Diabetes in Pregnancy

When diabetes is diagnosed in a woman for the first time during pregnancy, it is known as gestational diabetes. Diabetes in pregnancy also affects blood sugar levels like other types of diabetes. During pregnancy gestational diabetes affects the health of the mother and her baby. It affects nearly about 10% of pregnant women. High blood sugar levels affect the health of the baby and pregnancy.

Gestational diabetes can be managed with diet and exercise in some cases, but in some other cases, oral tablets or insulin is required. Gestational diabetes goes away after the birth of your baby – but it can increase the risk of type 2 diabetes afterwards – and also increases the risk of type 2 diabetes and obesity for your child as well.

Diabetes before pregnancy

Women who are diabetic before their pregnancy have unique demands – they must keep their blood sugar levels under control and also fulfil the demands of pregnancy – which may affect their blood sugar levels. If you’re thinking about having a baby, take steps to lessen the risks for both you and your child.

How diabetes affects your baby?

Women with diabetes in pregnancy have babies much bigger than normal (macrosomia). Growing baby gets more sugar than required through the placenta. More insulin is produced by the baby’s pancreas to take in the extra sugar – which is converted into fat making the baby large.

During the early stages of pregnancy – first 8 weeks – vital organs, such as heart, kidneys, brain and lungs develop – high sugar levels during this stage increases the risk of birth defects (heart, spine and brain defects).

The risk of miscarriage and a stillborn baby also increases due to high blood glucose levels.

High blood glucose levels during pregnancy can also increase the chance that your baby will be born too early (preterm delivery), weigh too much, or have breathing problems or low blood glucose right after birth.  The risks associated with preterm babies – heart problems, breathing problems, vision problems, intestinal problems and bleeding into the brain.

How diabetes can affect you during pregnancy?

If you are diabetic even before your pregnancy, then pregnancy can make your eyes and kidney problems worse. You will also have increased blood pressure. You may be at a higher risk of developing preeclampsia (An abnormal state of pregnancy characterized by hypertension and fluid retention and albuminuria; can lead to eclampsia if untreated). This condition can cause very serious health issues for you and your baby. If your condition gets worse, your gynaecologist may consider early delivery before 37 weeks.

C- Section (Cesarean Section)

Pregnant women with uncontrolled diabetes are at an increased risk of needing a Cesarean Section (C-section) to deliver the baby in view of big babies which fail to deliver vaginally. Women who have undergone C-section to deliver their baby may take longer to recover from childbirth.

How often do you need to check your blood sugar levels during pregnancy?

If you didn’t check your blood sugar levels before pregnancy, you should start checking them during pregnancy. Ask your gynaecologist about how frequently should you check your blood glucose levels. During pregnancy, your target blood sugar levels may change.

How to manage Diabetes?

Women who have diabetes and are planning to have a baby should try to get their blood sugar levels under control – near to normal – prior to getting pregnant. In case, if you don’t know that you have diabetes and you are already pregnant, then meet your doctor as soon as you know that you have diabetes. Your specialist will make a plan – following the plan will help you have a healthy pregnancy and a healthy baby.

  • Get your health checkups before and during pregnancy
  • Be physically active
  • Follow the diet plan as suggested
  • Follow the instructions of your endocrinologist and gynaecologist
  • Take diabetes medicines if you need to

Your diabetes health care team – your obstetrician with experience treating women with diabetes, a registered dietician, and an endocrinologist.

Target blood glucose levels during pregnancy for most pregnant women

  • Before meals – 90 mg/dL or less
  • One hour after eating – 130 mg/dL to 140 mg/dL or less
  • Two hours after eating – 120 mg/dL or less

Bottom Line

If you have gestational diabetes or diabetes before your pregnancy or diabetes in pregnancy, then meet us for a safe exercise program or plan; a diet plan from our experts and comprehensive care and diabetes management plan. Experts recommend gestational diabetes screening after 24 weeks of pregnancy for asymptomatic women with no previous history of type 1 and type 2 diabetes. Meet your obstetrician to know your risk and screening.

Dr Rajeshwari Reddy