Family Planning with T1D

Planning for pregnancy and parenthood with type 1 diabetes

Preconception Planning
Preparing your body and diabetes management before pregnancy

Target A1C Before Pregnancy

Aim for an A1C below 6.5% (ideally) or as close to normal as safely possible before conceiving. This reduces the risk of birth defects and complications.

Pre-pregnancy Health Checkups

  • Comprehensive eye exam to check for retinopathy
  • Kidney function tests (urine albumin and creatinine)
  • Thyroid function tests
  • Blood pressure evaluation
  • Cardiac assessment if indicated

Medication Review

Some diabetes and blood pressure medications need to be changed before pregnancy. Work with your doctor to switch to pregnancy-safe alternatives.

Folic Acid Supplementation

Take 400-800 mcg of folic acid daily starting at least 1-3 months before conception to reduce the risk of neural tube defects.

Diabetes Management During Pregnancy
Tighter targets and increased monitoring

Target Blood Sugar Ranges

  • Fasting: 60-95 mg/dL (3.3-5.3 mmol/L)
  • 1 hour after meals: 100-129 mg/dL (5.5-7.2 mmol/L)
  • 2 hours after meals: 100-119 mg/dL (5.5-6.6 mmol/L)
  • A1C goal: Less than 6% if achievable without significant hypoglycemia

Increased Monitoring

Test blood glucose 6-10 times daily, or use continuous glucose monitoring (CGM) with frequent checks. Monitor for ketones when blood sugar is elevated.

Insulin Needs Change

Expect insulin requirements to increase throughout pregnancy, especially in the second and third trimesters. Work closely with your diabetes team to adjust doses frequently.

Hypoglycemia Awareness

Be extra vigilant about low blood sugar. Always carry fast-acting glucose and let your support person know how to use glucagon.

Your Healthcare Team
Specialized care for pregnancy with T1D

Key Team Members

  • Maternal-fetal medicine specialist (high-risk OB)
  • Endocrinologist with pregnancy experience
  • Certified diabetes educator
  • Registered dietitian specialized in diabetes and pregnancy
  • Ophthalmologist for regular eye exams

Frequent Appointments

Expect weekly or bi-weekly appointments with your diabetes team, and monthly or more frequent visits with your OB. More monitoring means better outcomes.

Fetal Monitoring

Your baby will be monitored closely with regular ultrasounds to check growth and development, and non-stress tests in the third trimester.

Birth Planning & Postpartum
What to expect during delivery and after

Delivery Timing

Most women with well-controlled T1D can deliver at 39-40 weeks. Your team will discuss the best timing and method of delivery based on your health and your baby's health.

During Labor

Your blood sugar will be closely monitored and managed with IV insulin if needed. The goal is to keep levels in a tight range (70-110 mg/dL) during labor.

After Delivery

Insulin needs typically drop dramatically immediately after delivery. Your doses may temporarily be 30-50% of your third trimester needs. Work with your team to adjust.

Breastfeeding with T1D

Breastfeeding is encouraged and safe with T1D. Have snacks available during feeding sessions as breastfeeding can lower blood sugar. Stay hydrated and monitor glucose levels.

Postpartum Support

Continue working with your diabetes team postpartum. Adjust to new sleep schedules, eating patterns, and the demands of a newborn while managing diabetes.