Thinking about having a baby? When you have diabetes, preconception planning can help you have a healthier pregnancy.

You have diabetes and you're thinking about having a baby. Naturally, you're concerned about the risks associated with pregnancy and diabetes. But there's good news! If you control your blood sugar level before and during pregnancy, the odds of having a healthy baby are superb.

Is your body ready for pregnancy?

Before you conceive, see your doctor for a physical exam. Mention your interest in pregnancy. If you take oral diabetes medication, you may need to switch to insulin or make other changes to your diabetes treatment plan before you conceive. If you have high blood pressure or signs of eye, nerve or kidney disease — or other diabetes complications that may be aggravated by pregnancy — you may need treatment before conception.
Your doctor also may suggest scheduling preconception appointments with an obstetrician who specializes in high-risk pregnancies, a diabetes educator, a registered dietitian or other specialists.

Focus on blood sugar control

Controlling your blood sugar level is the best way to prevent diabetes complications. When it comes to pregnancy and diabetes, blood sugar control is more important than ever — even months before you conceive.
Your baby's brain, spinal cord, heart and other organs begin forming soon after conception, even before you know you're pregnant. If you have poor blood sugar control during the earliest days of pregnancy, your baby's risk of birth defects — particularly those affecting the brain, spine and heart — increases significantly. But if you manage your blood sugar level before you conceive, the risk of birth defects is nearly the same as if you didn't have diabetes.
Good blood sugar control also can reduce the risk of miscarriage and stillbirth, the other primary concerns for pregnancy and diabetes.
Your doctor will help you establish your target blood sugar range for now and early in pregnancy. The goal is to keep your blood sugar level as close to normal as possible.

Remember healthy-eating principles

Your diabetes diet probably includes plenty of fruits, vegetables and whole grains. You can eat the same foods as you're planning for pregnancy. If you're having trouble keeping your blood sugar level in your target range or you want to lose excess pounds before pregnancy, you may want to consult a registered dietitian. The dietitian can help you customize your diabetes meal plan to meet your pre-pregnancy needs.
To help fill any nutritional gaps, take a prenatal vitamin containing folic acid — ideally beginning three months before conception. Many doctors recommend at least 1 milligram (mg) of folic acid a day during this critical time.

Include physical activity in your daily routine

Physical activity is another important part of your diabetes treatment plan, even during pregnancy. During your preconception appointment, get your doctor's OK to exercise. Then choose activities you enjoy, such as walking, swimming or biking. What's most important is making physical activity part of your daily routine. Aim for at least 30 minutes of aerobic exercise most days of the week. Stretching and strength training exercises are important, too. If you haven't been active for a while, start slowly and build up gradually. Remember that physical activity affects blood sugar. Check your blood sugar level before any activity, especially if you take insulin. You might need to eat a snack before exercising to help prevent low blood sugar.

Know what's off-limits

Patience pays off

Preparing for pregnancy may take months. In fact, the American Diabetes Association recommends maintaining good blood sugar control for three to six months before attempting to conceive. Your doctor may want you to reach a specific A1C level — a reflection of your blood sugar level for the two to three months before the test — before pregnancy.
Until your doctor gives you the green light for pregnancy, remember to use birth control. The wait may seem long, but the result is priceless — a healthier pregnancy for you and your baby.
Sources: Mayo Clinic, American Diabetes Association, 2008.