Diabetes during pregnancy is a challenging situation. Blood sugar needs to be closely monitored during pregnancy.
Blood glucose control is a very important factor during pregnancy if uncontrolled it can be dangerous for the infant as well as the mother.
Diabetes control is essential for both diabetic women who want to start a family as well as for women who develop diabetes during their pregnancy (gestational diabetes).
Table of Contents:
- Diabetes and Pregnancy: What is The Relation?
- Gestational Diabetes (Diabetes Due to Pregnancy)
- Effects of Diabetes on The Baby
- Effect of Diabetes on the Mother
- Importance of Diabetes Management
- Hypoglycemic Shock
- Fetal Macrosomia or Big Baby Due to Diabetes
- Prevention of Diabetes During Pregnancy
Diabetes and Pregnancy: What is The Relation?
Pregnancy is a time when you may be needing to take more care of yourself. It is important for your as well as the health of your baby that your blood sugar levels are kept stable.
The ideal level of blood sugar is 4.0-5.5mmol/L when fasting and 7.0mmol/L two hours post meal. During pregnancy, some complications of diabetes may develop. You risk developing pre-eclampsia in which the baby also suffers. Babies who are born to diabetic women are larger than normal and may have a birth defect. They could be born prematurely or be stillborn. But if you keep your blood sugar in control, these risks can be mitigated.
Gestational Diabetes (Diabetes Due to Pregnancy)
Around 2%-4% of women develop temporary diabetes during pregnancy and this is known as gestational diabetes.
This occurs as an increased amount of insulin cannot be produced for overcoming the levels of resistance. It is basically when the blood glucose levels of the mother remain high as she is not able to make and use all the insulin required to meet the pregnancy demands. In gestational diabetes, symptoms are not presented which can be termed as characteristic of the condition.
Elevated blood during pregnancy is dangerous for the mother as well as the baby. Doctors must be vigilant enough to check for gestational diabetes so that it can be effectively managed.
Effects of Diabetes on The Baby
• Diabetes during pregnancy brings with itself chances of having bigger babies with birth defects.
• Baby’s organs like heart, brain, lungs, kidneys are forming in the first two months of pregnancy. During this stage, high blood glucose can be harmful and increase the chances of birth defects like defects in heart, brain, spine etc.
• High blood glucose during pregnancy can lead to premature birth.
• Heavy babies, babies with breathing troubles or hypoglycemia are common when pregnancy is associated with diabetes.
• High blood sugar increases the chances of having miscarriage or still baby.
Infant Mortality and Birth Defects
There is more chance of mortality or birth defects in babies of moms having diabetes than those without diabetes.  It is the responsibility of the preconception care team to reduce the risk by making sure that mother remains healthy during the course of and before pregnancy.
If a woman has got diabetes during pregnancy, many complications may hypertension, kidney damage, retinopathy, nerve damage etc. may arise.
Effect of Diabetes on the Mother
Blood glucose levels get affected by the hormonal and other changes during pregnancy.
So, mothers who are already diabetic may need to change the way how they managed their diabetes before pregnancy.
Despite the fact that you may be having diabetes for years, but you will be required to change your meal plan, medicines and physical activity. If you are on oral diabetes medicine you may be required to take insulin. Women who develop gestational diabetes may also need to know how to manage their insulin.
Complications Due to Diabetes during Pregnancy
Pregnancy can make long-term diabetic problems like kidney disease and eye issues worse particularly when the blood glucose levels are high.
Pregnant women who have diabetes have greater likelihood of getting preeclampsia or toxemia; the symptoms of which are high blood pressure and excessive protein in urine during the second half of pregnancy. It can be life-threatening for the mother and the baby.
If you have diabetes and are planning to have a baby, try to make sure that your blood glucose levels lie close to the target range before you become pregnant. And it is also important to stay in the target range. High blood sugar can actually harm the baby during the first few weeks of pregnancy before you even know that you are pregnant.
If you are diabetic and are already pregnant, consult your doctor to plan for managing diabetes. As you approach your due date, the plan may have to change again.
Importance of Diabetes Management
For meeting the blood glucose targets you will be required to test your glucose levels before each meal and an hour after eating. People on insulin will be required to test before going to sleep each night.
Blood Sugar Control During Pregnancy
Proper blood glucose control decreases the chances of complications for the child and mom. The target HbA1c for moms during and before pregnancy is 6.1% or 43mmol/mol.
Diabetic women are advised to take care of their blood sugar levels before or during their pregnancy . The first two months are particularly crucial and so strong control must be administered. Moms who get gestational diabetes are treated with diet and exercise but then they are put on oral hypoglycemics or insulin injections.
The baby of a diabetic mom produces extra insulin responding to high blood glucose levels within the mother’s body. In case of type 1 diabetes, no considerable excess insulin will be produced so your insulin requirements will increase.
At the time of birth, the baby may be hypoglycemic. This is because the maternal source of blood glucose is removed.
Heel stick blood test is used to detect it and these can be brought back to normal with oral or intravenous glucose. Also, a glucose tolerance test should be conducted at the sixth week post-natal check up to see if any more treatment needs to be done.
Fetal Macrosomia or Big Baby Due to Diabetes
When a pregnant lady has high blood glucose levels, the baby will store extra glucose as body fat. So, baby will be bigger than usual when it reaches the gestation date. This is called fetal macrosomia. It is believed that when a woman has gestational diabetes, she will go on to develop type 2 diabetes later in life.
Prevention of Diabetes During Pregnancy
There is nothing you can do to prevent the risk of diabetes during pregnancy. Some women will have it no matter how healthy the lifestyle is. But most people will be able to make through by:
• Maintaining healthy weight before pregnancy
• Staying active
• Following the right diet
• Getting yourself screened beforehand if there is family history of the condition.