Common Questions
What is the recommended care team for diabetes in pregnancy?Sometimes, whoever provides your prenatal care is all you will have access to for your care.
The ideal is a team based approach including your prenatal care provider (midwife, physician or OB/Gyn), a nurse, a dietician, a maternal fetal medicine specialist and a social worker. Each team member brings strengths and ideally, their practice is aligned so that you are not getting mixed messages that delay your care.
When your prenatal care provider/team is not able to provide adequate diabetes support or when you would like additional support in your diabetes care, you can pursue additional care with Radiance Women’s Wellness with Tara.
What are my care options for diabetes in pregnancy?Your options vary depending on your situation. Ideally you want to have your blood sugar levels within the normal range before pregnancy or at least as early as possible once you realize they are elevated.
You need appropriate care for your circumstances. Diet and exercise therapy can make a significant impact for many people but often are not enough. Delaying starting medication can mean increased risks for you and baby in pregnancy, birth and beyond.
Insulin is considered first line treatment for blood sugars that diet and exercise do not impact adequately.
Metformin is not FDA approved for diabetes in pregnancy but has long been used off label for people who prefer to not take insulin injections or who desire additional support offered by metformin alongside their insulin.
There are other oral medications that are rarely used due to side effects including low blood sugar and difficulty precisely adjusting them.
You can learn more at MotherToBaby: https://mothertobaby.org/fact-sheets/
Just type in the medication type you are interested in: insulin or metformin for diabetes in pregnancy
How do I get started?Getting started is simple. Reach out through our contact form, email or call.
Check with your insurance to verify if I am covered in your plan. If so, I will bill each visit and your copays and coinsurance will apply. If not, you have the option to self-pay for care.
Let your primary prenatal care and maternal fetal medicine providers know you are seeking additional support to manage your blood sugars. Sign a records release with their offices so that I can have access to your prenatal care records. You will sign a records release with me so that I can communicate with them and also send your records to them.
After these steps, we have some additional new patient documents to review and sign (privacy, communication preferences, health history) prior to your first appointment. Evening and weekend appointments are available.
What makes you different?I have over 9 years of intensive experience caring for individuals with all types of diabetes in a community health clinic (for people with higher risk conditions collaboratively with OB’s) as well as working in and establishing a diabetes in pregnancy program in a maternal fetal medicine clinic.
My primary focus is supporting you in your care to optimize your blood glucose levels within a normal range to promote the best outcomes for you and baby in pregnancy, birth and beyond.
In addition to my years of intensive work in this specific area, I have acquired additional training and certification to validate my knowledge and experience.
I have a unique approach to your care that centers you and the context of your life. I work with you to empower you with the knowledge, treatments and resources to manage what you have control over in order to make the most impact.
Can I see you if I already have another prenatal care provider?The care I offer is separate from your routine prenatal care and specific to helping you manage your blood sugars.
You would see me if your prenatal care provider and maternal fetal medicine teams are not able to accommodate intensive diabetes management into the rest of the care they offer you.
You would see me if you need virtual visits for this intensive care that they cannot accommodate - think evenings and weekends.
You would see me if you wanted additional support and care in addition to what they are able to offer you.
I encourage getting as much support as possible in this journey and in addition to your prenatal care provider for routine care and maternal fetal medicine care for ultrasounds and specialty care, also recommend a dietician for nutritional support and a social worker or therapist for the emotional toll inherent in managing life, pregnancy and diabetes.
Can you care for everyone with diabetes in pregnancy?No, some individuals have significant conditions that make it such that they need very specialized and tightly coordinated care with maternal fetal medicine specialists in order to have the best outcomes. These conditions can include but are not limited to heart disease, kidney disease, organ failure and severe mental health issues.
Individuals who have longstanding and difficult to manage diabetes, those with recurrent low blood glucose, severely elevated blood glucose or hospitalizations for hypoglycemia, diabetic ketoacidosis or other complications, need intensive specialized care with a comprehensive maternal fetal medicine team.
For anyone who is not able to achieve improvements toward the normal range of blood glucose in my care also needs additional intervention and care with obstetricians or maternal fetal medicine specialists.
How will you work with with the rest of my care team?While I will maintain regular communication with your primary prenatal care provider and maternal fetal medicine team to coordinate your care as seamlessly as possible, I will not be your primary provider and will be limited to supporting your diabetes care as an adjunct to your team.
I will share descriptive notes of my care for you to keep everyone aware of what our plan is and why. Each of your other providers may still offer additional reinforcement of our plan or alternative recommendations. Sometimes this can be confusing but there is almost always a good reason and I am always happy to talk through all of your options and why I recommend what I do.
What else do I need to know?You can do this!