Conception & Diabetes

For individuals with diabetes, planning for conception is important to ensure a healthy pregnancy for mother and baby. The best plan is to think about conception before stopping birth control methods.1 You might meet with a doctor or a dietitian if you are planning to conceive because   those with diabetes have higher risk pregnancy than those without.2  

 

Risks of having a pregnancy for an individual with diabetes include difficulty trying to conceive, miscarriage, birth defects, preterm delivery, gestational diabetes, gestational hypertension, and cesarean delivery.1 There are a few important goals prior to conception that the mother should aim for to reduce risks associated with diabetes during pregnancy  

First is a controlled blood glucose level, measured by hemoglobin A1c (HbA1c). To prevent birth defects, HbA1c levels should be < 6.5%.2  

To improve management of diabetes, it is recommended to lower weight to within normal BMI range or losing 5-10% of overall body weight loss.1 This weight loss has been linked to lower rates of birth defects and pregnancy complications for the mother. A prenatal vitamin is usually a good idea. Taking at least 400 mcg folic acid, 1000 mg calcium, and 600 IU vitamin D will help prevent birth defects.2  

 

If you are having trouble conceiving after 6-12 months, be sure to talk to your doctor. It might be worth considering additional changes to your diet. Fertility can be impacted by both individuals involved in conception. For men, energy within sperm is used to maintain motility to complete fertilization of the egg.4 High blood glucose within men with diabetes can impair development of the sperm, leading to decreased motility and fertilization rates.4 This leads to decreased sperm quality, seen within men with type 1 and type 2 diabetes.4 This decreased sperm quality impacts embryo quality and implementation rates.4 However, for women only type 1 diabetes has been found to decrease fertility, as no research has found decreased fertility in those with type 2 diabetes.5  

 

Dietary changes to control blood sugar can improve fertility and pregnancy outcomes for both men and women.6,7 Within your normal dietary pattern, make sure to consume enough protein and drink enough fluids. Overall, making simple dietary changes to improve blood glucose prior to conception can make a large impact on the chances of a healthy pregnancy for mom and baby.  

 

References: 

1. Wilkie G, Leftwich HK. Optimizing Care Preconception for Women with Diabetes and Obesity. Clinical Obstetrics and Gynecology. 2021;64(1). doi:10.1097/GRF.0000000000000590 

2. Alexopoulos AS, Blair R, Peters AL. Management of Preexisting Diabetes in Pregnancy: A Review. JAMA - Journal of the American Medical Association. 2019;321(18). doi:10.1001/jama.2019.4981 

3. Tieu J, Middleton P, Crowther CA, Shepherd E. Preconception care for diabetic women for improving maternal and infant health. Cochrane Database of Systematic Reviews. 2017;2017(8). doi:10.1002/14651858.CD007776.pub3 

4. Ding GL, Liu Y, Liu ME, et al. The effects of diabetes on male fertility and epigenetic regulation during spermatogenesis. Asian Journal of Andrology. 2015;17(6). doi:10.4103/1008-682X.150844 

5. Thong EP, Codner E, Laven JSE, Teede H. Diabetes: a metabolic and reproductive disorder in women. The Lancet Diabetes and Endocrinology. 2020;8(2). doi:10.1016/S2213-8587(19)30345-6 

6. Rama Raju GA, Jaya Prakash G, Murali Krishna K, Madan K, Siva Narayana T, Ravi Krishna CH. Noninsulin-dependent diabetes mellitus: Effects on sperm morphological and functional characteristics, nuclear DNA integrity and outcome of assisted reproductive technique. Andrologia. 2012;44(SUPPL.1). doi:10.1111/j.1439-0272.2011.01213.x 

7. Grieger JA. Preconception diet, fertility, and later health in pregnancy. Current opinion in obstetrics & gynecology. 2020;32(3). doi:10.1097/GCO.0000000000000629