Type 1 Diabetes and Pregnancy

Key points

  • Women with type 1 diabetes can have a healthy pregnancy.
  • Have a diabetes management plan, ideally before, during, and after pregnancy, to keep you and your baby healthy.
Pregnant woman looks down at her belly.

Before you get pregnant

Read these FAQs

Learn how you can boost your health and get ready for pregnancy. Being in good overall health before you become pregnant is important.

Manage your blood sugar

Many doctors recommend that you reach and stay at your A1C goal for a few months before becoming pregnant.

Review your medicines

Some medicines and supplements aren't safe to use while pregnant. Speak with your health care team about each medicine and supplement you take before you get pregnant. Don't stop taking prescribed medicines without talking to your doctor first.

During your pregnancy

During your pregnancy, you and your doctors will adjust your diabetes management plan. If these health care specialists aren't part of your diabetes care team already, consider looking for:

An endocrinologist (a doctor who treats hormone conditions, including diabetes). You may want to find one who specializes in caring for pregnant people with diabetes.

An obstetrician (a doctor who treats pregnant people). Your pregnancy may be considered high risk because of your diabetes. If that's the case, you may want to find an obstetrician who takes care of people with high-risk pregnancies.

A diabetes educator who can help you manage your diabetes during pregnancy.

pregnant woman at the doctor
During your pregnancy, you and your doctors will adjust your diabetes management plan.

Here are a few things to keep in mind:

Keep A1C levels on target

Blood sugar levels that stay high during pregnancy may cause your baby to grow too large or lead to birth defects.

Know your risks

It's important to monitor diabetes complications that could worsen throughout pregnancy, such as vision problems and kidney disease. Other risks include:

  • Preeclampsia—high blood pressure that can damage the liver and kidneys.
  • Insulin resistance—when insulin is less effective at lowering your blood sugar.
  • Miscarriage.
  • Macrosomia—a larger than normal baby. This can lead to a more difficult delivery.
  • Birth defects that may affect your baby's heart, brain, spine, or organs.

Your insulin needs may change

Your insulin needs can change throughout your pregnancy. Low blood sugar is common in women with type 1 diabetes. Check with your health care team about how much insulin you need and how often you need it.

Consider using a continuous glucose monitor (CGM)

A CGM will help you notice your blood sugar patterns, which can help you stay in your target range. Talk to your doctor to see if a CGM is right for you.

Create a birth plan

Questions to ask:

  • If delivering in a hospital, what is the procedure for women who wear an insulin pump?
  • Can you keep your CGM on during labor and delivery?
  • Who will manage your blood sugar levels during and after labor and delivery?
  • What diabetes supplies do you need to pack in your hospital bag?

During and after delivery

Monitoring blood sugar and insulin

Your blood sugar levels may rise during labor. Your blood sugar may drop just before you give birth or immediately after. This can happen whether you have a vaginal delivery or a cesarean (C-section).

Your doctor can help you plan for insulin dose changes and monitoring throughout your delivery and after. You can wear your insulin pump or CGM during delivery.


Women with type 1 diabetes can breastfeed their babies. Breastfeeding gives your baby the best nutrition to stay healthy, while reducing the risk of asthma, obesity, and severe lung disease. Having diabetes may delay your milk from coming in, but that should improve over time. Ask your health care provider for guidance if you have concerns.

Breastfeeding is an energy-consuming activity, just like physical activity. This can cause low blood sugar. Let those who will be around you know the signs of low blood sugar and how to treat it.