The goal: Tight blood sugar control

Controlling your blood sugar level before and during pregnancy is the best way to prevent diabetes complications. Good blood sugar control during pregnancy can:

• Reduce the risk of miscarriage and stillbirth. Good blood sugar control reduces the risk of miscarriage and stillbirth — primary concerns for pregnancy and diabetes, as patients with uncontrolled diabetes have a higher risk of miscarriage and stillbirth.
• Reduce the risk of premature birth. The better your blood sugar control, the less likely you are to go into preterm labor.
• Reduce the risk of birth defects. Good blood sugar control before and during early pregnancy greatly reduces your baby's risk of birth defects, particularly those affecting the brain, spine and heart.
• Reduce the risk of excess fetal growth. If you have poor blood sugar control, extra glucose can cross the placenta, resulting in your baby growing too large (macrosomia). A large baby makes vaginal delivery difficult, increases the risk of a cesarean delivery and puts the baby at risk of injury during birth.
• Prevent complications for mom. Good blood sugar control reduces your risk of urinary tract infections and yeast infections. It can also help avoid diabetic complications such as diabetic ketoacidosis. With diabetic ketoacidosis, your blood sugar is so high that your body fails to make enough insulin, resulting in a buildup of chemicals called ketones in your blood, and requiring hospitalization for management.

• Prevent complications for baby. Sometimes babies of mothers who have diabetes develop low blood sugar (hypoglycemia) shortly after birth because their own insulin production is too high. Good blood sugar control can help promote a healthy blood sugar level for your baby, as well as healthy levels of calcium and magnesium in the blood.

  Good blood sugar control also helps prevent a yellowish discoloration of the skin and eyes (jaundice) after birth, and decreases the risk of developing too much amniotic fluid around the baby — a condition known as polyhydramnios.