Healthy Pregnancy with Diabetes

Reviewed by James Brann, MD
Diabetes happens when you have a problem with your insulin. Insulin is what moves glucose, or blood sugar, from your body to your cells, where it’s then turned into energy. When you have diabetes before you get pregnant, it’s often called pre-gestational diabetes.
When you body is either not making enough insulin, or not responding to it, glucose stays in the blood instead of moving on into the cells. When this happens, your blood glucose level rises. As time goes on, this can lead to some pretty serious health issues, including vision problems, kidney disease and heart disease.

What does pre-gestational diabetes mean for pregnancy?

If you’re not able to manage your diabetes well, you may become at a greater risk of a number of diabetes-related complications. They may include:
  • High blood pressure
  • Birth defects
  • A large baby - In this case, the baby gets too much glucose from its mother, and grows too large. This may make delivery difficult, as well as lead to the need for a C-section.
  • Too much amniotic fluid in the amniotic sac around the baby - This may mean preterm labor and delivery.

What does it mean for by child?

When mothers have pre-gestational diabetes, their babies may have low glucose levels, jaundice, or even breathing problems. While most of these babies thrive, some may need to visit the special care nursery. By controlling your diabetes and planning ahead, however, you can lower the risks.

Should I tell my doctor if I want to get pregnant?

If you have diabetes, you most certainly should tell your doctor before trying to get pregnant. This gives your doctor the opportunity to help you get your blood glucose level under check. This is important because there are some birth defects due to high glucose levels that occur during the first eight weeks of pregnancy. Your baby’s organs are developing at this point, and you may not even realize you’re pregnant. You may need to change your diet, exercise or medications to help control your glucose level.

What else should I do?

To help control your glucose level, start by exercising, eating a good diet and taking the medications your doctor prescribes. You may need to visit your doctor more often, especially during pregnancy, to make sure your glucose level is good.

Your doctor may use a hemoglobin A1C test to track how you’re doing. This type of test estimates how your blood glucose has been over the past four to six weeks.

How pregnancy affects glucose levels

If you have diabetes and get pregnant, you’re more likely to have hypoglycemia, or low blood glucose levels. This may happen if you skip a meal, don’t eat enough, don’t eat at the right time of the day, or are exercising too much. Make sure you know what to do if you start having symptoms. These include suddenly feeling hungry, feeling weak, sweating, feeling shaky or becoming dizzy.

Diet & exercise during pregnancy

A good diet is important during any pregnancy because your baby needs that food for nourishment and to grow. When women have diabetes, your diet becomes even more important for your child. If you’re not eating properly, your glucose level could go too low or too high.

Exercise is also important because it can help keep your glucose level within a normal range. It also gives you an energy boost, helps you sleep, reduces the chance of backaches, bloating and constipation, and helps you control your weight.

Taking medications for diabetes during pregnancy

If you were already taking insulin before getting pregnancy, that dosage will probably increase during your pregnancy. Insulin is safe for pregnant moms, and it won’t cause birth defects. Even if you used an insulin pump before getting pregnant, you’ll probably be able to keep using it. In some situations, though, you may have to switch over to insulin shots.

If you usually use oral medications for managing your diabetes, you’ll probably be put on a different dosage, or need to switch to insulin.

Labor & delivery with diabetes

If you start to have some problems in your pregnancy, your doctor may choose to induce you ahead of your due date. During labor and delivery, he or she will also closely monitor your glucose level, usually about once an hour. If necessary, you may need to get insulin through an IV. If you already use an insulin pump, you may also need to use it during your labor.

What about breastfeeding?

It’s recommended that women with diabetes do breastfeed their child. This gives your baby the nutrition it needs to be healthy, and it’s good for mom, too. Breastfeeding helps moms take off the extra weight they gained during pregnancy, and helps your uterus shrink back down to the size it was before getting pregnant.

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