Type 1 diabetes and pregnancy: what you need to know

Medically reviewed by Neka Miller, PhD on May 15, 2020. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.


Pregnancy can be a challenging experience as you experience morning sickness, swollen ankles, and more. It can be especially challenging if you have type 1 diabetes, which comes with an increased risk of health complications for you and your unborn baby. Here, you'll learn what complications are associated with type 1 diabetes during pregnancy, steps you can take, and more, so read on.


HbA1c testing is important before and during pregnancy if you have type 1 diabetes. Easily check your A1c levels from the comfort of home with our at-home HbA1c test.


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What causes complications if you’re pregnant and have type 1 diabetes?

Maybe you’ve heard that conceiving with type 1 diabetes can be risky for you and your baby, but you might not know why.

Type 1 diabetes and pregnancy complications relate to the way your body changes when you’re carrying a baby. To support your pregnancy and help your baby grow in the womb, the placenta develops. Its goal is to send water and nutrients to the baby. It also makes hormones to help sustain the pregnancy.

In early pregnancy, the placenta makes hormones that can increase insulin secretion and decrease glucose production. This leads to relatively low blood sugar levels. Then, as the pregnancy progresses, these hormones can cause insulin resistance. If your body does not have enough insulin, it could have serious consequences on your and your baby’s health. For this reason, it’s a good idea to ask your healthcare provider about what medications can raise blood sugar levels so your provider can recommend safe prescription options for you during your pregnancy.

What are the risks of having a pregnancy with type 1 diabetes?

You have an increased risk of experiencing these health complications during early pregnancy if you have type 1 diabetes:

  • Insulin resistance can occur because of hormone changes associated with pregnancy.
  • Preeclampsia is high blood pressure (as well as protein in the urine) during pregnancy, which can be a serious condition. Women with diabetes are already predisposed to have high blood pressure, and pregnancy increases this risk.
  • Diabetic nephropathy is kidney damage that develops due to diabetes. The kidneys work extra hard during pregnancy, and the high blood pressure that can come with diabetes adds more strain to these organs—raising the risk of damage.
  • Miscarriage (losing the baby at 20 weeks of gestation) or stillbirth (losing the baby after 20 weeks) is more likely to happen in a type 1 diabetes pregnancy.

Your baby is also at risk of having the following health problems:

  • Birth defects can occur if your blood sugar levels are outside the normal range. High blood sugar levels can harm a baby's development in the womb, leading to problems with the lungs, heart, brain, spine, kidneys, gastrointestinal tract, and limbs. (Consider asking your healthcare provider how to lower blood sugar naturally and through other methods to help avoid these potential birth defects.)
  • Larger than normal size (macrosomia) is another complication of type 1 diabetes during pregnancy. All the additional glucose in your body can cause your baby to grow to a larger-than-average size in the womb. This can increase the risk of requiring a C-section during delivery.

Fortunately, it’s often possible for diabetic mothers to avoid complications like these and have a healthy pregnancy (and baby) by working closely with their diabetes care team.

Type 1 diabetes before and during pregnancy

Before you conceive and during your pregnancy, it’s a good idea to speak with your healthcare provider and diabetes care team to learn what tests you’ll need for monitoring and other recommendations. (For example, your provider may recommend changing certain medications or their dosages to help with managing diabetes during pregnancy.)

It’s recommended that women with type 1 diabetes who are planning a pregnancy get HbA1c levels checked prior to conception. In general, HbA1c levels should be below 7% (without hypoglycemia) before the pregnancy, as this can help reduce the risk of diabetes-related complications. Additionally, HbA1c levels may need to be tested regularly throughout the pregnancy. (You can use the Everlywell at-home HbA1c Test to check your levels from the comfort of home.)

It’s also recommended to check your blood glucose level often during the pregnancy so you can have a clear picture of what’s happening in your body and make changes (to your diet, physical activity levels, or medications, for example), based on the recommendations of your provider.


Warning signs of prediabetes


References

1. Type 1 or Type 2 Diabetes and Pregnancy. Centers for Disease Control and Prevention. URL. Accessed May 15, 2020.

2. Placenta: How it works, what's normal. Mayo Clinic. URL. Accessed May 15, 2020.

3. Sonagra AD, Biradar SM, Dattatreya K, Murthy J. Normal pregnancy- a state of insulin resistance. J Clin Diagn Res. 2014;8(11):CC01‐CC3. doi:10.7860/JCDR/2014/10068.5081

4. Pregnancy if You Have Diabetes. National Institute of Diabetes and Digestive and Kidney Diseases. URL. Accessed May 15, 2020.

5. Kc K, Shakya S, Zhang H. Gestational diabetes mellitus and macrosomia: a literature review. Ann Nutr Metab. 2015;66 Suppl 2:14‐20. doi:10.1159/000371628

6. Diabetes - Diagnosis and Treatment. Mayo Clinic. URL. Accessed May 15, 2020.

7. The A1C Test & Diabetes. National Institute of Diabetes and Digestive and Kidney Diseases. URL. Accessed May 15, 2020.

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