Diabetes

Diabetes is a serious disease in which your body cannot properly control the amount of sugar in your blood because it does not have enough insulin. Diabetes during pregnancy, called gestational diabetes is the most common medical complication, representing 3.3% of all live births. No matter what type of diabetes you have, there are many steps you and your healthcare team can take in order to have a safe and healthy pregnancy.

What is Diabetes?

There are two primary types of diabetes.

Type 1 Diabetes – the body does not produce insulin. The body breaks down the carbohydrates you eat into blood sugar that it uses for energy. And insulin is a hormone that the body needs to get glucose from the bloodstream into the cells of the body. With the help of insulin therapy and other treatments, everyone can learn to manage their condition and live long, healthy lives. Symptoms of Type 1 may include increased thirst and urination, constant hunger, weight loss, blurred vision, and extreme fatigue. The CDC estimates that nearly 1.6 million Americans have it, including about 187,000 children and adolescents. Type 1 diabetes occurs at every age and in people of every race, shape and size.

Type 2 Diabetes is the most common form of diabetes, and it means that your body doesn’t use insulin properly. And while some people can control their blood sugar levels with healthy eating and exercise, others may need medication or insulin to help manage it. Symptoms of Type 2 include bladder or kidney infections that heal slowly, increased thirst and urination, constant hunger and fatigue. This form of diabetes is often associated with older age, obesity, family history, previous history of gestational diabetes, physical inactivity, and it can be more prevalent in certain ethnic groups. Type 2 accounts for about 90-95% of diabetes cases in the United States.

How is preexisting diabetes treated during my pregnancy?

Whether you are trying to conceive or already pregnant, treating diabetes during pregnancy is key to the health of both you and your baby.

  • Take time to build your health care team and devise a care plan to manage your blood glucose levels. Frequent contact with your health care provider is essential in managing blood glucose levels and monitoring the health of you and your baby.
  • Talk to your health care provider, or dietitian, to develop a healthy meal plan. Prioritizing proper nutrition will assist in controlling your blood sugar both before and after conception.
  • Tell your doctor about any current medications you are taking for diabetes, or any other health conditions so you can take what is safest during your pregnancy.
  • Make appointments with the appropriate high-risk specialists. Specialists may include a perinatologist who treats women with high-risk pregnancies and an endocrinologist who treats women with diabetes and other health conditions.
  • Stay physically active. You will want to be in the best physical condition during your pregnancy.

What are hypoglycemia and hyperglycemia, and how can they affect my pregnancy?

Hypoglycemia and hyperglycemia are both common in women with preexisting diabetes. Hypoglycemia occurs when blood glucose levels are too low. When blood glucose levels are low, your body cannot get the energy it needs.
You may be experiencing this if you are:

Hypoglycemia can be triggered by:

  • Skipping or delaying meals
  • Eating portions that are too small
  • Overexerting yourself physically

Typically hypoglycemia is treated by eating or drinking something containing sugar, such as orange juice. Hyperglycemia is when your body doesn’t have enough insulin or can’t use insulin correctly.
You may be experiencing this if you are:

  • Always thirsty
  • Suddenly losing weight
  • Using the bathroom often

Hyperglycemia can be triggered by:

  • Improper balance in your food consumption
  • Problems with the amount of insulin you are taking
  • Stress
  • Sickness
  • Lack of physical movement

Typically hyperglycemia is treated by adjusting your insulin dosages.

What are the risks of diabetes to my unborn child?

There are a few potentially negative health risks to the baby when the mother has diabetes.

  • Macrosomia is a condition in which your baby grows too large due to excess insulin crossing the placenta. A large baby can make vaginal delivery difficult and increase the risk of injury to the baby during the birth process.
  • Hypoglycemia, or low blood sugar, can develop shortly after birth due to high insulin levels. Controlling your own blood sugar can help to lower the risks of hypoglycemia for your baby.
  • Jaundice is a yellowish discoloration of the skin and eyes and can sometimes be attributed to diabetes while pregnant. Your pediatric care provider will assist you with a plan to alleviate this condition for your newborn.

What are some other considerations?

There are a few other items to keep in mind:

  • During labor and delivery, your blood glucose will be managed closely to ensure safe delivery. Partnering with your health-care team and support partner will help ease any concerns you may have during labor.
  • Be sure to complete your postpartum care, in order to achieve a healthy weight with daily exercise and sound nutrition. Taking care of your body postpartum is important to managing glucose levels and remaining healthy.
  • Research and decide key items about your baby’s nutrition after birth. Some studies suggest breastfeeding can lower the risk of diabetes in your newborn.

Thousands of women each year are able to navigate diabetes in pregnancy with favorable results. Remember to manage your glucose levels, prioritize proper nutrition and exercise, and stay connected to your health care team. Medically managing your diabetes is key for your health and the success of future pregnancies.

Get the fee My Fetal Life app: iOS or Android.  It features meal recommendations, kick counter, blood glucose tracking, and more.

Want to Know More?

Compiled using information from the following sources:

  • Beckmann, C., Ling, F. W., Barzanksy, B. M., Herbert, W., Laube, D. W., & Smith, R. P., Obstetrics and Gynecology (6th ed.). Baltimore, MD: Lippincott Williams & Wilkins.
  • Mayo Clinic, Guide To A Healthy Pregnancy. New York, NY: HarperCollins Publishers Inc.
  • American Diabetes Association