Why Plan?
Uncontrolled diabetes in early pregnancy can lead to miscarriage, congenital defects, and
complications. But with preparation, most women with diabetes can have a healthy baby.
What to Do Before Conceiving
-Achieve Target HbA1c <6.5% for at least 3 months
-Stop harmful medications: ACE inhibitors, statins, some oral antidiabetics
-Start folic acid: 5 mg/day ideally 3 months before pregnancy
-Check for complications: Eyes, kidneys, heart — all must be stable
-Counseling: Discuss risks, options, and birth planning
Medications Safe in Pregnancy
-Insulin is the gold standard
-Metformin is sometimes used in early pregnancy but individualised
Follow-up Plan
-Monthly reviews until 28 weeks, fortnightly till 36 weeks, then weekly
-Monitor blood sugar multiple times a day
-Growth scans every 4–6 weeks
Patient Story:
Shalini, a 29-year-old teacher with type 2 diabetes, wanted a baby. With her doctor, she
switched to insulin, improved her sugar levels, and had an eye check. She conceived
naturally, and by sticking to her plan, delivered a healthy baby boy — and stayed
complication-free.
Take-Home Messages:
Don’t wait for a positive pregnancy test — start preparing months before. With proper
planning, motherhood is safe and joyful.
References: ADA 2025, Endocrine Society of India, RSSDI 2024
