Planning for pregnancy when you have diabetes means finding ways to improve your health before you get pregnant. This will help both you and your baby stay healthy during and after your pregnancy. The most important thing you can do is to control your blood sugar and keep it in your target range.

Getting regular exercise and eating healthy foods, as well as losing weight if you need to, can help get your blood sugar where it needs to be.

Continue to Why?

During the first few weeks of pregnancy, the baby's organs are already forming. If your blood sugar is high during that time, it can affect how your baby's organs develop and can cause birth defects. But if your blood sugar is under control when you get pregnant, you lower the risk that your baby will have problems. Most women don't know that they are pregnant until after those first weeks. Also, women whose blood sugar is not controlled before they get pregnant tend to have more miscarriages. So be sure to plan ahead to get your blood sugar under control before you start trying to get pregnant.

High blood sugar during pregnancy can also lead to other problems, including:

• A larger-than-normal baby at birth. When the mother has high blood sugar, the extra sugar is passed on to the baby. This causes the baby to get bigger. It may increase the future risk of obesity and type 2 diabetes in the child. And big babies can cause problems for both mother and baby during delivery.
• Low blood sugar in the baby after birth. This happens because the baby's body releases more insulin to deal with the extra sugar during the pregnancy. Sometimes the baby's body continues to release more insulin after the baby is born. This can lead to low blood sugar, which can be an emergency if it's not treated.
• Jaundice, which means that the skin and the whites of a baby's eyes appear yellow because of a buildup of bilirubin in the blood. Bilirubin is a yellow-brown substance produced by the breakdown of red blood cells in the body. Women who have diabetes are more likely than those who don't have diabetes to have babies with jaundice.

Continue to How?

You play a major role in managing your diabetes. Work with your doctor to keep your blood sugar as close to your target range as possible before you get pregnant. To do this:

• Eat a balanced diet. And if you are overweight, try to cut calories in your diet to lose some weight before you get pregnant. Losing as little as 10 to 20 pounds can improve your blood sugar levels. There are many ways to manage how much and when you eat. Your doctor, a diabetes educator, or a dietitian can help you find a plan that works for you.
• Exercise regularly. Get at least 30 minutes of exercise on most, preferably all, days of the week. Exercise helps control your blood sugar by making your body use glucose for energy during and after activity. It also helps you stay at a healthy weight; lower high cholesterol; raise HDL, or good, cholesterol; and lower high blood pressure. Walking, running, biking, and swimming are good activities for people with diabetes. Talk to your doctor about starting a safe exercise program.
• Take your medicine or insulin if prescribed, but let your doctor know that you are planning to get pregnant. Also let your doctor know about any other medicines you take, including over-the-counter medicine, to see if you need to make any changes before you get pregnant.
• Check your blood sugar levels regularly, as advised by your doctor. This will help you figure out how medicine, exercise, and food affect your blood sugar.

It is also important to take folic acid supplements before and during your pregnancy. This may help prevent neural tube defects in the baby.

If you smoke, talk to your doctor about getting help to quit. Smoking can harm your baby and increases the chances that you will have problems from diabetes.

Before you start trying to get pregnant, have your doctor check for problems from diabetes, such as eye or kidney disease. These problems can get worse during pregnancy.

Continue to Where?

Now that you have read this information, you are ready to get your blood sugar under control and plan a healthy pregnancy.

Talk to your doctor

If you have questions about this information, print it out and take it to your next doctor visit. You may want to mark areas or make notes in the margins where you have questions.

If you are planning to get pregnant and haven't talked with your doctor about getting your blood sugar under control, now is a good time to make an appointment.

If you would like more information on planning a healthy pregnancy when you have diabetes, the following resources are available:

Organizations

Academy of Nutrition and Dietetics
120 South Riverside Plaza
Suite 2000
Chicago, IL  60606-6995
Phone:	1-800-877-0877
Email:	knowledge@eatright.org
Web Address:	www.eatright.org
The Academy of Nutrition and Dietetics sets standards for all types of prescribed diets. The organization produces a variety of consumer information, including videos. This group will help you find a registered dietitian in your area who provides nutrition counseling.
American Diabetes Association (ADA)
1701 North Beauregard Street
Alexandria, VA  22311
Phone:	1-800-DIABETES (1-800-342-2383)
Email:	AskADA@diabetes.org
Web Address:	www.diabetes.org
The American Diabetes Association (ADA) is a national organization for health professionals and consumers. Almost every state has a local office. ADA sets the standards for the care of people with diabetes. Its focus is on research for the prevention and treatment of all types of diabetes. ADA provides patient and professional education mainly through its publications, which include the monthly magazine Diabetes Forecast, books, brochures, cookbooks and meal planning guides, and pamphlets. ADA also provides information for parents about caring for a child with diabetes.