Preparing for pregnancy

Pregnancy is a landmark and much anticipated event in a couple’s life. Planning a pregnancy is an important and exciting step. However, for women living with diabetes, some extra measures need to be taken. With proper preparation and medical guidance, most diabetic women can have healthy pregnancies and healthy babies. The focus needs to be on achieving good blood sugar control and addressing potential risks well before conception. Let’s take a look at a few essentials:

Preconception counselling is a must

Women with type 1, type 2 or gestational diabetes from a previous pregnancy should definitely seek preconception counselling. This allows healthcare providers to assess overall health, review diabetes management and discuss pregnancy-related risks. Early counselling helps in setting realistic goals and planning necessary lifestyle and treatment changes.

Optimal blood glucose control is required

Good glycaemic control before conception is key as it significantly reduces the risk of miscarriage, birth defects and pregnancy complications. Ideally, HbA1c levels should be as close to normal as possible (usually below 6.5%, as advised by the doctor) without causing frequent hypoglycaemia. Regular self-monitoring of blood are crucial during this phase.

Review medications and insulin therapy

Some oral antidiabetic drugs and other medications may not be safe during pregnancy. It may be advisable to switch to insulin or pregnancy-safe alternatives before conception. Medications for blood pressure, cholesterol or other conditions should also be reviewed and modified if necessary.

Screening for diabetes-related complications

Before pregnancy, women should be evaluated for diabetes-related complications such as retinopathy, nephropathy, neuropathy and cardiovascular disease. A detailed eye examination, kidney function tests and blood pressure assessment are particularly important, as pregnancy can worsen existing complications if not managed carefully.

Prioritising healthy nutrition and weight management

A balanced diet tailored to diabetes management plays a vital role in preconception care. Women should focus on regular meals with appropriate portions of complex carbohydrates, lean proteins, healthy fats and plenty of fibre. Achieving a healthy body weight before pregnancy helps improve insulin sensitivity and reduces the risk of complications such as preeclampsia and gestational hypertension.

Start folic acid supplementation early

Folic acid is crucial in preventing neural tube defects. Diabetic women are often advised a higher dose of folic acid (usually 5 mg daily) starting at least one to three months before conception and continuing into early pregnancy.

Adoption of a healthy lifestyle

Regular moderate physical activity, adequate sleep, stress management and avoidance of smoking and alcohol are essential. Exercise helps improve blood glucose control and overall fitness, preparing the body for pregnancy.

Pregnancy should be timed carefully

Unplanned pregnancies carry higher risks for women with diabetes. Using effective contraception until blood glucose levels and overall health are well controlled ensures a healthy pregnancy.

Protecting your pregnancy

The good news is that with careful planning, medical supervision and healthy lifestyle choices, women with diabetes can look forward to a safe pregnancy and a healthy baby. Preconception care empowers women to enter pregnancy confidently, with risks minimised and outcomes optimised.