Women who have diabetes are at an increased risk for complications during pregnancy, including increased risk of birth defects or fetal death. These risks can be minimized by planning pregnancy ahead with the help of your obstetrician and primary diabetes care provider. Women who are pregnant with type 1 or type 2 diabetes may have a few questions about how the pregnancy will affect their health and diabetes care.

Can I take my medications as normal during the first trimester of pregnancy?

Many oral diabetes medications have not been thoroughly tested for safety during the first trimester of pregnancy or the remaining months of gestation. Your diabetes physician may choose to switch you to insulin injections, if your symptoms will be efficiently treated with injections, for the duration of pregnancy.

Will I need to continue insulin injections during the first trimester of pregnancy?

Yes, you will need to continue care as normal. With the help of your obstetrician and primary diabetes physician, insulin injection doses may need to be altered based on your body’s reaction to pregnancy during the first trimester. The dose may be increased or decreased, as your body calls for changes, but each case is unique.

Will weight gain increase the severity of my symptoms during the first trimester of pregnancy and beyond?

Normal pregnancy weight gain will not typically increase symptoms of diabetes during the first trimester of pregnancy and beyond. Normal pregnancy weight gain is attributed to increased blood volume and the weight of the uterus, fetus, placenta and amniotic fluid. Personal weight gain, above and beyond normal, could increase the severity of diabetes symptoms and severity of symptoms during the first trimester of pregnancy and beyond.

Should I change my diet during the first trimester of pregnancy?

It is important to talk with your diabetes care provider about your diet  during the first trimester of pregnancy. Most often, a lower carbohydrate, sugar restricted diet is normal for the diabetic, so there are no real changes during the first trimester of pregnancy and beyond. If you are having increased symptoms or severity of diabetes during the first trimester of pregnancy and subsequent trimesters, it is important to evaluate your diet with the help of a dietician to rule out hidden carbohydrates.

Having diabetes does not mean you have to give up your chances of having a healthy baby. With coordinated care between your obstetrician and diabetes physician, in conjunction with a planned pregnancy, diabetes can be kept under control and risks to the fetus can be minimized. If you have not planned a pregnancy but believe you are pregnant, contact your gynecologist and diabetes physician immediately for consultations and a pregnancy test.