Diabetes medications during pregnancy and breastfeeding
In the past, women with diabetes were at high risk for complications during pregnancy. Today, with advancements in treatment and good blood glucose control, women with diabetes can have a safe pregnancy and delivery similar to that of a woman without diabetes.
(Please note: this article focuses on pre-existing diabetes, which refers to women who have diabetes before becoming pregnant. This is different than gestational diabetes, which occurs during pregnancy.)
Planning your pregnancy
For women who have diabetes, obtaining preconception (‘before pregnancy’) care is associated with better birth outcomes. By discussing pregnancy with your healthcare team prior to conception, they can help you reach your blood glucose targets, start folic acid supplementation and discontinue potentially harmful medications to lay the groundwork for a healthy pregnancy.
Blood glucose targets
It is important that woman who are planning a pregnancy get their preconception A1C levels to less than 7%, or as close to normal as can be achieved safely. This will decrease the risk of spontaneous abortion, birth defects and pregnancy-induced high blood pressure (this is known as ‘preeclampsia’). Good blood glucose control in pregnancy is important, because high blood glucose levels can cause the baby’s size and weight to be larger than average and increase the risk of complications during and after delivery.
Women should speak to their healthcare team, as blood glucose targets change in pregnancy; hence, more frequent blood glucose monitoring is recommended to ensure these goals are being met. Continue reading