What do I Need to Know About Pregnancy and Diabetes?

Pregnancy and diabetes shouldn't be confused with gestational diabetes.

Gestational diabetes occurs in women who develop a resistance to insulin while pregnant. It usually appears at about 24 – 28 weeks gestation and disappears after the birth of the baby.

If you are diabetic and are, or plan to become, pregnant this pregnancy and diabetes section is for you.

A healthy pregnancy and baby is the aim every pregnant woman but with diabetes you will need to put in some effort to achieve it.

Good planning before and careful management after conception will go a long way towards keeping you on track.

Things to consider before you conceive.

Get your blood sugar under control. Tight control of your blood glucose levels is essential. Your baby's physical development is rapid during the first couple of months of gestation and poor glucose control can lead to developmental problems.

Eat well. Pregnancy and diabetes is often difficult to manage. Getting your diet right and your blood sugars stable before trying to conceive will help you to maintain good control during the pregnancy.

Speak to your healthcare team about good nutrition to prepare your body for the task ahead. You will be advised to take folic acid supplements. These are recommended for all women planing to have a baby. Folic acid has been shown to help prevent spinal cord development problems such as spina bifida.

Discuss your medication with your doctor. This can be a problem for type 2 diabetics in particular. Certain diabetes medications can harm your developing baby. You may need to switch to insulin to control your diabetes while you are pregnant.

Certain blood pressure medications can also lead to problems. If you are on any medication at all, speak to your healthcare team before trying to conceive.

Stop drinking and smoking. I know this is easier said than done, but both alcohol and smoking can damage your health and that of your baby. Try to cut out alcohol altogether until after your baby is born.

Smoking and alcohol can harm your baby before it is born and can have lasting effects on its health even after birth. Some damage is permanent.

Smoking with diabetes can lead to severe complications regardless of whether you intend to fall pregnant or not. Speak to you doctor for help and advice on giving up.

What happens during pregnancy?

Pregnancy is divided into three phases called trimesters. Each one is three months long.

The first trimester. During this phase the baby's major organs are formed and the nervous system, eyes, nose and ears all begin to develop.

It's important to monitor your blood sugars regularly and keep them as close to normal range as possible.

If you are a type 1 diabetic be sure to test your urine for ketones if your sugars run high.

Maintain a healthy diet and be sure to take your folic acid and any other supplements your healthcare team may have recommended.

If you experience morning sickness and are vomiting, seek advice from your doctor or your dietician. This is especially important if your diabetes is controlled with insulin.

The second trimester. This is the stage where your baby's body grows rapidly and the brain develops further. You may also begin to feel the baby moving in this phase.

Keep a close watch on your blood sugars and make sure you get plenty of good nutrition and rest as well as some exercise. Consult your healthcare team if you have any problems or questions.

The third trimester. This phase sees rapid brain and body growth and it can place extra strain on your body. The baby may move around a lot at this stage and it may be helpful if you can find the time to rest when the baby is resting.

It's still important at this stage to keep your sugars in check and to follow a good nutritious diet plan.

As the delivery date draws near your baby will begin to move into position ready for the birth.

What are the risks?

Pregnancy and diabetes is always a risk, but knowing that in advance can help you to minimise potential problems.

Expectant mothers with poorly controlled diabetes run the risk of their babies being born with birth defects or even being unable to carry a baby to term.

The risk of miscarriage increases if poor diabetic control leads to the production of ketones as this increases the body's acidity.

If your sugars run high during pregnancy your baby could have a much higher than normal birth weight (fetal macrosomia) and a natural birth may not be possible.

Babies born to mothers with high glucose levels can also suffer from jaundice, hyper- or hypoglycemia.

Be sure to attend regular ante-natal appointments and contact a member of your healthcare team if you have any concerns whatsoever.

Pregnancy and diabetes is a challenge but if you approach it with a positive attitude and a willingness to be diligent in your health care the reward of a healthy baby will be well worth the effort.

Return to Gary's Diabetes Management from Pregnancy and Diabetes

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