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Published in on Nov 26th 2025

Planning for Pregnancy with Diabetes: What Women Should Know

While diabetes adds an extra layer of medical care to pregnancy, you can still have a healthy and positive experience. With a bit of preparation and a care team that understands your needs, you can shape a pregnancy that feels safe, supported, and aligned with your health goals.

Types of Diabetes & Pregnancy

Type 1 Diabetes

Type 1 diabetes occurs when the body does not produce insulin, the hormone that helps move sugar from the blood into the body’s cells. Therefore, women with type 1 diabetes rely on insulin injections to keep their blood sugar levels within an appropriate range. During pregnancy, insulin needs can fluctuate, sometimes decreasing during the first trimester and then rising again mid-way through the pregnancy. This makes regular blood sugar checks, insulin adjustments, and close communication with your care team essential throughout each trimester.

Type 2 Diabetes

Type 2 diabetes occurs when the body becomes resistant to insulin, which can lead to high blood sugar. Because of this, many women need to monitor their blood sugar levels closely and may require medication adjustments to keep blood sugar within a safe range.

Gestational Diabetes

Gestational diabetes develops during pregnancy, even in women who have never had diabetes before. While it usually goes away after delivery, it requires careful meal planning, activity, and sometimes medication to prevent complications.

How Diabetes Can Affect Pregnancy

Regardless of type, controlling blood sugar levels remains crucial. When glucose stays too high — especially early on — it can increase the risk of complications for both the mother and the developing baby. Good diabetes management helps:

• Reduce the risk of miscarriage
• Lower the chance of birth defects
• Prevent complications like preeclampsia (high blood pressure)
• Support healthy fetal growth
• Reduce the likelihood of preterm birth and/or a larger than normal baby (macrosomia)

Maintaining stable blood sugar levels protects your body and creates the healthiest environment possible for your baby to grow.

Managing Diabetes During Pregnancy

If you have diabetes and are planning on getting pregnant, consider meeting with your provider for preconception planning. Early pregnancy is a critical period for fetal development, and high blood sugar at this stage can increase the risk of complications. By talking with your doctor ahead of time, you’ll have the time to review your medications, assess your current glucose control, and make any changes needed to support a safe and healthy start to pregnancy. If planning ahead isn’t possible, let your doctor know as soon as you’re pregnant to start appropriate care.

Pregnancy with diabetes can look different from person to person, but generally, your provider may recommend:

• Aiming for an A1C below 6% — your A1C reflects your average blood sugar over the past 2–3 months.
• Medication adjustments—certain medications aren’t safe during pregnancy, and your provider may need to change doses as your pregnancy progresses.
• Nutrition changes – Balanced meals with steady carbohydrates, lean proteins, and healthy fats help keep your glucose levels stable. Many women benefit from meeting with a registered dietitian who specializes in diabetes or pregnancy nutrition.

How Pacific Women’s OB-GYN Can Support You

Diabetes doesn’t prevent you from having a safe, fulfilling pregnancy. It simply means you’ll need a bit more planning and more frequent check-ins with your care team. With good blood sugar control, timely prenatal care, and support from specialists, most women with diabetes have healthy pregnancies and healthy babies. If you’re beginning your pregnancy journey, or you have questions about managing diabetes during pregnancy, don’t hesitate to reach out to our team.