DiabetesSource

Pregnancy is a time of wonder and amazement -- and for women with
pre-existing diabetes, it is also a time for very extremely careful (and
sometimes baffling) disease management. How do you plan for this? What
risks are involved? What can you expect? The August issue of Diabetes
Forecast, the consumer magazine of the American Diabetes Association,
features articles about pregnancy with pre-existing diabetes to help you.
With good care and planning, says Diabetes Forecast, women with either
type 1 or type 2 diabetes can have safe pregnancies -- and healthy
babies.

Planning starts now. If you have diabetes and want to become
pregnant, the first step should be visiting your doctor -- or several
doctors. Depending on your diabetes management, you may want to see
an endocrinologist in addition to your ob-gyn for a pre-conception
visit. When choosing your doctors, keep in mind that you may have
appointments as often as twice a week, so try to find a physician
that you are comfortable with and whose office you are comfortable
getting to.

While pre-existing diabetes automatically puts your pregnancy in the
high-risk category, healthy habits can lower the chance of problems
for both mother and child. First and foremost, keep your blood
glucose in check -- in general, your A1C should be below 7 percent
before you conceive. Your health care team may also want to discuss
your weight, use of prenatal vitamins and other supplements, the
status of any diabetes-related complications, and your current
medications (such as ACE inhibitors or statins, which are not
considered safe for use in pregnancy). Polycystic ovary syndrome is
associated with type 2 diabetes, so for some women with diabetes,
asking about fertility treatments may also be in order.

Once you become pregnant, your body's changes can make blood glucose
levels go from one extreme to the other. "I spent the entire first
trimester with my face buried in the fridge," says Kerri Sparling,
31, who has type 1 diabetes and whose daughter was born in April. "I
was low all the time. It wasn't until probably the second trimester
that the insulin resistance kicked in. Everything I ate, the insulin
didn't cover it." As your body changes through your pregnancy, so
will its reactions to the elements you normally use to manage your
blood glucose, so be prepared to communicate with your health care
team often and make any necessary adjustments.

From pre-conception planning to integrating diabetes management into
your birth plan and facing post-partum depression, having a baby can
seem like an overwhelming task for women with diabetes, and yet, many
women with diabetes find they have the best glucose control of their
life during pregnancy. "This was so, so important to me that I was
willing to do whatever to make sure she came out right," says
Sparling. "It's so worth it." Find more advice, explanations and
insight about what to expect in the August issue of Diabetes
Forecast.

This issue of Diabetes Forecast also features:

-- A Birthday Challenge: Marking 40 years with 40 races for ADA's Team
Diabetes
-- Drinking Calories: How you hydrate yourself makes a difference
-- A Serious Subject: Dealing with erectile dysfunction

Diabetes Forecast has been America's leading diabetes magazine for more
than 60 years, offering the latest news on diabetes research and
treatment to provide information, inspiration and support to people
with diabetes.

The American Diabetes Association is leading the fight to stop
diabetes and its deadly consequences and fighting for those affected
by diabetes. The Association funds research to prevent, cure, and
manage diabetes; delivers services to hundreds of communities;
provides objective and credible information; and gives voice to those
denied their rights because of diabetes. Founded in 1940, its mission
is to prevent and cure diabetes and to improve the lives of all
people affected by diabetes.