Managing Pregnancy in T1D: 'One of the Hardest Things We Do'

This transcript has been edited for clarity.

One of my very favorite topics is the management of pregnancy in women with preexisting diabetes. This is one of the hardest things we do — certainly one of the hardest things women do — but it ends up with a wonderful outcome. I want to reinforce what we know and talk about continuous glucose monitoring (CGM).

First, let's talk about pregnancy planning. Women with diabetes have about the same rate of unplanned pregnancies as women who don't have diabetes. I'd like to think it was less, but [unplanned] pregnancies happen.

For anyone who I think is going to become pregnant or is likely to become pregnant, I start her on prenatal vitamins. This might be someone who just got married and says, "I want to have a baby in a year or two." Those are the women that I often find getting pregnant before they know it, so I have them on prenatal vitamins.

Second, when I'm working with somebody who is planning on pregnancy in the near future, I make sure she gets an eye exam, I check her renal function, and I evaluate her to be sure that she is otherwise healthy.