Diabetes and Pregnancy

What is diabetes mellitus?

Diabetes mellitus is a condition that prevents the body from properly using food to provide energy. Insulin is a hormone produced by the pancreas that removes glucose from the blood and into the body’s cells to use for energy.

Diabetes is caused by one of two problems with insulin:

The pancreas makes little or no insulin. This is called Type 1 diabetes.
The pancreas makes insulin, but the body does not respond to it correctly. This is called Type 2 diabetes.

As a result, glucose remains inside the bloodstream, which can create problems such as:

Heart disease
Kidney disease
Vision problems
Pregestational diabetes refers to diabetes that has been diagnosed before pregnancy.

How can pregestational diabetes affect my pregnancy?

Some problems that can occur in pregnant women with diabetes are:

Birth defects
High blood pressure
Hydramnios – Hydramnios means an increased amount of amniotic fluid within the amniotic sac that surrounds the fetus.
This can cause preterm labor and delivery.
Macrosomia – Macrosomia is a term that is used to describe a newborn that is significantly larger than average (more than 8 pounds). This is due to the baby receiving too much glucose from the mother’s blood.
Macrosomia can cause delivery to be more difficult, increasing the chance of having a cesarean delivery.

How can pregestational diabetes affect my baby?

Potential problems that may occur in the newborn:

Breathing troubles
Low glucose levels
Jaundice
Need for special care nursery.

You can prevent these problems with proper planning and maintaining control of your diabetes.

If I have diabetes and wish to become pregnant, is that safe?

Yes, it is safe, but controlling your glucose levels is important. High glucose levels can cause birth defects, which can happen before you even know you are pregnant. Controlling your diabetes may require modifications to your diet, medications, and exercise.

How can I control my diabetes during pregnancy?

You can control your diabetes with a combination of the following:

Taking medications as directed by your doctor
Proper diet
Exercising
Frequent prenatal appointment visits.

How does my health care provider know if my blood glucose levels are sufficient?

Your healthcare provider can check your blood glucose levels by performing a Hemoglobin A1C test. This test provides an estimate for how well your glucose levels have been over the past 4-6 weeks.

Can pregnancy affect my glucose levels?

Pregnancy can increase the likelihood of hypoglycemia in women with diabetes. Hypoglycemia refers to low blood glucose levels.

Contributing factors include:

Skipping meals
Not eating enough
Eating at odd times of the day
Exercising too much
Symptoms may include:Dizziness
Sweating
Feeling shaky
Weakness
Sudden hunger.

How can my diet affect my pregnancy?

For any pregnancy, a healthy, well-balanced diet is critical. The baby depends on the mother’s food supply for its growth and development. Diet becomes even more critical for those with diabetes. Not eating properly can alter your glucose levels, which can then affect the baby.

How can exercise help during my pregnancy?

Exercising helps to maintain glucose levels within the normal range. Exercising also helps in the following ways:

Weight control
Boosting energy
Sleep
Reducing backaches
Reducing constipation and bloating.

Will I take medications to control my diabetes during pregnancy?

If you were taking insulin before becoming pregnant, then insulin dosages will likely increase while pregnant. Insulin is safe to use during pregnancy and does not cause birth defects.
If you were using an insulin pump before becoming pregnant, then you most likely will be able to continue using it while pregnant, but you may be advised to switch to insulin shots.
If you normally take oral medications, then you may be advised to alter your dosage.

How will diabetes affect labor and delivery?

Labor could potentially be induced earlier than the expected due date, especially if problems during the pregnancy arise.
While in labor, blood glucose levels will be monitored closely (typically every hour).
If needed, insulin may be pumped through an IV line.
You may use an insulin pump during labor if desired.

If I have diabetes, can I breastfeed my baby?

It is highly recommended that women with diabetes breastfeed.

Benefits include:
- Adequate nutrition for the baby
- Shedding weight
- Returning uterus to pre-pregnancy state.

Diabetes and Pregnancy