Getting pregnant, making it through a pregnancy, giving birth—these are all achievements that many women assume will happen naturally. Most of the time, all goes according to plan, but if you have diabetes, your path to parenthood may be a little bumpier.

The good news is that you can carry a healthy baby to term, and (assuming your blood sugar is in tight control), your chances of doing so aren't much different from a woman who does not have diabetes. Still, it's important to keep in mind that having diabetes automatically makes your pregnancy high-risk.

If you've just learned that you're expecting, here are some numbers that you should be paying close attention to:

Hemoglobin A1C

Before you get pregnant and throughout your pregnancy, you should keep your hemoglobin A1C levels as close to six as possible.

"This should be your target," says Marie Frazzitta DNP, FNP-c, CDE, MBA, director of Diabetes Education at North Shore LIJ health Ssystem. But, she adds, after about 16 weeks, the hemoglobin A1C is no longer an accurate barometer of how tight your blood sugar control is.

"At that point in your pregnancy, you have more fluid in your body, and it's simply not as accurate," Frazzitta explains. "That is why monitoring your blood glucose levels with a blood glucose monitor—before you eat in the morning, before and one hour after meals, and at bedtime—is so important to make sure that your glucose is under control."

Blood Sugar

Your bedtime/overnight and your pre-meal blood sugar should be 60 to 99 and your post-prandial (after a meal) blood sugar should be between 100 and 129, Frazzitta says.

Blood Pressure

Having high blood pressure during pregnancy is harmful to both you and your developing baby. Normal blood pressure during pregnancy is 120/80, Frazzitta says. Women with diabetes are at a high risk for developing a complication called pre-eclampsia. This can happen in the second half of your pregnancy.

Signs of pre-eclampsia include high blood pressure, protein in the urine, and swelling in the lower extremities that doesn't go away.

Fetal Kick Count

At around 28 weeks, you may be instructed by your doctor to lie down on your side after meals and count the baby's movements (kicks, flutters, swishes, or rolls). You should feel 10 movements in about two hours, Frazzitta says.

Lying on your left side allows for the best circulation, which could lead to a more active baby, she says. Ask your doctor when you should pay close attention to your baby's kicks.

Weight Gain

If your weight is normal before you get pregnant, you should gain between 25 and 35 pounds, according to the American Diabetes Association.

Overweight women should gain 15 to 20 pounds, and an obese expectant mom should keep weight gain to between 11 and 20 pounds.

How to Help Ensure a Healthy Baby

  1. Before you become pregnant, visit your health care provider to discuss your care, recommends the American College of Obstetricians and Gynecologists.
  2. Do your best to have optimum blood sugar control for a couple of months before you try to conceive. Your doctor might even change your medication to help get your blood sugar into the normal range.
  3. Be aware that as your baby grows, your insulin needs will increase. This is especially common in the last trimester when hormones that are necessary for your baby to grow may block the action of your insulin. Your doctor will let you know how to adjust your dose of insulin.

Marie Frazzitta, DND, FNP-c, CDE, MBA, reviewed this article.



"Living with Diabetes." American Diabetes Association.

"Pregnancy and Pre-Existing Diabetes." 20 July 2010. American Diabetes Association.

"High blood pressure during pregnancy." American College of Obstetricians and Gynecologists