Type 1 or Type 2 Diabetes Mellitus During Pregnancy, Self Care
Type 1 or Type 2 Diabetes Mellitus During Pregnancy, Self-Care

Type 1 or Type 2 Diabetes Mellitus During Pregnancy, Self Care

Caring for yourself during your pregnancy when you have type 1 or type 2 diabetes (diabetes mellitus) means keeping your blood sugar (glucose) under control with a balance of:
  • Healthy eating.
  • Exercise.
  • Lifestyle changes.
  • Insulin or medicines, if needed.
  • Support from your health care team and others.

The following information explains what you need to know to manage your diabetes at home during your pregnancy.

What are the risks?

If diabetes is treated, it is unlikely to cause problems. If it is not controlled with treatment:
  • It may cause problems during labor and delivery. Some of those problems can be harmful to the unborn baby (fetus) and the mother.
  • It may also cause a newborn to have breathing problems and low blood glucose.

Having diabetes can put you at risk for other long-term, or chronic, conditions, such as heart disease and kidney disease. Your health care provider may prescribe medicines to help prevent complications from diabetes.

How to monitor blood glucose

Be sure to:
  • Check your blood glucose every day, as often as told by your health care provider.
  • Contact your health care provider if blood glucose is above your target for 2 tests in a row.
  • Have your hemoglobin A1C (HbA1C) level checked as often as told.

Your health care provider will set personal treatment goals for you. Generally, the goal of treatment is to maintain the following blood glucose levels during pregnancy:
  • After not eating (after fasting) for 8 hours: at or below 95 mg/dL (5.3 mmol/L).
  • After meals:
    • One hour after a meal: at or below 140 mg/dL (7.8 mmol/L).
    • Two hours after a meal: at or below 120 mg/dL (6.7 mmol/L).
  • HbA1C level: less than 6%.

Follow these instructions at home:

Medicines

  • Take over-the-counter and prescription medicines only as told by your health care provider. This includes diabetes medicines. Take insulin or diabetes medicines every day, if your health care provider prescribed them.
  • Do not run out of insulin or other diabetes medicines that you take. Plan ahead so you always have these available.
  • If you use insulin, adjust your dosage based on your physical activity and what foods you eat. Your health care provider will tell you how to adjust your dosage.
  • Your health care provider may recommend that you take one low-dose aspirin (81 mg) each day to help prevent high blood pressure during pregnancy (preeclampsia or eclampsia). You may be at risk for preeclampsia or eclampsia if:
    • You had any of the following during a previous pregnancy:
      • Preeclampsia or eclampsia.
      • A fetal growth rate that was slower than normal.
      • An early, or preterm, birth.
      • Placental abruption. This is when the placenta separates from the uterus.
      • Loss of an unborn baby (fetal loss).
    • You are pregnant with more than one baby.
    • You have other medical conditions, such as high blood pressure or an autoimmune disease.

Eating and drinking

What you eat and drink affects your blood glucose and your insulin dosage. Making good choices helps to control your diabetes and prevent other health problems. A healthy meal plan includes eating lean proteins, complex carbohydrates, fresh fruits and vegetables, low-fat dairy products, and healthy fats.

Make an appointment to see a registered dietitian to help you create an eating plan that is right for you. Make sure that you:
  • Follow instructions from your health care provider about eating or drinking restrictions.
  • Drink enough fluid to keep your urine pale yellow.
  • Eat healthy snacks between nutritious meals.
  • Keep a record of the carbohydrates that you eat. Do this by reading food labels and learning the standard serving sizes of foods.
  • Follow your sick-day plan whenever you cannot eat or drink as usual. Make this plan in advance with your health care provider.

Activity

  • Do at least 30 minutes of physical activity a day, or as much as your health care provider recommends during your pregnancy.
  • If you start a new exercise or activity, work with your health care provider to adjust your insulin, medicines, or food intake as needed.

Lifestyle

  • Do not drink alcohol.
  • Do not use any products that contain nicotine or tobacco. These products include cigarettes, chewing tobacco, and vaping devices, such as e-cigarettes. If you need help quitting, ask your health care provider.
  • Learn to manage stress. If you need help with this, ask your health care provider.

Care for your body

  • Keep your immunizations up to date.
  • Schedule an eye exam during the first term (trimester) of your pregnancy, or as told.
  • Check your skin and feet every day for cuts, bruises, redness, blisters, or sores. Schedule a foot exam once every year.
  • Brush your teeth and gums two times a day, and floss one or more times a day. Visit your dentist one or more times every 6 months.
  • Maintain a healthy weight during your pregnancy.

General instructions

  • Talk with your health care provider about your risk for preeclampsia or eclampsia.
  • Share your diabetes management plan with people in your workplace, school, and household.
  • Check your urine for ketones when you are sick and as told.
  • Wear a medical alert bracelet or carry a medical alert card.
  • Keep all follow-up visits during your pregnancy (prenatal) and after delivery (postnatal). This is important.

Questions to ask your health care provider

  • Do I need to meet with a certified diabetes care and education specialist?
  • Where can I find a support group for people with diabetes?

Where to find more information

Contact a health care provider if:

  • Your blood glucose is at or above 240 mg/dL (13.3 mmol/L).
  • You have been sick or have had a fever for 2 days or more and you are not getting better.
  • You have any of the following problems for more than 6 hours:
    • You cannot eat or drink.
    • You have nausea and vomiting.
    • You have diarrhea.

Get help right away if:

  • You have severe hypoglycemia. This means your blood sugar is below 54 mg/dL (3 mmol/L).
  • You become confused.
  • You have trouble thinking clearly.
  • You have trouble breathing.
  • Your baby is moving around less than usual.
  • You develop unusual discharge from your vagina.
  • You start having contractions early (prematurely). These may feel like tightening in your lower abdomen.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.

Summary

  • Caring for yourself when you have type 1 or type 2 diabetes means keeping your blood sugar (glucose) under control. You can do that with a balance of insulin and other medicines, healthy eating, exercise, and lifestyle changes.
  • Check your blood glucose every day, as often as told by your health care provider.
  • Take insulin or diabetes medicines every day, if your health care provider prescribed them.
  • Keep all follow-up visits during your pregnancy (prenatal) and after delivery (postnatal). This is important.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.