Managing Type 1 Diabetes During Pregnancy
As your body changes during pregnancy, so does your T1D management. Knowing what to expect along the way can help you feel more prepared, confident, and at ease.
Changing Needs During a T1D Pregnancy
Insulin Adjustments
In the first trimester, your body may become more sensitive to insulin. Your insulin needs may drop, increasing your risk of hypoglycemia (low blood sugar).
As your pregnancy progresses, your body may become more resistant to insulin. Your insulin needs will likely increase, increasing your risk of hyperglycemia (high blood sugar).
Work with your healthcare team every week of your pregnancy to adjust your insulin doses as needed.
Morning Sickness
Morning sickness can make managing T1D more challenging, especially because nausea and vomiting can affect both your blood sugar levels and your ability to eat regularly. This can increase the risk of hypoglycemia or, in more severe cases, diabetic ketoacidosis (DKA).
If you’re experiencing frequent vomiting, it’s important to stay hydrated and check your blood glucose more often than usual. Even if you’re not able to tolerate full meals, try to take small sips of fluids and eat bland, easy-to-digest foods like crackers or toast to help keep your blood sugar stable.
Stay in close communication with your healthcare team—they can guide you on insulin timing and dosage adjustments to help you stay safe and feel your best during this time.
CGM and Insulin Pump Placement
Check with your manufacturer on FDA-approved locations for your continuous glucose monitor (CGM) and insulin pump site during pregnancy.
Using T1D Technology During Pregnancy
Technologies like continuous glucose monitors (CGM) and automated insulin delivery systems can give you more real-time information about your blood-glucose levels and patterns, help keep you in a tighter range, and reduce the risk of hyperglycemia and hypoglycemia.
Developing a Birth Plan
If you’re pregnant and living with type 1 diabetes (T1D), creating a birth plan can be a helpful and empowering way to prepare for delivery.
A birth plan gives you a chance to think through your preferences, ask important questions, and feel more confident about what lies ahead. Below are a few questions that may help you to get started:
- Do I want to receive pain medication at any time during labor, or do I prefer to give birth naturally?
- Who will manage my T1D during the labor and delivery (my partner, my doctor, someone else?)
- Will I be able to wear my insulin pump and CGM during labor and delivery?
- Do I want to breastfeed or formula feed?
- If my baby experiences a low blood-sugar level after delivery, what are my options?
- Who are the people I want present in the room during my child’s birth? Are there any restrictions on how many people can be there?
- If there is an emergency, who will make medical decisions on my behalf or my child’s behalf if I am unable to do so?
- After birth, do I have any plans for the umbilical cord and/or placenta, which can be used for T1D research, stored, or encapsulated?
As you think through these choices, remember that flexibility is key. Birth doesn’t always go exactly as planned, and that’s okay. What matters most is that you and your baby are safe, supported, and well cared for.
Pregnancy Support for T1D Moms
Connect with others who have gone through pregnancy with type 1 diabetes in the Breakthrough T1D Community Forum.
Working With Your Diabetes Care Team
Make sure that you and your healthcare team are in agreement about how your T1D will be managed during and after the birth of your child. Having these conversations ahead of time can help you feel more prepared, supported, and confident in the moment.
Here are a few things to discuss and plan with your healthcare team before your baby’s delivery day:
- Does the hospital have a protocol in place for women with T1D using insulin pumps, CGMs, or taking multiple daily injections?
- How will my insulin needs change during labor and immediately after my baby is born?
- How will my insulin needs change in the few days following the day my baby is born?
- Should I adjust my time-in-range targets during and after delivery?
Taking the time to talk through these details now can help ensure everyone is aligned—and give you one less thing to think about when it’s time to meet your baby.
More Pregnancy Guidance
Get tips on building your pregnancy support team, explore the lifestyle habits that may need a check-in, and learn about the risk of passing T1D onto your baby.
Learn what to expect and ways to support your pregnant partner along the way so you can feel more confident and focus on enjoying this exciting journey together.
Learn what to expect during a vaginal birth or a C-section and get guidance on managing T1D in the hospital after childbirth.
Learn more about the challenges of sleep deprivation, post-partum depression, and your body’s unique needs as you recover.
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