Women with diabetes typically feel worse effects during pregnancy. But, preparation and education can lead to improved outcomes for moms with diabetes and their babies.
Tight blood sugar management during pregnancy is important. If you have been seeing a dietitian or diabetic educator, great. If not, schedule a refresher meeting to implement strict goals.
Consult with a specialist: Maternal fetal medicine from Sanford Health
If you are already on diabetes medication, you may need higher doses through your pregnancy. If you have diet-controlled diabetes, you may need to start medication.
Diabetes is also associated with increased risk of hypertension and preeclampsia. Potential development of these conditions is monitored closely as risk-reduction strategies are implemented.
Risks of diabetes during pregnancy
The risk of preterm birth is higher in women with diabetes. If you are considering pregnancy, it is advisable to begin more strict management of the condition.
If you had diabetes before pregnancy, your doctor may recommend early delivery to decrease risks for you and your baby. These cases also call for additional monitoring of the baby throughout pregnancy. In the third trimester it’s common to monitor growth by ultrasound every three to four weeks. After 32 weeks, heart rate monitoring/and or special ultrasound are typically also recommended.
Diabetes is associated with babies growing larger, which can increase risks to mom and baby during vaginal delivery. To avoid these problems, a cesarean section may be considered. However, in some cases babies face the opposite issue: difficulty growing adequately. These cases indicate an improperly functioning placenta.
Types of diabetes
During pregnancy, women can face two types of diabetes. Gestational diabetes develops during pregnancy. It goes away after the baby is born and happens to women who didn’t have diabetes prior to pregnancy.
In cases of pre-gestational diabetes, women have diabetes before becoming pregnant. Women with type 1 diabetes have bodies that don’t make insulin. They take insulin shots to meet the body’s need to use blood sugar. Women with type 2 diabetes either can’t use the insulin their bodies make, or their bodies make insufficient amounts. This condition requires blood sugar-lowering medicine and possibly insulin.
Diagnosing diabetes during pregnancy
Your doctor will monitor you for diabetes during pregnancy. With risk factors for type 2 diabetes — such as being overweight — your doctor will check earlier in pregnancy. Gestational diabetes screenings typically take place between 24 and 28 weeks of pregnancy with an oral glucose tolerance test. This test checks your blood sugar levels after ingesting sugar (glucose).
You may have one of these tests:
- One-step test. After not eating, you’ll drink 75 grams of glucose. Then, your health care provider will check your blood sugar at a set interval.
- Two-step test. Not requiring fasting like the one-step test, in this test you’ll drink 50 grams of glucose. Then, your provider will check your blood sugar at a set interval. If your blood sugar is high, you’ll do another oral glucose tolerance test with 100 grams of glucose.