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Patient education: Preparing for pregnancy when you have diabetes (The Basics)

Patient education: Preparing for pregnancy when you have diabetes (The Basics)

How should I prepare for pregnancy if I have diabetes? — If you want to get pregnant, it is very important that you talk to your doctors before you start trying to get pregnant. You will need to see your primary care doctor and possibly an obstetrician (a doctor who takes care of pregnant people). If you see an endocrinologist (a doctor who manages your diabetes), you should mention your pregnancy plans to them, too. These doctors can make sure that you do everything possible to have a healthy baby.

Before you start trying to get pregnant, you will need to work closely with your healthcare team to get your blood sugar as close to normal as possible. That might mean using more insulin, if you already use it. Or switching to insulin, if you do not already use it. Plus, you might need to change the way you eat.

Normal blood sugar levels help prevent miscarriages and birth defects.

You should also talk to your doctors about all medicines you take, including any supplements or herbal medicines. If you use any medicines that are not safe to take during pregnancy, you might need to switch or go off them.

This article discusses the things you should do before getting pregnant if you have diabetes. There are also steps that anyone should take before trying to get pregnant. These include things like taking vitamins and avoiding smoking, alcohol, and certain foods. Your doctor or nurse can talk to you more about general planning for pregnancy.

Which medicines should I stop taking before I try to get pregnant? — You should:

Stop taking certain medicines used to treat high blood pressure or kidney disease. It is especially important to stop medicines called angiotensin converting enzyme inhibitors (usually called "ACE inhibitors") and angiotensin receptor blockers (usually called "ARBs"). These medicines can cause birth defects.

But don't stop your high blood pressure medicine on your own. High blood pressure can be harmful. Your doctor will switch you to a blood pressure medicine that is safe to take during pregnancy.

Stop taking medicines called statins, which are used to lower cholesterol. These medicines have not been well studied in pregnant people. But doctors recommend that most people stop taking them during pregnancy, because there is a chance they could affect a baby's development.

Don't stop your statin medicine on your own. Your doctor will help you decide whether you are one of the few people that should continue taking this medicine.

Remember, by the time you find out you are pregnant, your baby has already started to form many important body parts. That's why it is not enough to stop taking medicines that might be harmful when you learn you are pregnant.

If you get pregnant while taking any medicines, tell your doctors right away. They can explain any possible risks to your baby and help you decide how best to move forward.

Before you start trying to get pregnant, your doctors might want you to stop taking diabetes medicines that come in pill form. They might want you to use insulin instead, or a different pill.

Will I need any tests before I start trying to get pregnant? — Yes. You will need these tests:

An eye exam (if you have not had one in the last 12 months) – You will need to be checked for an eye disease called "diabetic retinopathy." This condition is caused by diabetes, and it can lead to vision loss or even blindness. Pregnancy can increase your chances of getting diabetic retinopathy, and it can make the condition worse if you already have it. If you have severe diabetic retinopathy, you might need to treat the condition before you get pregnant.

Blood and urine tests to check the health of your kidneys – People with diabetes are at risk for kidney disease. Pregnancy can worsen kidney disease that already exists.

Blood pressure test – Having high blood pressure during pregnancy can cause problems for you and your baby. If your blood pressure is too high, your doctors might give you medicines to treat it. But they will choose medicines that are safe to use during pregnancy. Some of the medicines normally used to treat high blood pressure are not safe to use during pregnancy.

Blood tests to measure thyroid hormone levels – Having normal thyroid hormone levels is very important for you and a developing baby. If your tests show that your thyroid hormone levels are too high or too low, you might need treatments to get them back to normal.

Urine tests to check for infection – People with diabetes can have bladder or kidney infections and not know it. It's important to treat these before pregnancy.

More on this topic

Patient education: How to plan and prepare for a healthy pregnancy (The Basics)
Patient education: Care during pregnancy for people with type 1 or type 2 diabetes (The Basics)
Patient education: Type 1 diabetes (The Basics)
Patient education: Type 2 diabetes (The Basics)
Patient education: Diabetes and diet (The Basics)
Patient education: Diabetic retinopathy (The Basics)
Patient education: Chronic kidney disease (The Basics)

Patient education: Care during pregnancy for patients with type 1 or 2 diabetes (Beyond the Basics)
Patient education: Type 1 diabetes: Overview (Beyond the Basics)
Patient education: Type 2 diabetes: Overview (Beyond the Basics)
Patient education: Type 1 diabetes and diet (Beyond the Basics)
Patient education: Type 2 diabetes and diet (Beyond the Basics)
Patient education: Chronic kidney disease (Beyond the Basics)

This topic retrieved from UpToDate on: Jan 01, 2023.
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