During Pregnancy
While diabetes complicates pregnancy, rest assured that if you are a woman with diabetes, you can have a healthy baby. Women who already have diabetes should consult with their healthcare team and take special precautions before, during and after pregnancy. Other women may be diagnosed with gestational diabetes while pregnant and should also take special precautions during pregnancy. To alleviate some of your questions and concerns, we've provided helpful information for you below.
Diabetes and Pregnancy
If you have diabetes and are planning on becoming pregnant, or are already pregnant, keeping your blood glucose (sugar) in the target range is more important than ever. Before, during and after your pregnancy, you will have to check your blood glucose frequently and keep a record of your results. Ask your healthcare team to help you find a nutritional and exercise plan during your pregnancy that will keep your insulin in balance.
When you're pregnant, high blood glucose levels can lead to bigger birth-weights and a more difficult delivery. To protect your baby, getting your glucose levels under control before you become pregnant is very important. It's recommended that your blood glucose levels be under control for three to six months prior to becoming pregnant.
Getting extra TLC
Every mother-to-be needs help, and that's even more important for expectant moms with diabetes. That's why when you're pregnant, you should assemble a healthcare team: a family doctor, obstetrician, diabetes educator and a registered dietician who are knowledgeable about diabetes care can help you through your pregnancy. A pediatrician (for children), or neonatologist (for infants), or an endocrinologist can treat your baby upon delivery.
The changes that occur in your body during pregnancy will affect your blood glucose level, so it's important that you do frequent checks at home. Keeping your diabetes under control may take more work than usual, but doing so will protect you and your baby. During pregnancy, your healthcare team may advise you to make changes to your insulin program, medications, diet plan and exercise program. It's important to listen to your own body and talk to your health care team about how you're feeling.
During delivery, both you and your baby will need extra attention, and your health care professionals will be working with you to keep your blood glucose level under control. Although during pregnancy your insulin needs will increase, during labor, your insulin needs will drop. Reading books about delivery or taking a class are good ways to prepare yourself for what will happen during delivery.
Motherhood
Recovering from pregnancy and delivery may make your blood glucose more difficult to control, so even though you'll have your hands full caring for your new baby, it's important to take care of yourself too! Keep monitoring your blood glucose and stick to healthy diet and exercise habits that will help you stabilize your blood glucose levels.
What is gestational diabetes?
Gestational diabetes is high blood sugar that occurs ONLY in pregnant women who do not already have diabetes. It usually goes away once the baby is born. Only a small number of women are affected. It occurs at about the 24th week of pregnancy, when your body makes large amounts of hormones to help your baby grow. These hormones keep your insulin from working the way it should. When this happens, your blood sugar rises.
High blood sugar will cause your baby to grow large and make insulin. Don't worry - most women with gestational diabetes have healthy babies. Still, the gestational diabetes has to be treated until your baby is born. Keeping your blood sugar as near normal as possible will prevent problems for you and your baby.
Am I at risk for gestational diabetes?
You could be at risk if:
- You are overweight.
- You have a family history of diabetes.
- You have had a baby in the past weighing over 9 pounds.
How is gestational diabetes treated?
Meet with a dietitian
For anyone with diabetes, meal planning is important to help control blood sugar. All foods turn into sugar. Carbohydrates like bread, rice and fruit affect your blood sugar the most. Protein and fat can also raise the blood sugar. Eating too many carbohydrates can cause you to have high blood sugar. A dietitian can help you learn how to control your blood sugar, while providing good nutrition for you and your baby.
Get enough exercise
Exercise is important when you have gestational diabetes. Talk to your healthcare team about the best kind of exercise to do while pregnant.
Test your blood sugar yourself with a blood glucose meter
This helps you and your healthcare team know how your gestational diabetes plan is working. Your healthcare team will tell you how often to test and what your blood sugar goals are. Sometimes changes in your diet or exercise are needed.
Test your urine for ketones
If your body has to burn body fat for energy, ketones are left over in your bloodstream. They can be a sign that your body is not getting enough sugar for fuel. Remember, when you are pregnant, you need energy for two. Ask your healthcare team about ketone testing.
Take insulin if directed by your doctor
When you have gestational diabetes, the insulin your body makes may not be working well. Some women need to take insulin injections to control blood sugar. Pills for diabetes cannot be used during pregnancy.
How can gestational diabetes affect me?
When you get gestational diabetes, some problems can occur. Fortunately, in most cases, good control of blood sugar may prevent these problems.
Urinary Tract Infections
Urinary tract infections are more common in women with gestational diabetes. These infections are caused by bacteria, which grow better when your blood sugar is high.
Cesarean Section
A Cesarean section (also known as a C-section) is more common for a woman with gestational diabetes.
Preeclampsia
Preeclampsia (you may have heard this called toxemia) is possible with gestational diabetes. If you get this condition, you will have high blood pressure; protein in your urine; swelling in your face, hands and feet and greater weight gain.
Polyhydramnios
Polyhydramnios can also occur, meaning you have too much amniotic fluid. Amniotic fluid is the liquid inside the uterus. The uterus is the part of your body that holds the baby during pregnancy. Polyhydramnios can cause your baby to be born too soon.
Can gestational diabetes affect my baby?
Yes, high blood sugar can affect your baby, but good control can lower the risk of your baby having problems.
Macrosomia
Macrosomia means large baby. When your blood sugar is too high, the extra sugar gets to your baby. Your baby makes more insulin. The extra insulin and sugar make your child grow bigger and fatter than normal. Macrosomia can make it difficult for you to deliver your baby.
Hypoglycemia
Hypoglycemia means low blood sugar. If you have high blood sugar while you are in labor, your baby will make extra insulin. After delivery, the extra insulin causes your baby's blood sugar level to get too low. Your baby's blood sugar level will be checked and treated, if necessary.
Jaundice of the Newborn
Jaundice of the newborn is a condition that makes your baby's skin look yellow. It is not normally serious, and can happen when you have gestational diabetes. Before delivery, your baby makes extra red blood cells. After delivery, your baby's liver breaks down the extra red blood cells and gets rid of them. The waste product from this process is called bilirubin. If your baby's liver is not mature enough at birth, the extra red blood cells and bilirubin stay in your baby's body. Bilirubin makes your baby's skin look yellow. It is simple to treat in the hospital using special lights.
Can I have a healthy baby?
Of course you can have a healthy baby when you have gestational diabetes. Here are some tips:
1. Follow the instructions of your healthcare team.
2. Check your blood sugar yourself with a meter.
3. Test your urine for ketones.
4. Follow your meal plan.
5. Exercise regularly.
Will my baby be born with diabetes?
If you have gestational diabetes, it does not necessarily mean your baby will have diabetes.
Will diabetes go away after my pregnancy?
Usually, your blood sugar will go back to normal as soon as your baby is born. However, your risk of getting diabetes later in life is higher if you have had gestational diabetes. It is important to stay on a healthy meal plan, maintain a healthy weight and exercise regularly. You should have your blood sugar checked again at your 6-week check up. Then, have your blood sugar checked at each yearly visit. Taking better care of yourself now will mean less chance of developing diabetes later.
For more information about controlling your diabetes and testing, please see Controlling Your Diabetes and Testing in the Diabetes Care section.