Diabetes and Pregnancy: What are the Risks?

To give your child the best chance at optimal growth and wellness, you must ensure you are in good health before and during your pregnancy. If you have preexisting type 1 or 2 diabetes, or develop gestational diabetes during pregnancy, it’s important to understand the increased risk of complications for you and your baby. Once you understand what you are up against, you can work with your OB/GYN to mitigate the risks and make it through your pregnancy without complications. For those with gestational diabetes, your OB/GYN can continue to provide care after your child is born to help you reduce your risks of developing type 2 diabetes. Here’s what you need to know about diabetes and pregnancy.

 

Pregnancy Preparations

 

If you have type 1 or 2 diabetes, you can ensure your pregnancy goes smoothly by preparing your body for this demanding process. You should establish a healthy diet, exercise and medication routine that keeps your blood sugar stable for at least six months before trying to get pregnant. If an unexpected pregnancy occurs, you can still have good results with help from your OB/GYN. Your doctor will help you establish a care routine that normalizes your blood sugar and keeps it in a healthy range.

Since pregnancy continually alters the way your body works, your OB/GYN will closely monitor your condition to verify that your established care routine adequately controls your blood sugar levels. Even with stable readings, your doctor will likely have you keep glucose tablets nearby at all times to handle emergency blood sugar crashes. If you notice your blood sugar fluctuating more than normal between checkups, you should schedule an appointment with your OB/GYN right away.

 

Gestational Diabetes Development

 

Pregnancy puts an enormous amount of stress on your body, which can trigger the development of health problems out of the blue. One of the most common health problems that develops during pregnancy is gestational diabetes. In fact, gestational diabetes develops during approximately nine percent of pregnancies.

Gestational diabetes develops when your pregnancy hormones interfere with your body’s ability to effectively create and use insulin to control your blood sugar. After your pregnancy, your body should resume normal production of insulin to drop your blood glucose levels back into a healthy range.

The condition often begins during the 24^th through 28^th week of pregnancy, so most OB/GYN doctors tend to test for it at that point. You will go to a medical lab to have the glucose challenge test performed. Upon arriving, you will need to quickly consume a glucose solution and have your sugar levels checked 60 minutes later.

If your blood glucose is out of range, you will need to return for the three hour glucose tolerance test. This subsequent test will require the same procedure, except your blood sugar will be tested three times on the hour, instead of just once. If your sugar levels are out of range with the three hour test, your doctor will diagnose you with gestational diabetes.

 

Glucose Control

 

With every type of diabetes, glucose control is vital to your, and your baby’s, health. To keep your glucose at a healthy, stable level, your doctor will provide blood glucose targets to follow through every stage of your pregnancy. The targets may change as your pregnancy progresses toward the 40^th week. You will need to follow the daily glucose monitoring schedule your doctor provides to keep your levels in check. You may need to use a home meter to check your glucose levels up to a half dozen times a day. You should write down all of your blood glucose readings to help your doctor track changes in your condition as your pregnancy progresses.

Since your risk of developing low blood sugar increases during pregnancy, it’s a good idea to keep the main symptoms of this condition in mind as you go about your day. Common low blood sugar symptoms include lethargy, dizziness, shaking, rapid heartbeat, confusion, headaches and anxiety. High blood glucose is always possible as well since diabetes inhibits your body’s ability to produce or utilize insulin.

If you notice any of these symptoms, or if your levels shoot out of the healthy range, contact your OB/GYN. You may need to consume a glucose tablet to stabilize your blood sugar. Your doctor will also perform regular blood glucose and A1C tests at your prenatal visits to assess your, and your baby’s, overall health status.

 

Maternal Risks

 

If your blood glucose frequently hits the high range, your body might start to produce too many ketones. When ketones circulate through your body, your system switches from sugar to fat for fuel, which is called ketosis. The buildup of ketones is dangerous if ketosis evolves into ketoacidosis, which is potentially fatal without prompt treatment.

Women with type 1, 2 or gestational diabetes face an increased risk of preeclampsia. This condition tends to increase your blood pressure and decrease urine output. With 18% of maternal deaths linked to preeclampsia, OB/GYN doctors will watch for the development of this condition very closely by regularly recording your blood pressure.

Women who developed gestational diabetes must have their blood sugar levels monitored after giving birth due to the increased risk of type 2 diabetes. The first blood sugar check should occur 6 to 12 weeks after you deliver your baby. You can mitigate the increased risk of diabetes by working with your doctor to return to or remain at a healthy weight, adopt healthy eating habits and work exercise routines into   your everyday schedule.

 

Fetal Risks

 

In most cases, the potential risks your baby faces result from poorly controlled blood sugar levels. If your blood sugar fluctuates at an unhealthy rate, the risk of premature birth, breathing difficulties and abnormally high birth weight increases. Your child could also be born with low blood glucose, magnesium and calcium levels. With diabetes impacting your health, you also have an increased risk of miscarriage or stillbirth.

Even with well-controlled blood sugar, diabetes poses a risk to your unborn child. If you were diagnosed with diabetes prior to your pregnancy, your child’s risk of birth defects is about eight times greater than normal. If you developed gestational diabetes, however, the birth defect risk only increases past normal if you are overweight or obese as well.

 

Obtaining Care From Your OB/GYN

 

Early prenatal care gives you an excellent chance at mitigating the increased risk of pregnancy complications associated with diabetes. Alternatively, if you do not yet have diabetes, but exhibit the risk factors for gestational diabetes, your OB/GYN will monitor you throughout your pregnancy to watch for the development of this condition and provide assistance with glucose control, if needed. The OB/GYN team at Revere Health is skilled in providing expectant mothers with quality care through their high-risk pregnancies. Your doctor will follow your care well past the pregnancy and delivery to ensure you remain in good health over the years.

 

Mayo Clinic
National Institute of Diabetes and Digestive and Kidney Diseases
WebMD
University of California San Francisco Medical Center
March of Dimes

 

The obstetricians/gynecologists, nurse practitioners and certified nurse midwives at Revere Health OB/GYN provide a full range of healthcare services to women throughout all stages of their lives, including puberty, child-bearing years, menopause and beyond.