If you're a woman with T1DM thinking of becoming pregnant, you must undergo several tests before and during your pregnancy to ensure that you don't develop or worsen diabetic complications and that your baby is healthy at birth and stays healthy afterwards (see Chapter 7 for more about these tests). They include:
il Hemoglobin A1c testing: Results should be less than 7 percent before conception of the baby and stay that way throughout the pregnancy. Hemoglobin A1c should be measured every one to two months because the turnover of red blood cells is more rapid in a pregnancy, and therefore, the results will change more than normal during pregnancy.
l Kidney function testing: The test by urine microalbumin should be performed on a normal basis before pregnancy and should be repeated once each trimester during pregnancy.
l Eye examination: The examination should be normal before pregnancy, and it should be done once each trimester during pregnancy.
l Thyroid function testing: This test is done with a thyroid-stimulating hormone (TSH). It should be normal before pregnancy and conducted once each trimester during pregnancy.
l Blood pressure: A blood pressure reading should be taken at each doctor's visit, and results should be normal.
l Weight assessment: Weight gain should be appropriate at each doctor's visit. When the weight is normal before pregnancy, the average weight gain for a woman is about 25 pounds. If you're underweight at the beginning of the pregnancy, 30 pounds is recommended. If overweight, 20 pounds is suggested.
l Blood glucose: Your blood glucose level should be less than 90 mg/dl before meals and less than 120 mg/dl at one hour after eating throughout the pregnancy.
If you meet these criteria, it's time to stop the contraceptive pills, hide the condoms, or take out the IUD (intrauterine device) from your uterus. You're ready to have a baby! You'll have no more trouble with your pregnancy than if you didn't have diabetes. Even if the criteria aren't completely met, the pregnancy may be normal. This is where working with a specialist who manages pregnancies in T1DM is very valuable.
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