The Path to Parenthood: How I Prepared for Pregnancy with Diabetes

It’s amazing to think that nearly a decade ago, I was just beginning to imagine the possibility of starting a family. Now, with my incredible 7- and 8-year-olds filling our days with laughter and endless energy, it feels like a lifetime ago.

I vividly remember that chapter of my life – a mix of hopeful anticipation, a touch of nervous excitement, and a deep commitment to getting my health, especially my diabetes, in the best possible place for what was to come.

Why Preconception Care Matters

The moment the thought of starting a family fluttered into my mind, the little voice inside my head that’s always hyper-aware of my diabetes piped up. I knew that diabetes would make this journey a little different for me and that being proactive before a positive pregnancy test would be key to protecting both myself and my baby to be.

For me, preconception care felt like something I needed to do before I started a family. I wanted to get ahead of the curve, to understand and address any potential bumps in the road, and to arm myself with all the knowledge and support I could find about navigating pregnancy with diabetes.

As someone who worked in the healthcare field, I’d spent hours poring over research, and I knew that tightly managing my blood glucose levels early on could make a world of difference. The thought of potential complications like birth defects, preeclampsia, and having a large baby was scary, but I knew that getting my blood glucose levels optimized before conceiving could dramatically reduce these risks.

One of the best outcomes of focusing on preconception care was finding my healthcare team. Knowing I would be working so closely with these professionals throughout my pregnancy made it crucial to find people I trusted, who understood my unique needs, and who were completely on the same page as me.

The First Steps

Looking back, my first steps of planning for a pregnancy with diabetes involved focusing on my overall well-being. I made conscious efforts to follow a balanced eating plan, incorporating lots of vegetables, fruits, lean proteins, and whole grains into my meals. Regular movement also became a non-negotiable part of my routine. I found joy in long walks around my neighborhood and boxing classes that made staying active feel less like a task and more like something I looked forward to. I also worked hard to establish a consistent sleep schedule. These might seem like simple habits, but they laid a strong foundation for everything that followed.

Of course, managing my diabetes was a central focus as I prepared for pregnancy. I knew that achieving tight blood glucose management was an essential piece of the puzzle. I became even more diligent with carb counting and insulin dosing. I lowered the high alert threshold and raised the low alert threshold on my continuous glucose monitor (CGM) so I could catch and treat out-of-range blood glucose levels right away. It took a lot of work, but seeing my time in range improve was incredibly rewarding and motivating.

Utilizing Diabetes Technology

Diabetes technology played a significant role in this process for me. Since being diagnosed at age 9, I’d gone on and off insulin pump therapy over the years. I was taking a break from it when I began preparing for a potential pregnancy but decided to return to using an insulin pump along with my CGM.

Closed-loop systems were not available yet at that time, but having a pump that allowed me to pause my insulin when my blood glucose was dropping was a game-changer for helping to prevent lows. Using my CGM to view my glucose trends in real time gave me so much valuable information and allowed me to make proactive adjustments. 

Building My Healthcare Team

When it came to building my healthcare team for pregnancy, I knew I needed specialists who understood both diabetes and high-risk pregnancies. I spent hours scouring Facebook groups, doing research on the internet, and asking people I knew for recommendations for Maternal-Fetal Medicine (MFM) specialists in my area. I contacted several and had initial interviews to see who felt like the right fit. It was important to me to find someone who was not only experienced but also made me feel heard and supported.

Ultimately, I chose a fantastic MFM group. One of the most helpful aspects was that the practice had a dedicated diabetes educator. This became incredibly important because my endocrinologist at the time wasn’t comfortable managing my diabetes during pregnancy. Even though I worked as a dietitian and diabetes educator, pregnancy with diabetes was new territory for me, and having that diabetes educator within my high-risk OB’s team was a lifesaver. She worked closely with me on insulin adjustments throughout my pregnancy and provided invaluable guidance and support. It was such a relief to have a team that communicated well and understood the unique challenges of managing diabetes during pregnancy.

We also met with a genetic counselor who explained complex genetic information in an easy-to-understand way. She helped us understand the chances of our baby inheriting specific conditions based on our family history and ethnicity.

Importance of a Strong Support Network

A strong support network can be helpful when preparing for pregnancy with diabetes. I found a Facebook group specifically for moms with diabetes and was able to relate and connect with other women in the same situation as me. I also had a personal friend with diabetes who was planning to try to get pregnant around the same time, and we were able to talk regularly about our experiences.

Looking back, I wish I had known about peer support groups, such as those offered by DiabetesSisters, which can provide emotional support, shared experiences, and practical advice from others navigating similar journeys. 

When I think about that preconception period, I’m so grateful for the time and effort I put in. It wasn’t always easy, and there were definitely moments of anxiety and uncertainty, but knowing that I took those proactive steps to prioritize my health and build a strong healthcare team gave me much more confidence as we embarked on the journey of parenthood. Remember, even though you have diabetes, a healthy pregnancy, and a thriving baby are absolutely within reach!

About the Author: Lindsay Cohen RDN, LDN, CDCES, NBC-HWC, is a St. Louis-based Registered Dietitian, CDCES, and the friendly face behind Mama-Betes. Living with type 1 diabetes since she was 9 gives her a true understanding of what it’s like. Lindsay’s mission is to take the stress out of nutrition and wellness, making it simple, clear, and even fun for her readers and clients. When she’s not sharing her expertise, you can find her spending time with family and friends, playing taxi driver for her two kids, trying the latest workout craze, getting lost in a book, traveling, or exploring new restaurants around town.

Planning for pregnancy or navigating motherhood with diabetes? Join Lindsay Cohen, RDN, CDCES, each month for a supportive space where she shares personal experiences, professional insights, and encouragement for every step of the journey. You don’t have to do it alone—come connect with other women who get it. Sign up below.