Pregnancy and Diabetes

My approach is to aggressively manage diabetes in women who plan to get to achieve normal blood glucose levels before they become pregnant because if women have poorly controlled diabetes going into a pregnancy, they are at much higher risk for serious fetal complications.

Changing hormones in the body during pregnancy cause blood glucose levels to rise, and high blood glucose levels in early pregnancy (within the first four to six weeks) can result in a 30 to 40 percent chance of having a baby with a birth defect compared to a 2 percent risk in women whose diabetes is in excellent control.

Women with type 1 diabetes or type 2 diabetes are also at higher risk for:

  1. Large birth weight babies, resulting in more Cesarean deliveries and increased complications during delivery
  2. Premature births or fetal death
  3. Pre-eclampsia: a dangerous surge in blood pressure associated with protein in the urine
  4. Diabetic retinopathy: damage to the retina caused by high glucose levels
  5. Nephropathy: diabetic kidney disease
  6. Severe hypoglycemia: episodes of low blood glucose that can result in confusion or unconsciousness

Healthy pregnancy a key to healthy baby and happy mom

Women with uncomplicated diabetes who keep their blood glucose levels in a normal range before and during pregnancy have about the same chance of having a successful pregnancy as women without diabetes.

Following are ADA-recommended targets for women with type 1 or type 2 diabetes as well as GDM (Gestational Diabetes Mellitus)

Fasting ≤95 mg/dL (5.3 mmol/L) and either

○ One-hour postprandial ≤140 mg/dL (7.8 mmol/L) or

○ Two-hour postprandial ≤120 mg/dL (6.7 mmol/L)

A1C, a blood test that measures average blood glucose over two to three months: less than 7 percent

Care of a diabetic pregnant patient includes:

Review of diabetes and obstetrical history

Eye evaluations to screen for and discuss risks of diabetic retinopathy

Renal, thyroid, gynecological and cardiac evaluations

Other recommendations to ensure a successful pregnancy:

See your diabetes provider every one to four weeks

Follow diet guidelines, including folic acid supplements

Do some physical activity, as directed by your obstetrician

Always check your blood glucose before driving (due to an increased risk of severe hypoglycemia)