Health care providers no longer discourage women with diabetes from becoming pregnant.

We now know that the key to a healthy pregnancy for a woman with diabetes is keeping blood glucose (sugar) in the target range -- both before she is pregnant and during her pregnancy. To do this, you need a diabetes treatment plan that keeps meals, exercise, and insulin in balance. This plan will change as you change with pregnancy. You will also need to check your blood glucose often and keep a record of your results. With your blood glucose in the target range and good medical care, your chances of a trouble-free pregnancy and a healthy baby are almost as good as they are for a woman without diabetes.

Despite advances, babies born to women with diabetes, especially women with poor diabetes control are still at greater risk for birth defects. High blood glucose levels and ketones (substances that in large amounts are poisonous to the body) pass through the placenta to the baby. These increase the chance of birth defects.

For this reason, good blood glucose control before you get pregnant is very important. Most women do not know they are pregnant until the baby has been growing for two to four weeks. During the first six weeks of pregnancy, the baby's organs are forming. Your blood glucose levels during these early weeks affect the baby's growing organs. High blood glucose levels can lead to birth defects.

Because these early weeks are so important to your baby, you need to plan your pregnancy. If your blood glucose levels are not in good control, work to bring your diabetes under control before getting pregnant. It is a good idea to be in good blood glucose control three to six months before you plan to get pregnant. You'll want to keep excellent blood glucose control during pregnancy, and after as well.