Anitha was 32-years-old and a manager at an IT firm in Kochi when she and her husband decided it was time to have a child. However, the thought about the odds always lingered in her mind. Anitha carried with her a diagnosis of polycystic ovary syndrome (PCOS) since she was 22. She struggled with irregular cycles, weight gain, and acne — conditions closely tied to insulin resistance. She knew her risk of diabetes was high. For Anitha, the dream of motherhood was not just about holding a baby in her arms — it was about rewriting her family’s story. Her mother had struggled with type-2 diabetes, and Anitha wanted to break that cycle.
Her journey began long before conception. When she and her husband began trying for a baby, months passed without success. Blood tests revealed insulin resistance and borderline high sugar levels. Sitting in her doctor’s office, she listened carefully as her physician explained the importance of preconception planning. If she wanted to minimise risks, she needed to take control of her health before pregnancy.
“When we discussed these risks, the woman was understandably anxious. But I reassured her that discovering this before conception actually gave us a valuable opportunity — to control her blood sugar levels and decrease the HbA1c levels to prepare her body for a safer pregnancy,” said Dr Rujul Jhaveri, consultant, Narayana Health SRCC Children’s Hospital, Mumbai.
Lifestyle over medication
Anitha had started GLP drugs for weight loss and diabetes, but stopped them on her doctor’s advice as they are unsafe during pregnancy.
“During preconception counselling, we optimise diabetes control and shift patients to pregnancy-safe medicines,” said Dr Meghana Reddy Jetty of Aster Whitefield Hospital, Bengaluru. Without medication, Anitha focused on lifestyle changes—healthier food and regular walks. Gradually, her blood sugar stabilised and her energy improved.
From preparation to pregnancy
With dietary changes and modest weight loss, Anitha’s cycles normalised, and she conceived within a year. “I realised managing my sugar wasn’t just about fertility, but my overall health,” she said. By then, her HbA1c — a marker of long-term glucose control — was within the safe range.
“Overt diabetes increases the risk of foetal and maternal complications. Women with diabetes should ensure their HbA1c is below 6 before pregnancy,” said Dr Simi Haris, consultant, KIMSHEALTH, Thiruvananthapuram.
Prepared paths, healthier outcomes
Dr Reji Mohan, Associate Professor, Department of Reproductive Medicine, Sree Avittom Thirunal Hospital for Women and Children, Thiruvananthapuram, highlighted why planned pregnancies are the right approach. “Planning helps to prepare the mother and mitigate risks which are not just diabetic related. We advise folic acid before pregnancy to reduce the risk of neural tube defects to some extent. Pre-pregnancy counselling is a proactive health check and guidance session,” he said.
Dr Suhasini Inamdar, consultant at Motherhood Hospitals, Indiranagar, Bengaluru, said most of her patients are around 30, with nearly 80% of cases linked to sedentary lifestyles. While some have a strong family history or conditions like type-1 autoimmune diabetes, she emphasised that managing stress and maintaining a healthy BMI are key. She also noted that delivery timing is carefully planned: up to 40 weeks for those controlled by diet, 38 weeks if on oral medication, and 37 weeks for those on insulin.
Motherhood may be seen as a natural phase, but for many women it is shaped by biology, lifestyle and heredity. Insulin resistance can complicate pregnancy, but with the right approach, it can be managed successfully.