Diabetes and Pregnancy
Having a baby is a big decision for anyone, but it can be especially important for women who have type 1 or type 2 diabetes. After all, you're probably already aware that poorly controlled diabetes can put your baby at greater risk of birth defects.1 But did you know that keeping your blood sugar in tight control before and during pregnancy can lower the risk of birth defects to the same level as a woman without diabetes?2
Planning Ahead
It's common for a woman not to know she's pregnant until the baby's been growing for two to four weeks. But the first six weeks of a pregnancy are when the baby's organs are forming. High blood sugar during this time can affect the baby's developing organs and lead to birth defects.1 That's why it's critical to plan your pregnancy -- that way, you can have your blood sugar well controlled from the moment you conceive. The American Diabetes Association recommends having your blood sugar under control for three to six months before you get pregnant.1
Once you've decided you want to expand your family, work closely with your doctor, an obstetrician who has had patients with diabetes, a pediatrician who can treat the special problems associated with diabetic mothers, your dietitian, and the other members of your healthcare team to ensure a safe, healthy pregnancy.3
While You're Pregnant
There are two reasons to manage your blood sugar carefully throughout your pregnancy -- you and your baby. For you, all the changes taking place in your body will affect your blood sugar. Your need for insulin is likely to go up. (If you're taking diabetes pills, your doctor may have you switch to insulin.) And pregnancy can make it harder to identify low blood sugar.3 Testing your blood sugar frequently -- as often as six or eight times a day -- will help you keep your blood sugar in the range recommended by your healthcare team.2
How does your blood sugar affect your baby throughout the pregnancy?
Extra blood sugar in your system passes through the placenta to the baby. High blood sugar can cause your baby to grow too big, making delivery difficult for both of you.3 And your baby may be at higher risk of obesity and type 2 diabetes later in life.2
In addition, a baby who receives extra sugar will create more insulin to counteract it. After birth, the baby may need to be watched carefully for low blood sugar until their body begins producing insulin at normal levels.3
To help avoid these problems:
•see the members of your healthcare team regularly throughout your pregnancy
•eat healthy foods -- your registered dietitian can help create a meal plan that will nourish you and the baby, and help control your blood sugar
•exercise regularly to help balance food intake and feel your best
•test blood sugar often, since levels can change quickly during pregnancy
2
Being pregnant isn't easy on anyone. You'll need more rest and nutrients, and you'll have lots to prepare for. Eating well, getting enough exercise, and having your diabetes under control will allow you to focus on all the excitement that lies ahead.
Delivery Day
You've read all the baby books. You've taken birthing classes. But how will the experience be different with diabetes?
In the last months of your pregnancy, your doctors will probably watch the baby's growth carefully. Together you'll decide if you should wait for labor to start on its own or if you should schedule a C-section.4 Either way, once labor begins, your blood sugar will be monitored closely throughout.4 During active labor, many women's insulin needs drop. You may not need any insulin for 24 to 72 hours after delivery.4
Back at Home
Having a baby is hard work. To make things even more complicated, many women experience unpredictable blood sugar during the first few weeks of their recovery. Breastfeeding may make blood sugar even less stable, but it's still good for you and the baby.5,6
Lack of sleep, odd schedules, the excitement of bringing baby home
-- all can lead to stress and fatigue. It's especially important to make sure you don't sleep through meals or allow your blood sugar to drop too low, leaving you confused and unable to care for the baby. Sticking to a frequent blood sugar monitoring plan during this time will help you feel better and help you and your doctor determine how much insulin or medication you need.5
Remember, in order to take good care of your baby, you first have to take good care of yourself.
For information on gestational diabetes, click here.
1 American Diabetes Association. "Before Pregnancy." Available at: http://diabetes.org/type-1-diabetes/sex-and-pregnancy/before-pregnancy.jsp. Accessed July 3, 2007.
2 Centers for Disease Control and Prevention. "Diabetes and Pregnancy Frequently Asked Questions." Available at: http://www.cdc.gov/
ncbddd/bd/diabetespregnancyfaqs.htm. Accessed July 3, 2007.
3 American Diabetes Association. "Good Prenatal Care." Available at: http://diabetes.org/type-1-diabetes/sex-and-pregnancy/prenatal-care.jsp. Accessed July 3, 2007.
4 American Diabetes Association. "Delivery." Available at: http://diabetes.org/type-1-diabetes/sex-and-pregnancy/delivery.jsp.
Accessed July 3, 2007.
5 American Diabetes Association. "After Delivery." Available at: http://diabetes.org/type-1-diabetes/sex-and-pregnancy/after-delivery.jsp. Accessed July 3, 2007.
6 Centers for Disease Control and Prevention. "Breastfeeding." Available at: http://www.cdc.gov/breastfeeding/. Accessed July 12, 2007.