Type 1 Diabetes and Pregnancy

Pregnant woman looks down at her belly.

Managing your diabetes while pregnant will help keep you and your baby healthy.

If you have type 1 diabetes and you’re thinking about having a baby, planning before you become pregnant is important. Learn how you can stay healthy and help prevent health problems for you and your baby before, during, and after pregnancy.

Deciding to start a family is an exciting time! It can also be overwhelming. It’s natural to have questions about how to keep yourself and your baby healthy during pregnancy, especially if you have type 1 diabetes.

Women with type 1 diabetes can have a healthy pregnancy. Having a plan to manage your diabetes before, during, and after your pregnancy will help keep you and your baby healthy.

Before You Get Pregnant

Use this planning checklist pdf icon[PDF – 887KB] to 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 will recommend that you reach and keep your A1C goal for a few months before becoming pregnant.

Review your medicines. Some medicines and supplements aren’t safe to use while pregnant. You should 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.

View this guide to planning a pregnancyexternal icon with type 1 diabetes for more info.

Your insulin needs may change throughout your pregnancy. Be sure to talk to your doctor about how to manage your blood sugar.

During Your Pregnancy

As soon as you find out that you’re pregnant, work with your medical team to manage your blood sugar and head off complications.

During your pregnancy, you and your doctors will adjust your diabetes management plan, so it’s important that you trust your team and feel free to reach out to them. If you don’t have these health care specialists as 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 women with diabetes.
  • An obstetrician (a doctor who treats pregnant women). 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 women with high-risk pregnancies.
  • A diabetes educator who can help you manage your diabetes during pregnancy.

Here are a few things to keep in mind:

Keep your A1C levels on target. Blood sugar levels that stay high during pregnancy may cause your baby to grow too large (macrosomia) or harm the early development of organs and lead to birth defects.

Know your risks. Women who have type 1 diabetes can have a safe pregnancy and a healthy baby, but it’s important to monitor diabetes complications that could worsen throughout pregnancy, such as high blood pressure, vision loss, and kidney disease. Other risks include:

  • Preecalampsia – 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-average baby. This can lead to a more difficult delivery.
  • Birth defects that may affect your baby’s heart, brain, spine, kidneys, digestive system, limbs, and mouth.

Read more about possible risks during pregnancy.

Be aware of changing insulin needs. Your insulin needs may 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. You may want to consider:

  • If you are 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?

Learn more about birth plansexternal icon for people with type 1 diabetes.

During and After Delivery

Monitoring blood sugar and insulin. Your blood sugar levels may rise during labor, but they may drop just before you give birth or immediately after—regardless of whether you have a vaginal delivery or a Cesarean (C-section). Your doctor can help you plan for the insulin dose changes and monitoring throughout your delivery and after. You may wear your insulin pump or CGM during delivery.

Breastfeeding. Breastfeeding offers many health benefits to both the mother and baby. For the mother, it can help you lose extra weight you may have gained during pregnancy, and it can reduce the risk of high blood pressure, ovarian cancer, and breast cancer. Breastfeeding gives the baby the best nutrition to stay healthy, while reducing the risk of asthma, obesity, and severe lung disease. Women with type 1 diabetes can breastfeed their babies. Having diabetes may delay your ability to produce breast milk at first, but it should improve over time. Breastfeeding is an energy-consuming activity, just like physical activity. This can cause low blood sugar, so you should let those who will be around you know the signs of low blood sugar and how to treat it.

Careful planning and attention to your medical needs give you the best chance to stay healthy during pregnancy and have a healthy baby. You can do it!

Page last reviewed: March 30, 2021