Diabetes and Pregnancy

Pregnant women who have diabetes prior to getting pregnant have special health concerns. In addition to the new demands of pregnancy, women with diabetes must also carefully monitor and control their blood sugar levels, and manage their diabetes medications.

If you have diabetes and would like to get pregnant, there are steps you can take to ensure that both you and your baby stay healthy.

Diabetes Pregnancy Preparation

Meeting with your health care provider before becoming pregnant is very important to ensure a healthy pregnancy. Your diabetes health care provider can help you determine if your diabetes is controlled well enough for you to stop your birth control method. A blood test called the glycosylated hemoglobin test (HbA1c) can help your health care provider evaluate how well your diabetes has been controlled over the past 8-12 weeks.

Having other medical tests before you become pregnant can help your diabetes health care provider monitor your health and prevent the development of diabetic complications during pregnancy. Some of the tests your health care provider may recommend include:

• A urinalysis to screen for diabetic kidney complications.
• Cholesterol and triglyceride blood tests.
• Eye exam to screen for diseases common in diabetics such as glaucoma, cataracts, and retinopathy.

A pre-conception counseling appointment with your health care provider is another important step in preparing for pregnancy. Pre-conception counseling helps educate women so they can be physically and emotionally prepared -- and healthy -- for pregnancy.

Diabetes Pregnancy and the Importance of Blood Sugar Control

Good blood sugar control means keeping blood glucose levels within the ideal range (70 to 100 mg/dL before meals, less than 120 mg/dL two hours after eating, and 100-140 mg/dL before the bedtime snack), as well as balancing meals, exercise, and diabetes medications.

Good blood sugar control is important before becoming pregnant because many women do not even know they are pregnant until the baby has been growing for 2-4 weeks. High blood sugar levels early in the pregnancy (before 13 weeks) can cause birth defects.

Good blood sugar control is just as important during pregnancy because high blood sugar levels can increase the risk of miscarriage and can increase your risk of developing diabetes-related complications.

How Diabetes and Pregnancy May Affect Baby

A common problem among the babies of pregnant diabetic women is a condition called "macrosomia," which means "large body." In other words, babies of diabetic women are apt to be considerably larger than others.

This occurs because many of these babies receive too much sugar via the placenta because their mothers have high blood sugar levels. The baby's pancreas senses the high sugar levels and it produces more insulin in an attempt to use up all the extra sugar. That extra sugar is converted to fat, making a large baby.