctivit+ 6ecor&9
0o)r ph+sica" activit+ recor&s can he"p +o) an& +o)r hea"th care team see 'hether +o)r
&ia(etes care p"an is 'orking9
5+ 5e&ications
&edications or Diabetes
D)ring pregnanc+3 the safest &ia(etes me&ication is ins)"in9 0o)r hea"th care team 'i""
'ork 'ith +o) to make a persona"i>e& p"an for +o)r ins)"in ro)tine9 %f +o)4ve (een taking
&ia(etes pi""s to contro" +o)r ("oo& g")cose "eve"s3 +o)4"" nee& to stop taking them9
6esearchers have not +et &etermine& 'hether &ia(etes pi""s are safe for )se thro)gho)t
pregnanc+9 %nstea&3 +o)r hea"th care team 'i"" sho' +o) ho' to take ins)"in9
%f +o)4re a"rea&+ taking ins)"in3 +o) might nee& a change in the kin&3 the amo)nt3 an&
ho' or 'hen +o) take it9 The amo)nt of ins)"in +o) take is "ike"+ to increase as +o) go
thro)gh pregnanc+ (eca)se +o)r (o&+ (ecomes "ess a("e to respon& to the action of
ins)"in3 a con&ition ca""e& ins)"in resistance9 0o)r ins)"in nee&s ma+ &o)("e or even
trip"e as +o) get c"oser to +o)r &e"iver+ &ate9 %ns)"in can (e taken in severa" 'a+s9 0o)r
hea"th care team can he"p +o) &eci&e 'hich 'a+ is (est for +o)9
For more information a(o)t ins)"in3 see What I need to know about Diabetes (edicines3
'hich is a"so avai"a("e from the ND%29 See :$here can % get more information a(o)t
&ia(etes; for contact information9
Other &edications
Some me&ications are not safe &)ring pregnanc+ an& sho)"& (e &iscontin)e& (efore +o)
get pregnant9 Te"" +o)r hea"th care provi&er a(o)t a"" the me&ications +o) c)rrent"+ take3
s)ch as those for high cho"estero" an& high ("oo& press)re9 0o)r provi&er can te"" +o)
'hich me&ications to stop taking9
2hanges in 5+ Dai"+ 6o)tine
*ick Days
$hen +o)4re i""3 +o)r ("oo& g")cose "eve"s can rise rapi&"+9 Dia(etic ketoaci&osis3 a
&angero)s con&ition for +o) an& +o)r (a(+3 can occ)r9 Ta"k 'ith +o)r hea"th care team
a(o)t 'hat +o) sho)"& &o if +o) get sick9 Be s)re +o) kno'
'hat to &o if +o)4re na)seate& or vomiting
ho' often +o) sho)"& check +o)r ("oo& g")cose
ho' often +o) sho)"& check +o)r )rine or ("oo& for ketones
'hen +o) sho)"& ca"" +o)r hea"th care provi&er
!eing $way rom #ome
$hen +o)4re a'a+ from home=for severa" ho)rs or for a "onger trip=+o)4""
'ant to (e prepare& for pro("ems9 5ake s)re +o) a"'a+s have the fo""o'ing 'ith
+o)#

:$hen %4m not fee"ing 'e""3 % check m+ ("oo& g")cose more often than )s)a"9 %
kno' that (eing sick can make m+ ("oo& g")cose "eve" go too high9;
a snack or a mea"
foo& or &rinks to treat "o' ("oo& g")cose
+o)r &ia(etes me&icines an& s)pp"ies
+o)r ("oo& g")cose meter an& s)pp"ies
+o)r g")cagon kit
+o)r hea"th care team4s phone n)m(ers for emergencies
?Top@
Checking Your !aby1s #ea"th During Pregnancy
0o) are "ike"+ to have tests a"" thro)gh +o)r pregnanc+ to check +o)r (a(+4s hea"th9 0o)r
hea"th care team can te"" +o) 'hich of the fo""o'ing tests +o)4"" have an& 'hen +o)
might have them9 0o)r hea"th care provi&er might a"so s)ggest other tests9 %f certain
&iseases or con&itions r)n in +o)r fami"+3 +o) might meet 'ith a genetic co)nse"or9 The
co)nse"or ma+ recommen& tests (ase& on +o)r fami"+ histor+ an& can e<p"ain the risk of
certain con&itions for +o)r (a(+9
&aterna" !"ood *creening Test
The materna" ("oo& screening test is a"so ca""e& the m)"tip"e marker screen test3 the trip"e
screen3 or D)a& screen9 %t meas)res severa" s)(stances in +o)r ("oo&9 6es)"ts can te"" +o)
'hether +o)r (a(+ is at risk for spina" cor& an& (rain pro("ems3 Do'n s+n&rome3 an&
other (irth &efects9 %f the res)"ts sho' an increase& risk for pro("ems3 a&&itiona" tests
s)ch as )"traso)n& or amniocentesis can provi&e more information9
."trasound
M"traso)n& )ses so)n& 'aves to provi&e a pict)re of areas insi&e the (o&+9 The pict)re
pro&)ce& (+ )"traso)n& is ca""e& a sonogram9 M"traso)n& can sho' the (a(+4s si>e3
position3 str)ct)res3 an& se<9 %t can a"so he"p estimate age3 eva")ate gro'th3 an& sho'
some t+pes of (irth &efects9
Feta" /chocardiogram
The feta" echocar&iogram )ses )"traso)n& to check for pro("ems in the str)ct)res of the
(a(+4s heart9
$mniocentesis
!mniocentesis )ses a thin nee&"e inserte& thro)gh the a(&omen into the )ter)s to o(tain a
sma"" amo)nt of the f")i& that s)rro)n&s the (a(+9 2e""s from the f")i& are gro'n in a "a(
an& then ana"+>e&9 !mniocentesis can he"p te"" 'hether +o)r (a(+ has hea"th pro("ems
an& if +o)r (a(+4s ")ngs have finishe& &eve"oping9 Deve"ope& ")ngs are nee&e& for the
(a(+ to (reathe 'itho)t he"p after &e"iver+9
Chorionic 0i""us *amp"ing 2C0*3
2VS invo"ves a thin nee&"e inserte& into the p"acenta to o(tain ce""s9 2e""s then are
ana"+>e& to "ook for hea"th pro("ems9 M"traso)n& is )se& to g)i&e the nee&"e into the
p"acenta3 either thro)gh the vagina an& cervi< or thro)gh the a(&omen an& )ter)s9 The
p"acenta is compose& of tiss)e an& ("oo& vesse"s that &eve"op to attach the (a(+ to the
mother4s )ter)s so the &eve"oping (a(+ can get n)trition from mom9
)ick Counts 2Feta" &o(ement Counting3
2o)nting kicks is an eas+ 'a+ to keep track of +o)r (a(+4s activit+9 0o)4"" co)nt ho'
man+ times the (a(+ moves &)ring a certain perio& of time9
-onstress Test
! feta" monitor checks 'hether +o)r (a(+4s heart rate increases as it sho)"& 'hen the
(a(+ is active9
!iophysica" Proi"e
M"traso)n& checks +o)r (a(+4s m)sc"e tone3 (reathing3 an& movement to o(tain a
(ioph+sica" profi"e9 M"traso)n& a"so estimates the amo)nt of amniotic f")i& s)rro)n&ing
the (a(+9
Contraction *tress Test
This test meas)res the (a(+4s heart rate &)ring contractions )sing a feta" monitor9 The
res)"ts can he"p +o)r &octor &eci&e 'hether the (a(+ nee&s to (e &e"ivere& ear"+9
?Top@
$bout 'abor and De"i(ery
Timing o De"i(ery
0o)r hea"th care team 'i"" consi&er +o)r hea"th3 +o)r (a(+4s hea"th3 an& the state of +o)r
pregnanc+ in &eci&ing ho' an& 'hen &e"iver+ sho)"& occ)r9 Some &octors prefer to
&e"iver (a(ies of 'omen 'ith &ia(etes 7 or 8 'eeks (efore their &)e &ates to "o'er the
risk of pro("ems9 0o)r &octor ma+ recommen& in&)cing "a(or (efore +o)r &)e &ate or
&e"ivering the (a(+ s)rgica""+ )sing a cesarean section3 a"so ca""e& a c-section9 ,o'ever3
most 'omen 'ith &ia(etes have the option of &e"ivering vagina""+9 0o)4"" 'ant to ta"k
'ith +o)r hea"th care team a(o)t +o)r options 'e"" ahea& of time9
The factors +o)r hea"th care team 'i"" consi&er in &eci&ing 'hat t+pe of &e"iver+ is (est
for +o) an& +o)r (a(+ ma+ inc")&e

:% ta"ke& 'ith m+ &octor 'a+ (efore % 'as &)e a(o)t m+ options for &e"ivering m+ (a(+9;
+o)r (a(+4s si>e an& position
+o)r (a(+4s ")ng mat)rit+
+o)r (a(+4s movements
+o)r (a(+4s heart rate
the amo)nt of amniotic f")i&
+o)r ("oo& g")cose an& ("oo& press)re "eve"s
+o)r genera" hea"th
!"ood G"ucose Contro" During 'abor and De"i(ery
Keeping +o)r ("oo& g")cose "eve"s )n&er contro" he"ps ens)re +o)r (a(+ 'on4t have "o'
("oo& g")cose after (irth9 Beca)se +o)4"" (e ph+sica""+ active 'hen +o)4re in "a(or3 +o)
ma+ not nee& m)ch ins)"in9 ,ospita" staff 'i"" check +o)r ("oo& g")cose "eve"s
freD)ent"+9 Some 'omen take (oth ins)"in an& g")cose3 as 'e"" as f")i&s3 thro)gh an
intraveno)s (%V "ine &)ring "a(or9 %nf)sing ins)"in an& g")cose &irect"+ into +o)r
("oo&stream thro)gh a vein provi&es goo& contro" of ("oo& g")cose "eve"s9 %f +o) are
)sing an ins)"in p)mp3 +o) might contin)e to )se it thro)gho)t "a(or9
%f +o) are having a c-section3 +o)r ("oo& g")cose "eve"s ma+ increase (eca)se of the
stress of s)rger+9 0o)r hea"th care team 'i"" c"ose"+ monitor +o)r ("oo& g")cose "eve"s
an& 'i"" "ike"+ )se an %V for ins)"in an& g")cose to keep +o)r "eve"s )n&er contro"9
?Top@
$ter Your !aby $rri(es
$bout !reasteeding
Breastfee&ing is high"+ recommen&e& for the (a(ies of 'omen 'ith &ia(etes9
Breastfee&ing provi&es the (est n)trition an& he"ps +o)r (a(+ sta+ hea"th+9

:*ven tho)gh % have &ia(etes3 % can sti"" (reastfee& m+ (a(+9 5+ mi"k gives m+ (a(+
e<act"+ 'hat he nee&s9;
Your &ea" P"an
%f +o)4re (reastfee&ing3 +o) might nee& more ca"ories each &a+ than +o) nee&e& &)ring
+o)r pregnanc+9 0o)r &ietitian can provi&e persona"i>e& recommen&ations an& ans'er
an+ D)estions +o) have a(o)t 'hat3 'hen3 an& ho' m)ch to eat9
Your &edications
!fter +o)4ve given (irth3 +o) might nee& "ess ins)"in than )s)a" for severa" &a+s9
Breastfee&ing can a"so "o'er the amo)nt of ins)"in +o) nee&9 Dia(etes pi""s are not
recommen&e& &)ring (reastfee&ing9
'ow !"ood G"ucose
0o)4"" (e at increase& risk for "o' ("oo& g")cose3 especia""+ if +o)4re (reastfee&ing9 0o)
might nee& to have a snack (efore or after +o) (reastfee& +o)r (a(+9 0o)r hea"th care
team ma+ s)ggest that +o) check +o)r ("oo& g")cose more often than )s)a"9
The M9S9 1overnment &oes not en&orse or favor an+ specific commercia" pro&)ct or
compan+9 Tra&e3 proprietar+3 or compan+ names appearing in this &oc)ment are )se&
on"+ (eca)se the+ are consi&ere& necessar+ in the conte<t of the information provi&e&9 %f
a pro&)ct is not mentione&3 the omission &oes not mean or imp"+ that the pro&)ct is
)nsatisfactor+9
?Top@
For &ore Inormation
#ow can I ind diabetes educators and dietitians4
Diabetes /ducators
To fin& &ia(etes teachers=n)rses3 &ietitians3 an& other hea"th professiona"s=ca"" the
!merican !ssociation of Dia(etes *&)cators to""-free at 7KBGGKT*!5MPH (BC8K6BJH9
Er go to '''9&ia(etese&)cator9org an& see the :Fin& a Dia(etes *&)cator; section9
Dietitians
To fin& a &ietitian3 ca"" the !merican Dietetic !ssociation4s Nationa" 2enter for N)trition
an& Dietetics at 7KBGGKBJJK76GG9 Er go to '''9eatright9org an& see the :Fin& a
N)trition Professiona"; section9
Where can I get more inormation about diabetes4
-ationa" Diabetes Inormation C"earinghouse
7 %nformation $a+
Bethes&a3 5D 8GB98KC56G
Phone# 7KBGGKB6GKBJHJ
Fa<# JGCKJCBKH989
*mai"# n&icPinfo9ni&&k9nih9gov
%nternet# '''9&ia(etes9ni&&k9nih9gov

-ationa" Diabetes /ducation Program
7 Dia(etes $a+
Bethes&a3 5D 8GB98KC56G
Phone# 7KBGGKHCBK5CBC
Fa<# JGCKJCBKH989
*mai"# n&epPmai"9nih9gov
%nternet# '''9n&ep9nih9gov
$merican Diabetes $ssociation
Nationa" Service 2enter
7JG7 North Bea)regar& Street
!"e<an&ria3 V! 88C77K7JH8
Phone# 7KBGGKD%!B*T*S (CH8K8CBC
Fa<# JGCK5H9K6995
*mai"# !sk!D!P&ia(etes9org
%nternet# '''9&ia(etes9org
5u(eni"e Diabetes +esearch Foundation Internationa"
78G $a"" Street
Ne' 0ork3 N0 7GGG5KHGG7
Phone# 7KBGGK5CCK2M6* (8BJC
Fa<# 878KJB5K9595
*mai"# infoPR&rf9org
%nternet# '''9R&rf9org
Where can I get more inormation about pregnancy4
Eunice Kennedy Shriver -ationa" Institute o Chi"d #ea"th 6 #uman De(e"opment
Inormation +esource Center
P9E9 Bo< CGG6
6ockvi""e3 5D 8GBHJ
Phone# 7KBGGKCJGK89HC
Fa<# CG7K9BHK7HJC
*mai"# N%2,D%nformation6eso)rce2enterPmai"9nih9gov
%nternet# '''9nich&9nih9gov
This p)("ication ma+ contain information a(o)t me&ications )se& to treat a hea"th
con&ition9 $hen this p)("ication 'as prepare&3 the N%DDK inc")&e& the most c)rrent
information avai"a("e9 Eccasiona""+3 ne' information a(o)t me&ication is re"ease&9 For
)p&ates or for D)estions a(o)t an+ me&ications3 p"ease contact the M9S9 Foo& an& Dr)g
!&ministration at 7KBBBK%NFEKFD! (H6CK6CC83 a to""-free ca""3 or visit their 'e(site at
'''9f&a9gov9 2ons)"t +o)r &octor for more information9
?Top@

-ationa" Diabetes Inormation C"earinghouse
7 %nformation $a+
Bethes&a3 5D 8GB98KC56G
Phone# 7KBGGKB6GKBJHJ
TT0# 7KB66K569K7768
Fa<# JGCKJCBKH989
*mai"# n&icPinfo9ni&&k9nih9gov
%nternet# '''9&ia(etes9ni&&k9nih9gov
The Nationa" Dia(etes %nformation 2"earingho)se (ND%2 is a service of the Nationa"
%nstit)te of Dia(etes an& Digestive an& Ki&ne+ Diseases (N%DDK9 The N%DDK is part of
the Nationa" %nstit)tes of ,ea"th of the M9S9 Department of ,ea"th an& ,)man Services9
*sta("ishe& in 79JB3 the 2"earingho)se provi&es information a(o)t &ia(etes to peop"e
'ith &ia(etes an& to their fami"ies3 hea"th care professiona"s3 an& the p)("ic9 The ND%2
ans'ers inD)iries3 &eve"ops an& &istri()tes p)("ications3 an& 'orks c"ose"+ 'ith
professiona" an& patient organi>ations an& 1overnment agencies to coor&inate reso)rces
a(o)t &ia(etes9
P)("ications pro&)ce& (+ the 2"earingho)se are caref)""+ revie'e& (+ (oth N%DDK
scientists an& o)tsi&e e<perts9 This (ook"et 'as revie'e& (+ Bo+& *9 5et>ger3 59D93
Tom D9 Spies Professor of 5eta(o"ism an& N)trition3 Division of *n&ocrino"og+3
5eta(o"ism T 5o"ec)"ar 5e&icine3 North'estern Mniversit+ Fein(erg Schoo" of
5e&icine3 an& U)"ie 59 S"oc)m Da"e+3 69N93 59S93 29D9*93 $omen T %nfants4 ,ospita"
of 6ho&e %s"an&9
This p)("ication is not cop+righte&9 The 2"earingho)se enco)rages )sers of this
p)("ication to &)p"icate an& &istri()te as man+ copies as &esire&9

N%, P)("ication No9 GBK5H97
Fe(r)ar+ 8GGB
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