If you are currently expecting or hoping to be in the future, congratulations! This is undoubtedly an exciting time in your life. But what if you have diabetes? Can you deliver a healthy baby? Should you even try to conceive?
Women who have diabetes can and do bring healthy babies into the world every day – but pregnancy will put new demands on every woman’s body, especially those with diabetes. That’s why it’s important to know what to expect before, during, and after pregnancy with diabetes.
Types of Diabetes
There are three different types of diabetes, each of which can affect an expectant mother or her baby differently.
Type 1 Diabetes
Type 1 diabetes is also known as insulin dependent diabetes mellitus. This is an autoimmune disorder where the body’s immune system attempts to destroy the insulin-producing cells in the pancreas.
Type 2 Diabetes
Type 2 diabetes is also known as non-insulin-dependent diabetes mellitus. It is a metabolic disorder that results when the body cannot make enough insulin.
Gestational Diabetes
Gestational diabetes is a condition where the blood glucose level is increased during pregnancy, In addition, other diabetic symptoms may appear although the woman had not been previously diagnosed with diabetes.
What Happens During Pregnancy With Diabetes?
In every pregnancy, the placenta is responsible for supplying a growing fetus with water, nutrients, and hormones to maintain the pregnancy.
Early on in pregnancy, hormones can cause an increase in insulin and a decrease in glucose, which can lead to hypoglycemia meaning low blood glucose levels. Similarly, hormones can block insulin later in pregnancy and cause a condition called insulin resistance.
Through pregnancy as the placenta grows, additional hormones are produced which increases insulin resistance. While the pancreas normally is able to overcome insulin resistance, sometimes it fails and the result is gestational diabetes or a worsening of pregestational diabetes.
How Diabetes Can Affect a Baby
Diabetes can affect pregnancy in numerous ways depending on the type of diabetes you have and to what degree. Some complications include:
Birth Defects
Studies show that infants of diabetic mothers are two to six times more likely to have birth defects. Overall, major birth defects occur in five to ten perfect of infants born to insulin-dependent mothers. These birth defects can affect:
Brain and spine
Digestive tract
Heart and connecting blood vessels
Urinary and kidney
High blood sugar levels that occur during the first trimester of pregnancy (12 weeks) can especially cause birth defects and increase your risk of miscarriage and other diabetes-related complications.
Macrosomia
The main concern is a condition called macrosomia. Macrosomia is when a baby is larger than the average baby. Babies born to women with diabetes tend to be larger because high levels of blood sugar cause the baby to get too much sugar in the placenta.
The baby’s pancreas senses the sugar while in utero and makes a surplus of insulin to use it. The extra sugar is converted to fat, making a larger baby. In some cases, a baby will be too big to deliver vaginally and you will need a c-section. Your doctor will keep an eye on your baby’s size throughout your pregnancy, allowing you to plan for the safest delivery.
Hypoglycemia
Hospitals keep a close eye on babies born to mothers with diabetes following birth as their blood sugar can dip dangerously low. This occurs because the baby is used to your sugar and insulin levels. Once they are out of the womb, they can experience a significant drop. If this occurs, medical staff will give your baby glucose to balance their levels. In addition to glucose, their levels of calcium and magnesium can be off too, but both can be treated with medication.
Schedule a Preconception Appointment
If you have diabetes and aren’t already pregnant, we recommend scheduling a preconception appointment. A preconception appointment will help ensure you are both physically and emotionally prepared for pregnancy.
During your appointment, your doctor will tell you if your diabetes is controlled well enough for you to safely stop your birth control method. He or she will likely order a glycosylated hemoglobin test which will show how well your blood levels have been over the past two to three months.
In addition to this test, your doctor may order additional tests to help determine any risks that may be associated with pregnancy. These include:
– Cholesterol and triglyceride blood tests
– Electrocardiogram
– Eye exam to test for cataracts, glaucoma, or retinopathy
– Foot exam
– Urinalysis to assess any kidney issues
Managing Your Diabetes During Pregnancy
Of course, many women don’t realize they’re pregnant until two to four weeks after conception. This is why it is especially important to ensure you have good control of your blood sugar at all times.
Once you are pregnant, there are specific things you should do to manage your diabetes.
Control your blood sugar, exercise, and watch what you eat
While it’s always important to have good control of your blood sugar, it is especially important if you are pregnant or planning on becoming pregnant because high blood sugar levels can negatively affect a fetus.
The ideal range for blood glucose levels:
– 70 to 100 mg/dL before meals
– Less than 120 mg/dL two hours after eating
– 100-140 mg/dL before your bedtime snack
As always, it’s important that you watch what you eat, exercise, and take your medications daily.
Fetal movement counting
Your doctor may advise you to count the number of kicks or movements during a certain period of time. Watching for a change in activity can decrease the risk of stillbirth.
Nonstress testing
This test measures the fetal heart rate in response to the fetus’s movement.
Doppler flow studies
This is a type of ultrasound. It uses sound waves to measure blood flow.
Ultrasounds
This diagnostic imaging technique can view the fetus’s internal organs, tissues, and vessels.
Will My Medication Change Once I’m Pregnant?
If you’re expecting and use insulin, your doctor will advise you on how to adjust your dosage. In many cases, pregnant women with diabetes need more insulin, especially during the last trimester.
If you take a pill, your doctor may want you to switch to insulin. Some drugs may not be safe to take while pregnant, and insulin may help you better control your blood sugar levels.
Will I Carry My Baby to Term If I Have Diabetes?
Many women with a mild form of diabetes, or women who have their blood sugar levels under control, carry their baby to term, or close to term. Your doctor may prefer that you deliver your baby a few weeks early to avoid potential complications.
What Can I Expect During Delivery With Diabetes?
It’s normal for any expectant mother to be nervous leading up to delivery, especially for those who live with diabetes. While labor is undoubtedly a stressful time, your doctor will help you throughout the process.
If you use insulin throughout your pregnancy you may find that you need more insulin when labor begins. After delivery, your need will drop. In any case, you will be able to take your insulin as a shot or it can be delivered intravenously.
Call OB-GYN Women’s Centre of Lakewood Ranch for Treatment and Care During Your Pregnancy
At OB-GYN Women’s Centre of Lakewood Ranch, we provide a variety of services for every woman. If you have diabetes and are expecting, or trying to get pregnant, let us help you deal with everything associated with pregnancy. Call (941) 907-3008 today to schedule an appointment.
