What should I do?
When a woman of childbearing age has diabetes, it is very important to plan the pregnancy ahead of time for a number of reasons.
The first reason is that studies have shown that the risk of birth defects (called congenital malformations) is much higher if the diabetes is not well controlled at the time of becoming pregnant.
Improving control of the diabetes as quickly as possible after dis-covering the pregnancy will not fully reverse this risk, which in some studies has been found to be as high as one in five.
Therefore, it is important to establish and confirm that your diabetes is in the best possible control before proceeding with a plan to become pregnant.
The second issue is that women with longstanding diabetes who suffer from its microvascular complications are more likely to have a complicated pregnancy and will need to be reassessed prior to and during the pregnancy.
Of particular importance are the possibility of progression of retinopathy and nephropathy during the course of pregnancy.
Finally, it may be necessary to change the type of treatment during the pregnancy, and this may require some forward planning. For example, pills are generally not used during pregnancy. Therefore, a woman with type 2 diabetes will almost always need to learn how to take insulin and it may be more convenient to do this as part of pre-pregnancy planning.