1. Schedule a pre-pregnancy exam that includes the following:
• an A1C test;
• blood pressure check; and
• evaluation of heart, kidney, nervous system, and thyroid.
2. Appoint a medical team and schedule regular visits. You’ll need to monitor your and your baby’s health often.
3. Test often. A continuous glucose monitor (CGM) can be enormously helpful in tracking your pregnancy blood sugars. It provides a nearly real-time graph of where your blood glucose has been and where it’s heading. This advance warning of an impending low is a crucial safety feature when you’re aiming for tight targets.
4. Log often. Insulin requirements increase dramatically during pregnancy. Keep a log of what you’re eating, how much insulin you’re taking and your blood sugar level. Review them with your endocrinologist and obstetrician so they can help you adjust doses as your pregnancy progresses.
5. Be prepared for morning sickness. For women with Type 1 diabetes, morning sickness can be dangerous. If you eat food and take insulin but then throw up the food you took the insulin to cover, you’re at risk of a serious low blood sugar. It’s a good idea to ask your endocrinologist about the best foods to eat to help manage your morning sickness and diabetes at the same time.
6. Get your team ready and communicating. Obstetricians and hospitals have very different protocols for caring for pregnant women who have Type 1 diabetes. It’s a good idea to find out early in your pregnancy what your doctor’s and hospital’s approaches are so you can make changes in your birth plan.
7. Exercise. Pregnancy is not a time to suddenly begin vigorous exercise. However, physical
activity is beneficial during pregnancy. Ask your doctor about the best kinds of exercise for you and any precautions you should take.