MANAGING YOUR 1 ST PREGNANCY With Diabetes
By Madeline Pistorius
F . inding out you’re pregnant for the first time comes with a mix of excitement, nervousness, and a million questions. That’s normal for every woman. But for a woman managing diabetes, that moment may bring an extra layer of concern. With the right planning and support, howev- er, a diabetes diagnosis won’t define the pregnancy journey. Understanding Diabetes in Pregnancy Diabetes comes in three different forms: Type 1, Type 2, and gestational. According to the CDC, diabetes occurs when the pancreas makes either very little insulin or none at all. Simply put, insulin is a messenger that helps transform blood sugar into energy in our bodies; with diabetes, insulin has to be managed manually rather than naturally. Type 1 is typically diagnosed early in a person’s life, while Type 2 develops later on. Gestational diabetes, rather, develops in pregnant women who have never had the disease. As of 2025, diabetes during pregnancy is reported to affect about one in six pregnancies. Joseph R. Biggio, MD, chair of women’s services and mater- nal-fetal medicine (MFM) at Ochsner Health, explains that, for someone with diabetes deciding whether to pursue pregnancy, it’s important to talk to their OB-GYN and endocrinologist, who can evaluate their diabetic history and look
for any red flags that may pose risks. If there are no preexisting-risks, taking the necessary steps to prepare for a safe
was diagnosed with Type 1 diabetes in her youth. During pregnancy, she had to adjust her day-to-day habits to fit a new routine. Lindsay was surprised by how quickly her blood sugars changed and how frequently insulin adjustments were needed. She shares that it means going back to the basics: carb counting, weighing in and measuring foods, and focusing on insulin timing. She even tracked her blood sugars and insulin dosages on paper to review weekly with her MFM team. “I constantly reminded myself of the ‘ why ’ behind the constant monitoring—a healthy baby was more important to me than anything else. I knew that once the baby was born, I could be a bit more lenient with my blood sugar control,” says Lindsay. When certified culinary scientist, food scientist, and author Jessica Gavin of jessicagavin.com was diagnosed with gestational diabetes, she felt guilty, overwhelmed, and surprised. “Pregnan- cy is already a stressful time, and the thought of closely monitoring every- thing I ate felt daunting,” she reflects. But she leaned into learning. Testing her glucose four times a day felt like a personal experiment, and tracking her meals and results taught her which food combinations worked best. “Once you figure out what works for your body, it gets easier. There may be
experience is the next step. First Steps to Consider
Start by coming off any medications used to treat diabetes that are not recommended during pregnancy, and transition to a safe alternative. Dr. Big- gio also recommends taking folic acid at least three months prior to pregnancy to reduce the risk of spina bifida or neural tube defects. “We know that people who have blood sugars that are significantly elevated around the time of conception are at an increased risk for miscarriages, as well as an increased risk of having babies with structural problems,” he says. The most important thing to do is to maintain tight control of blood sugar levels—even before attempting conception. “Not much is dramatically done dif- ferently during pregnancy in terms of monitoring diabetes and controlling insulin; it’s just a little more control and an emphasis on monitoring more regu- larly than someone who’s not pregnant,” Dr. Biggio says. Starting a pregnancy with a healthy head start typically leads to a favorable outcome. Real Life, Real Experiences Lindsay Cohen, RDN, LDN, CDCES, and owner of Mama-Betes ,
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PINK&BLUE | SPRING 2026
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