Type 1 Diabetes in Pregnancy

A guide to managing your diabetes during pregnancy

You can have a healthy pregnancy with Type 1 diabetes. This presentation explains what to expect and how we'll work together.

What Is Type 1 Diabetes?

Type 1 diabetes means your pancreas doesn't make insulin.

Insulin is a hormone that helps sugar from food enter your cells for energy.

Without insulin, blood sugar levels rise too high. You need insulin injections or a pump to stay healthy.

Why It Matters in Pregnancy

Pregnancy changes how your body uses insulin. Your baby depends on you for steady blood sugar.

Good news: With careful monitoring and teamwork, most people with Type 1 diabetes have healthy pregnancies and healthy babies.

Your insulin needs will change throughout pregnancy. That's normal and expected.

Your Blood Sugar Targets

Time Target Range
Fasting (before eating) < 95 mg/dL
1 hour after meals < 140 mg/dL
2 hours after meals < 120 mg/dL

These targets are tighter than before pregnancy. Your care team will help you reach them safely.

How Often to Check Blood Sugar

You'll check your blood sugar more often during pregnancy:

  • Before each meal (3 times daily)
  • 1 or 2 hours after meals (3 times daily)
  • Before bed
  • Anytime you feel symptoms of high or low blood sugar

A continuous glucose monitor (CGM) can make this easier and safer.

Your Insulin Needs Will Change

First Trimester

You may need less insulin. Risk of low blood sugar is higher.

Second & Third Trimester

You'll need more insulin as pregnancy hormones increase resistance.

This is normal. Your care team will adjust your doses regularly throughout pregnancy.

Managing Low Blood Sugar

Hypoglycemia (low blood sugar) is blood sugar below 70 mg/dL.

Symptoms: Shaking, sweating, confusion, rapid heartbeat, dizziness.

What to do:

Eat 15 grams of fast-acting carbs (juice, glucose tablets). Recheck in 15 minutes. Repeat if needed.

Keep fast-acting sugar with you always. Tell family members what to do if you can't treat yourself.

Your Prenatal Visit Schedule

You'll see your care team more often than standard prenatal care:

  • Every 1-2 weeks in the first and second trimester
  • Weekly in the third trimester
  • Ultrasounds to monitor baby's growth
  • Additional testing in the third trimester (like non-stress tests)

These visits help us keep you and your baby healthy.

What We're Monitoring

Your care team watches for conditions that are more common with diabetes:

  • Preeclampsia (high blood pressure in pregnancy)
  • Baby's growth (making sure baby isn't growing too large)
  • Amniotic fluid levels
  • Your kidney and eye health

Close monitoring helps us catch and manage problems early. Most issues can be managed with good diabetes control.

Your Care Team

Managing Type 1 diabetes in pregnancy takes a team approach:

  • Maternal-Fetal Medicine specialist or obstetrician
  • Endocrinologist or diabetes specialist
  • Diabetes educator
  • Dietitian who specializes in pregnancy
  • You – the most important member

We work together to support you every step of the way.

Eating Well During Pregnancy

A diabetes dietitian will create a meal plan that:

  • Provides nutrition for you and your baby
  • Helps keep blood sugar steady
  • Prevents low blood sugar episodes
  • Includes regular meals and snacks

Don't skip meals. Eating consistently helps prevent dangerous blood sugar swings.

Planning for Labor and Delivery

Your care team will discuss:

  • Timing of delivery (often between 37-39 weeks)
  • Blood sugar management during labor
  • Insulin adjustments after delivery
  • Whether induction or scheduled cesarean is recommended

Many people with Type 1 diabetes have vaginal deliveries. Your health and your baby's health guide these decisions.

After Your Baby Arrives

Your insulin needs drop quickly after delivery – often returning to pre-pregnancy levels within days.

Your baby will be monitored for low blood sugar in the first hours after birth. This is routine and expected.

Breastfeeding is safe and encouraged. It may affect your blood sugar, so work with your team to adjust insulin and meals.

What You Can Do

  • Check your blood sugar as recommended
  • Take insulin as prescribed
  • Keep all appointments with your care team
  • Eat regular meals and follow your meal plan
  • Report symptoms like vision changes or severe headaches right away
  • Ask questions whenever something isn't clear

Questions to Ask Your Care Team

  • What should I do if my blood sugar is out of range?
  • When should I call you between appointments?
  • How will we adjust my insulin as pregnancy progresses?
  • What symptoms should I watch for?
  • Can I use a continuous glucose monitor?
  • What happens if I get sick during pregnancy?

No question is too small. Your care team is here to support you.

Key Takeaways

You can have a healthy pregnancy with Type 1 diabetes.

It requires close monitoring, teamwork, and frequent adjustments.

Your efforts make a real difference in your health and your baby's health.

We're here to support you every step of the way.

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