For women with type 1 diabetes (T1D) planning a family, the best time to see your endocrinology team is before you get pregnant, not after — at least three to six months before, says Donna Miller, MSN, FNP-C, CDE, Nurse Practitioner and Certified Diabetes Educator at the Westside Center for Diabetes.
One of Donna’s specialties is working with women who have T1D throughout their pregnancies, from pre-conception on. For many years, women with T1D were advised not to get pregnant, she notes. Although it represents more challenges for women with T1D, a healthy pregnancy is entirely possible with careful preparation. “It’s important to create a plan to minimize the risk of complications and maximize the health of the mother and the baby,” says Donna.
High blood glucose at conception and throughout pregnancy can spell added dangers for the baby, including miscarriage and potential birth defects. However, these complications can largely be avoided by intensive glucose management. “The mothers we see are able to do an amazing job at controlling their blood sugar levels in order to have a successful pregnancy. We consider it a joy to be able to help mothers bring healthy infants into the world.”
Donna advises her patients to use a continuous glucose monitor (CGM) and insulin pump to get the most accurate, convenient monitoring and delivery of insulin. “Using these devices, the woman can make insulin decisions based on the trending blood glucose,” she says. For women who decide against CGM and a pump, Donna offers other options for managing their pregnancy.
She also works with her patients to develop a nutritional plan, critical for managing the demands of pregnancy. “In some cases, meals you’ve always eaten might not work during pregnancy because they tend to raise your glucose too high.” Exercise — walking and yoga, for example — also are important.
Each pregnancy plan is highly individualized. But one recommendation Donna makes applies to all, she says: interview your potential OB/GYN and perinatologist. “Find out their comfort level and understanding of type 1 diabetes.” The WCD maintains referral lists and can help you find one that works for you.
To begin planning for your healthy pregnancy, contact Donna at the WCD.