The CGM Blog
Preparing for Pregnancy When You Live with Diabetes
Planning for pregnancy is essential for women living with diabetes. Here are a few important tips to help you start preparing to conceive.
Getting ready to have a baby can feel incredibly exciting. If you’re living with diabetes and are hoping to start or grow your family, it’s especially important to begin preparing to have a child well before you become pregnant. Women living with type 1 diabetes (T1D) or type 2 diabetes (T2D) may be concerned about whether they’re able to have a healthy pregnancy. With good blood sugar management before and during pregnancy, women living with diabetes are just as likely to have a healthy pregnancy as those who do not live with the condition.1,2
Preconception Diabetes Care Supports Mom and Baby
As soon as you think you’re interested in taking the next steps on your parenthood journey, it’s a good idea to talk to your doctor about how your diabetes management plan needs to change to support pregnancy. Taking care of yourself right from the beginning will help ensure that you can support your little one as they develop.
A mother’s blood sugar, or glucose, levels start to have an impact on her baby soon after conception—which is the moment that a sperm joins an egg that’s been released from the ovaries in the fallopian tube. It’s not always easy to know exactly when you’ve conceived, which is why it’s a good idea to ensure that you’re focusing on blood sugar control and overall diabetes management before you begin trying to get pregnant. A baby’s main organs form during the first eight weeks of pregnancy. Having high blood sugar levels, also known as hyperglycemia, or an A1C of 10.0% or greater, in early pregnancy can increase the risk that the baby has issues with the development of the heart, lungs, and kidneys.1,2,4
Body weight can also have an impact on pregnancy. Women experiencing T2D who have overweight or obesity may be advised to work on weight loss before they conceive. Mothers experiencing obesity are at higher risk of having a baby that grows too big, which is known as macrosomia. When a baby is too large, it can lead to difficulties during labour and birth, which may result in having to undergo a Cesarean delivery, also known as a C-section.1,2
Will I pass diabetes on to my baby?
Parents living with diabetes might be concerned about whether their children will experience the condition as well. It’s important to understand that a diabetes diagnosis is never anyone’s fault. Diabetes is a complex condition, and doctors are still trying to determine how and why diabetes develops. Unfortunately, we can’t predict whether a child whose parents live with diabetes will develop the condition, too.
Having a parent or sibling who lives with T1D slightly increases the risk that a child will experience the condition, but genetics may only play a limited role in its development. Individuals who have a close relative living with T2D are also at higher risk of developing the condition as well.1 However, they may also be able to take steps throughout their life to reduce the risk of experiencing T2D, such as eating a healthy diet, exercising regularly, and avoiding smoking.7
Getting Ready for Pregnancy when You’re Living with Diabetes
Preparing for pregnancy when you’re living with diabetes might feel overwhelming. Managing diabetes during pregnancy isn’t always easy, so it’s a great idea to have a support system and a plan in place to help you feel a little more confident throughout your journey. Here are just a few tips to help you start the planning process.
Expand Your Diabetes Care Team
Diabetes Canada recommends that women who are planning to have a baby get personalized care from an interdisciplinary team of healthcare professionals that includes your certified diabetes educator, dietitian, and endocrinologist, as well as an obstetrician—who is a doctor specializing in pregnancy.1 These individuals can establish a diabetes management plan to prepare you for a healthy pregnancy and provide guidance around when it’s a good time to conceive. Having your pregnancy care team lined up before you get pregnant helps ensure you’ll get the care you need during the process of trying to conceive and in the critical weeks following conception.
Healthcare system studies show that women living with obesity or T2D may be less likely to seek out preconception care than those living with T1D.1 Know that no matter what health conditions you’re experiencing, you—and your baby—deserve to get the care you need right from the start.
Prioritize Lowering Your A1C and Reducing Hyperglycemia
A healthy pregnancy starts with good blood sugar control. Women who are hoping to have a baby should talk to their diabetes care team to determine realistic glucose goals and aim to achieve them ahead of conception. Diabetes Canada generally recommends that women work to keep their A1C at or below 7.0% and, if possible, lower their A1C to 6.5% or less while they plan to get pregnant.1
Lifestyle changes such as eating a healthy, nutrient-rich diet, getting regular movement into your day, reducing stress, and getting enough sleep are just a few of the many habits that can help you lower your A1C. Adding a continuous glucose monitoring (CGM) system to your diabetes management toolkit can also help you achieve your A1C goals. The Dexcom G7 CGM System is proven to help individuals managing diabetes spend more time in their target glucose range and reduce low glucose or hypoglycemia. Dexcom G7 has also been shown to help those living with T1D or T2D lower their A1C.8-13
Diabetes Canada recommends that all women living with T1D who are having a baby should be offered a CGM system.1 CGM systems have been shown to help women decrease high glucose and spend more time in their target glucose range throughout their pregnancy.1 Using a CGM system during pregnancy has also been shown to help reduce the risk of the baby growing too large or experiencing low blood sugar after being born.1
Discuss Your Diabetes Medication and Supplement Plan
If you’re thinking about trying for a baby, talk to your doctor about making diabetes medication adjustments. Some diabetes medications shouldn’t be used before or during pregnancy.1 Your doctor may recommend switching from glucose control medication to insulin therapy during pregnancy if you’re not already using it.1 Additionally, talk to your doctor about whether you should start taking other new medications or supplements to support your pregnancy. It’s recommended that women living with diabetes begin taking a folic acid vitamin supplement three months before getting pregnant.14
Get Your Eyes and Kidneys Checked
Pregnancy can increase the risk of experiencing diabetes complications. Retinopathy, or issues with the eyes, can worsen during pregnancy and in the first year after the baby is born.1 Diabetes Canada recommends getting your eyes checked before and throughout your pregnancy.1,4 It’s also important to get checked for chronic kidney disease, also called nephropathy, before you conceive, as the condition can increase the likelihood that you or your baby will experience pregnancy complications.1
A CGM System Can Help You Reach Your Preconception Glucose Goals
Ensuring that your A1C is at or below 7.0% is an important part of preparing for pregnancy.1 With Dexcom G7, you can get greater insight into what’s affecting your glucose every day. Dexcom G7 can provide glucose readings and notify you about hyperglycemia right on your compatible smart device or receiver, eliminating the need to check your glucose with routine fingersticks.*†
Getting readings and alerts in the palm of your hand can empower you to take proactive action to manage your glucose in the moment, helping you spend more time in range and lower your A1C.
* For a list of compatible devices, please visit dexcom.com/compatibility.
† Routine fingersticks required for diabetes treatment decisions if symptoms or expectations do not match readings.
† Routine fingersticks required for diabetes treatment decisions if symptoms or expectations do not match readings.
1 Feig DS, et al. Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada: Diabetes and Pregnancy. Can J Diabetes. 2018 Apr;42 Suppl 1:S255-S282. doi: 10.1016/j.jcjd.2017.10.038
2 How your diabetes can affect your baby. National Health Service (NHS) UK. Reviewed September 2022. https://www.guysandstthomas.nhs.uk/health-information/diabetes-and-pregnancy/how-your-diabetes-can-affect-your-baby
3 Conception. Cleveland Clinic. REviewed September 6, 2022. https://my.clevelandclinic.org/health/articles/11585-conception
4 Diabetes and Pregnancy. American Diabetes Association. Accessed June 11, 2024. https://diabetes.org/living-with-diabetes/life-stages/gestational-diabetes/diabetes-and-pregnancy
5 Preparing for pregnancy. Breakthrough T1D. Accessed June 10, 2024. https://www.breakthrought1d.org/t1d-resources/pregnancy/preparing-for-pregnancy/
6 Preventing diabetes. Diabetes Canada. Accessed June 20, 2024. https://www.diabetes.ca/type-2-risks/preventing-diabetes
7 Beck RW, et al. JAMA. 2017;317(4):371-378.
8 Beck RW, et al. Ann Intern Med. 2017;167(6):365-374.
9 Martens T, et al. JAMA. 2021;325(22):2262-2272.
10 Laffel LM, et al. JAMA. 2020;323(23):2388-2396.
11 Welsh JB, et al. J Diabetes Sci Technol. 2024;18(1):143-7.
12 Heinemann L, et al. Lancet. 2018;391(10128):1367-1377.
13 Pregnancy and T1D. JDRF Canada. Accessed June 10, 2024. https://jdrf.ca/life-with-t1d/pregnancy/
2 How your diabetes can affect your baby. National Health Service (NHS) UK. Reviewed September 2022. https://www.guysandstthomas.nhs.uk/health-information/diabetes-and-pregnancy/how-your-diabetes-can-affect-your-baby
3 Conception. Cleveland Clinic. REviewed September 6, 2022. https://my.clevelandclinic.org/health/articles/11585-conception
4 Diabetes and Pregnancy. American Diabetes Association. Accessed June 11, 2024. https://diabetes.org/living-with-diabetes/life-stages/gestational-diabetes/diabetes-and-pregnancy
5 Preparing for pregnancy. Breakthrough T1D. Accessed June 10, 2024. https://www.breakthrought1d.org/t1d-resources/pregnancy/preparing-for-pregnancy/
6 Preventing diabetes. Diabetes Canada. Accessed June 20, 2024. https://www.diabetes.ca/type-2-risks/preventing-diabetes
7 Beck RW, et al. JAMA. 2017;317(4):371-378.
8 Beck RW, et al. Ann Intern Med. 2017;167(6):365-374.
9 Martens T, et al. JAMA. 2021;325(22):2262-2272.
10 Laffel LM, et al. JAMA. 2020;323(23):2388-2396.
11 Welsh JB, et al. J Diabetes Sci Technol. 2024;18(1):143-7.
12 Heinemann L, et al. Lancet. 2018;391(10128):1367-1377.
13 Pregnancy and T1D. JDRF Canada. Accessed June 10, 2024. https://jdrf.ca/life-with-t1d/pregnancy/