Getty ImagesBy Kate Stinchfield
Pregnancy is full of challenges-and even more so if you have type 1 or type 2 diabetes.
So how do you handle a demanding disease and pregnancy? It may not be as hard as you think, says Cheryl Alkon, author of Balancing Pregnancy With Pre-Existing Diabetes. But you do need a plan.
Before starting a family, check out these 7 tips that can help you ace diabetes management and have a healthy pregnancy.
Health.com: Pregnancy advice myths and facts
Get your blood sugar under control
If you're thinking about getting pregnant, you need to kick bad habits (like smoking), lose weight (if you're overweight), and take prenatal vitamins. You can add one more item to the list if you have diabetes: Get your blood sugar under control.
If your blood sugar levels are too high or too low, you may have a tough time getting pregnant. "In that case, your body may recognize that it's not a hospitable place for a pregnancy," says Alkon.
Women with type 2 diabetes are particularly at risk for polycystic ovary syndrome (PCOS), which can also make it difficult to get pregnant. Medications that stimulate ovulation, such as Clomid and Serophene, can help.
Health.com: How often should you test your blood sugar?
Assemble a diabetes team
Pregnant women with diabetes could have up to three times as many appointments as women at a lower risk of complications. Find a high-risk obstetrician to monitor your pregnancy and check whether your endocrinologist is willing to work with your ob-gyn.
"You want doctors who really know what diabetes is all about," says Alkon.
The constant monitoring, ultrasounds, and additional blood sugar tests add up. So "make sure you know the ins and outs of your insurance plan," she adds.
Consider going off oral medications
Most doctors suggest that pregnant women with type 2 diabetes discontinue oral medications, says Alkon.
This is because there is not enough evidence that diabetes pills, such as metformin, are safe to take during pregnancy. While oral medications are convenient, insulin may be a better choice to help you keep a tight rein on your blood sugar before and during pregnancy.
You have to take insulin if you have type 1 diabetes, so talk to your doctor about whether your current insulin regimen will meet your needs during pregnancy.
Health.com: Why drug combinations are used to treat diabetes
Get a grip on morning sickness
If you're taking insulin, you need to have food in your system for the insulin to act upon. That becomes a problem when you can't keep anything down.
Alkon recommends eating a cracker as soon as you wake up to help with morning sickness. "Keep a sleeve of saltines next to your bed," she says. "And take a few bites before you even get out of bed."
Certain prescription drugs, like Zofran, can also help with extreme nausea. If you have severe morning sickness, discuss the options with your doctor.
Maintain blood sugar control
The challenge of keeping your blood sugar under control will continue throughout pregnancy.
That means you need to get up close and personal with your blood glucose monitor.
"When I was pregnant with my son, I tested about 15 times a day, or at least every hour," says Alkon. "You don't want to wait until you feel your blood sugar spike or dip. You want to know where you're at all the time."
Health.com: 7 ways to make blood-sugary testing less painful
Have a quick-carbs stash
If you're insulin dependent, be ready to cope with hypoglycemia, a condition that occurs when the blood sugar in your body is too low. This is caused by taking too much insulin or not eating enough to match the insulin level in your body.
You can keep glucose tablets or gels-products designed specifically to reverse hypoglycemia-on hand.
But if you can't stand the taste, stash 100% juice boxes in your purse. "I figured I was at least giving my baby a serving of fruit along with the juice," says Alkon.
Life Savers candy doesn't offer a nutritional benefit to your baby, but it can be a good source of carbs in a pinch.
Health.com: How many carbs am I eating?
Log on to find support
Your mom, your sister, and your best friend might all offer great pregnancy advice, but unless they also have diabetes, they may not fully understand what you're going through.
Link up with other diabetic moms at diabeticmommy.com to get more targeted support and information.
"You don't want to feel alone," says Alkon. "You can find people just like you online."