Diabetes can affect a pregnancy and pregnancy can affect diabetes. But most women with type 1 diabetes can have healthy pregnancies without undue risk.

The challenges women face in pregnancy depend on many factors, including how long they have had diabetes, whether or not their diabetes is complicated by heart, eye, kidney, or vascular disease (such as high blood pressure), and whether they have other conditions (such as thyroid disease).

Women with diabetes should be evaluated before becoming pregnant. This may include eye exams, blood tests, and electrocardiograms. Women with diabetes can improve their health before becoming pregnant by maintaining tight control of blood sugars. This will minimize the chances of miscarriage, birth defects and other complications. Diabetic women with high blood pressure will also need to have that treated.

Target levels for blood sugars during pregnancy may be lower than normal. As a result of this and the effects of pregnancy hormones, insulin doses are often increased during pregnancy. Insulin can be safely used during pregnancy. In fact, its proper use is the key to a healthy pregnancy.

The care of women with diabetes can be a challenge. Some obstetricians prefer that such women seek care with specialists (high-risk obstetricians also known as perinatolgists). Obstetricians are likely to work with a diabetic mother's endocrinologist to help her make the changes she needs and to monitor her pregnancy.