Having high blood sugar levels during pregnancy can increase the risk of:

  • Worsening diabetes complications such as retinopathy, kidney disease, or high blood pressure
  • Birth defects. High blood sugars can influence the development of your baby’s organs
  • Giving birth to a baby weighing more than 9 pounds
  • Delivering your baby by C-Section (a surgical procedure)
  • Developing a condition called preeclampsia
  • Delivering your baby early. This increases the risk of health complications for your baby
  • Hypoglycemia
  • Miscarriage or Stillbirth


If you are taking oral medications (pills) to manage your diabetes, you may not be able to take them during your pregnancy. The safety of diabetes pills during pregnancy is still being researched. Your doctor will likely switch you to insulin therapy for the duration of your pregnancy. You may return to using your oral medications after your baby is born or your doctor may recommend that you continue to use insulin to manage your blood sugars if you are doing well with insulin. If you are already on insulin therapy, your body’s need for insulin is higher in pregnancy and you will need to adjust your treatment accordingly.

Blood Sugar Goals

For the health of you and your baby, you may need to have tighter goals for your blood sugar levels.

  • Before meals aim for 3.5-5.5 mmol/L
  • After meals aim for 5.5-7.0 mmol/L
  • Aim for an A1c less than 6%

Everyone is different and together with your healthcare team you will set individual blood sugar goals.

Eating Healthy

Your doctor or registered dietitian may ask you to change your meal plan to avoid high and low blood sugar levels. Make sure you include a variety of foods and eat appropriate portion sizes. Pregnancy does not require you to eat a lot more than before you were pregnant. In your second trimester you only need to eat an additional 300 calories, which is equivalent to an extra snack. In your third trimester you will need an additional 450 calories, which is equivalent to two extra snacks. Try to get these extra calories by having a snack that contains both a carbohydrate and a protein.

Carb/Non-Carb Handout

Physical Activity

Exercise is an important part of managing your diabetes and having a healthy pregnancy. Its best to get fit before you become pregnant. However, it is safe for pregnant women to start low impact activities such as walking, swimming, or water aerobics. Pregnant women should avoid activities with a high risk of falls and contact sports. Regular physical activity can offset some of the negative side effects of pregnancy such as varicose veins, leg cramps, fatigue, and constipation. Physical activity will also help you keep your blood sugar levels in a tighter range.