Nearly two decades after my Type 1 diabetes diagnosis, I thought I knew my body pretty well. Then I became pregnant.
When I started thinking about pregnancy, I knew it would be different for me because I had been living with Type 1 diabetes since I was 17.
I knew blood sugar mattered. I knew insulin mattered. I knew I would need more medical appointments.
But looking back, I realize there were so many things I wish I had thought about before getting pregnant.
I wish I had understood how much preparation could go into pregnancy with Type 1 diabetes. I wish I had asked more questions. And I wish I had realized earlier that preparing for pregnancy isn’t only about the mom.
Both parents are part of the preparation.
If you’re living with Type 1 diabetes and thinking about trying to conceive, this is what I would want you to know.
A note before we begin: This post is based on my personal experience and is meant for general informational purposes. Pregnancy with Type 1 diabetes is different for everyone. Your endocrinologist, OB/GYN, and other healthcare providers can help you create a plan based on your own health and circumstances.
Start preparing before you start trying
One of the biggest things I wish I had understood is that pregnancy preparation doesn’t really begin with a positive pregnancy test.
Ideally, it begins before you start trying to conceive.
When you’re planning a pregnancy with Type 1 diabetes, there are more things to think about before pregnancy because your diabetes management, medications, overall health, and any diabetes-related complications can all become part of the conversation.
If you’re thinking about pregnancy, consider making a preconception appointment with your healthcare team.
Depending on your situation, that could include your:
- Endocrinologist
- OB/GYN
- Maternal-fetal medicine specialist
- Diabetes educator
- Registered dietitian
- Eye-care professional
You don’t have to figure everything out in one appointment.
Sometimes the most helpful thing you can do is simply start asking questions.
1. Get Your Diabetes Management Ready
Before pregnancy, I already had years of experience managing Type 1 diabetes.
Checking my blood sugar, taking insulin, thinking about food, and dealing with highs and lows were already part of my everyday life.
But pregnancy made me realize that diabetes management can take on a completely different meaning.
You’re not just thinking about getting through today anymore. You’re preparing your body for pregnancy and everything that comes with it.
Before trying to conceive, talk with your diabetes care team about your individual glucose goals and what pregnancy might mean for your insulin needs.
Some questions worth asking include:
- What should my A1C goal be before pregnancy?
- What glucose targets should I aim for?
- Is my current insulin regimen appropriate?
- Should anything about my pump or CGM change?
- How should I handle overnight lows?
- What should I do if my blood sugar becomes difficult to manage?
- What is my plan for ketones or illness?
- What should I do if I become pregnant unexpectedly?
The goal isn’t perfection.
The goal is to enter pregnancy with a plan and a care team that knows how to support you.
2. Have Your Medications and Supplements Reviewed
This is one of those things that’s easy to overlook.
Before trying to conceive, make a list of everything you take regularly:
- Prescription medications
- Over-the-counter medications
- Vitamins
- Prenatal vitamins
- Supplements
- Herbal products
Then review them with your healthcare provider.
Some medications may need to be changed before pregnancy, while others may be perfectly appropriate.
And don’t stop a medication on your own because you’ve read something online. Your doctor can help you weigh the benefits and risks and decide what is appropriate for you.
I would also encourage your partner to do the same.
Medication review isn’t only a “Mom” conversation.
3. Don’t Forget About the Rest of Your Health
Type 1 diabetes affects much more than blood sugar.
Before pregnancy, it’s worth talking with your healthcare team about whether you need evaluations for diabetes-related complications or other health conditions.
Depending on your individual situation, this can include:
- Eye health
- Kidney health
- Blood pressure
- Thyroid health
- Diabetes-related complications
- Other existing medical conditions
This is another reason I think preconception care is so valuable.
It’s an opportunity to look at the whole picture rather than focusing only on your glucose numbers.
4. Start Thinking About Prenatal Vitamins and Folic Acid
Don’t wait until you see a positive pregnancy test to ask about prenatal vitamins.
Folic acid is particularly important before conception and early in pregnancy.
The CDC recommends that women who could become pregnant get 400 micrograms of folic acid daily. Your healthcare provider may have different or additional recommendations based on your individual health and medical history.
So instead of guessing which prenatal vitamin is right for you, ask your doctor:
“What prenatal vitamin and folic acid recommendation is appropriate for me?”
It’s a small thing that’s much easier to address before you’re pregnant.
5. Remember That Dad’s Health Matters Too
This is something I think deserves much more attention.
When people talk about preparing for pregnancy, so much of the conversation focuses on the woman.
What should she eat?
What vitamins should she take?
What should her blood sugar be?
What appointments does she need?
But there are two people involved in creating a pregnancy.
Dad’s health matters too.
Before trying to conceive, partners can talk with their healthcare providers about their overall health, medications, lifestyle, family history, and reproductive health.
That can include looking at:
Nutrition
A balanced diet and overall healthy lifestyle are important for both partners.
Smoking and tobacco
Smoking can affect reproductive health, and avoiding secondhand smoke is important too.
Alcohol
Heavy alcohol use can affect male reproductive health, so it’s worth discussing alcohol use when preparing for pregnancy.
Medications
Some medications can affect fertility or reproductive health.
One particularly important example is testosterone or anabolic steroid use, which can suppress sperm production.
Family history
Don’t only look at Mom’s side of the family.
Both parents’ family histories can be useful when discussing inherited conditions, genetic screening, and family health risks.
Preparing for a baby should feel like a team effort—not something Mom has to carry by herself.
6. Talk about genetics
Having Type 1 diabetes doesn’t mean your child will automatically develop Type 1 diabetes.
But family history and genetics are still worth discussing with your healthcare providers.
Before pregnancy, you may want to ask about:
- Family medical history
- Genetic conditions
- Carrier screening
- Family history of birth defects
- Any inherited conditions on either side of the family
Genetic and carrier screening isn’t something every couple will approach in exactly the same way, so your healthcare provider can help you understand what makes sense for you.
7. Think About Nutrition Without Chasing Perfection
Before pregnancy, I think it’s easy to fall into the mindset of:
“I need to eat perfectly.”
But I don’t think that’s a realistic goal.
Instead, I would focus on building habits that you can actually maintain.
Think about:
- Balanced meals
- Protein
- Fiber-rich foods
- Fruits and vegetables
- Adequate hydration
- Regular movement
- Enough sleep
And because Type 1 diabetes adds another layer to food and insulin management, it’s important to remember that someone else’s diabetes diet isn’t necessarily your diabetes diet.
Your insulin needs, activity, preferences, and health are individual to you.
If you’re unsure about nutrition before pregnancy, your diabetes care team or a registered dietitian can help you create a plan that makes sense for you.
8. Get Comfortable With Your Diabetes Technology
If you use an insulin pump or CGM, pregnancy is also a good time to talk about your diabetes technology.
My own diabetes technology journey has changed over the years.
I spent years using insulin pens. Then I moved to Medtronic in 2024 and eventually switched to Omnipod in 2025.
My choices weren’t made in isolation. Life circumstances—including becoming a mom—changed what I wanted from my diabetes technology.
You can read more about that journey here:
[From Insulin Pens to Medtronic to Omnipod: My T1D Journey]
I also went through several generations of CGM technology over the years.
[From FreeStyle Libre 2 to Dexcom G7: My Type 1 Diabetes CGM Journey]
If you’re preparing for pregnancy, ask your healthcare team whether your current pump and CGM are appropriate for your pregnancy and how your diabetes technology may need to be managed differently.
9. Prepare for the Unexpected
This might be one of the most important things you can do.
Because pregnancy doesn’t always follow the plan.
Your appetite might change.
You might experience nausea or vomiting.
Your insulin needs can change.
Your blood sugar can become harder to predict.
And sometimes your body simply does something you weren’t expecting.
Before pregnancy, ask your care team what you should do if you experience:
- Vomiting
- High blood sugar
- Ketones
- Severe lows
- Illness
- Dehydration
- Pump failure
- Difficulty eating
Having a plan before something happens can make a stressful situation a little less overwhelming.
10. Prepare Emotionally, Too
This is the part I wish we talked about more.
Pregnancy with Type 1 diabetes can come with a lot of emotions.
You might feel excited and scared at the same time.
You might worry about your blood sugar.
You might worry about the baby.
You might feel guilty when your numbers aren’t what you wanted.
You might become tired of thinking about diabetes on top of everything else pregnancy brings.
Those feelings don’t mean you’re not grateful for your pregnancy.
They mean you’re human.
And if you feel overwhelmed, talk about it.
Your emotional health deserves attention too.
11. Build Your Support System Before You Need It
Think about the people who will be part of your pregnancy journey.
That could be:
- Your partner
- Family
- Friends
- Endocrinologist
- OB/GYN
- Maternal-fetal medicine specialist
- Diabetes educator
- Therapist
- Other people living with Type 1 diabetes
And talk with your partner about what support actually looks like.
Sometimes support isn’t saying:
“Don’t worry. Everything will be fine.”
Sometimes it’s:
“I’ll come to your appointment.”
Or:
“I’ll learn what to do if you’re having a low.”
Or simply:
“I know you’re doing your best.”
Those little things can mean a lot.
My Pregnancy Experience With Type 1 Diabetes
I found out I was pregnant toward the end of 2022.
My first trimester was actually better than I expected. I felt relatively good, and at that point I was mostly taking things one appointment at a time.
But as pregnancy progressed, things became more difficult.
During my second trimester, I started experiencing backaches and more blood sugar fluctuations.
By the third trimester, things were much harder.
I was dealing with significant back pain and sciatic nerve pain in my leg, and my blood sugar was often higher than I wanted it to be.
At the same time, I was still working and trying to prepare for becoming a mom.
Looking back, one of the biggest lessons pregnancy taught me was that you can prepare without controlling everything.
I could prepare.
I could monitor my blood sugar.
I could go to appointments.
I could ask questions.
I could take care of myself.
But I couldn’t make pregnancy perfectly predictable.
And I think that’s an important thing for anyone with Type 1 diabetes to remember.
If I Were Preparing for Pregnancy Again
If I could go back to the time before I became pregnant, I wouldn’t try to make everything perfect.
I would simply try to be more prepared.
For myself:
☐ Schedule a preconception appointment
☐ Discuss my individual A1C and glucose goals
☐ Review my insulin regimen
☐ Review my medications and supplements
☐ Ask about my CGM and pump
☐ Have recommended eye and kidney evaluations
☐ Discuss thyroid and blood pressure
☐ Ask about prenatal vitamins and folic acid
☐ Have a plan for highs, lows, illness, and ketones
☐ Talk about nutrition and physical activity
☐ Think about emotional support
For my partner:
☐ Review medications
☐ Look at overall health
☐ Discuss smoking/tobacco
☐ Discuss alcohol use
☐ Review family medical history
☐ Discuss genetic or carrier screening
☐ Talk about nutrition and lifestyle
☐ Discuss how we will support each other
What I Wish I Had Known
If I could sit down with the version of myself who was preparing for pregnancy, I think I’d tell her:
You don’t need to have everything figured out before becoming a mom.
You don’t need to know exactly what every trimester will feel like.
You don’t need to predict every blood sugar.
You don’t need to know how your body will respond.
But you can prepare.
You can ask questions.
You can get your health checked.
You can work with your diabetes care team.
You can review your medications.
You can involve your partner.
You can build a support system.
And you can remind yourself that managing Type 1 diabetes during pregnancy is something you don’t have to navigate alone.
My pregnancy wasn’t perfect.
My blood sugar wasn’t perfect.
And by the end, my body certainly didn’t feel perfect.
But pregnancy became one of the biggest chapters of my Type 1 diabetes story.
And if you’re considering pregnancy with Type 1 diabetes, I hope this gives you a place to start.
You can prepare without expecting perfection.
A Note From Lady Clay
Everything shared on Lady Clay is based on my personal experiences and is intended for general informational purposes only. It is not medical advice and should not replace guidance from your doctor, endocrinologist, OB/GYN, maternal-fetal medicine specialist, or diabetes care team.
Pregnancy with Type 1 diabetes is different for everyone. Please work with your healthcare team before making changes to your medications, insulin, diet, exercise, or diabetes management.
