By Becky Gregory

While diabetes during pregnancy is a health challenge, it doesn’t have to mean pregnancy will be difficult or giving birth to a healthy baby is impossible.

Eight million women have diabetes and one in 20 million develop gestational diabetes, according to ehealthmd.com. Fortunately, there is much that women with diabetes can do to promote healthy pregnancies and deliver normal babies.

Even before becoming pregnant, women with diabetes should get their blood sugar under control three to six months before they conceive to reduce the risk of birth defects.

They should engage their health care team — family physician, endocrinologist or diabetes specialist, diabetes educator and registered dietitian — to adjust their treatment plan as needed.

Once pregnant, a woman with diabetes needs to choose an obstetrician who handles high-risk pregnancies and has cared for other diabetic patients.

She also should visit an eye specialist to make sure that diabetes-related damage to the small blood vessels in the eyes does not occur.

And, of course, she must choose a pediatrician to care for the baby.

Gestational diabetes, which has no obvious symptoms, is caused when too much glucose builds up in the bloodstream during pregnancy.

Risk factors for gestational diabetes include a family history of diabetes, previously giving birth to a stillborn baby or a baby weighing more than 9 pounds, obesity, being over 25, and being African American, Native American or Hispanic.

To control blood sugar during pregnancy, women should take care to monitor their blood sugar several times per day, take insulin as prescribed, follow the diet outlined by their doctor and/or dietitian and follow an exercise program.

According to mayoclinic.com, controlling blood sugar level is the best way to prevent diabetes complications, especially during pregnancy.

Good blood sugar control during pregnancy can reduce:

• The risk of miscarriage and preterm birth, primary concerns for pregnancy and diabetes.
• The risk of birth defects, especially those affecting the brain, spine and heart.
• The risk of excessive growth. With poor blood sugar control, extra glucose crosses the placenta and triggers the baby’s pancreas to make extra insulin, causing the baby to grow too large. When the baby is too large, vaginal delivery is difficult, and the baby’s shoulders are at risk of injury.
• Complications for the mother, such as the risk of high blood pressure, urinary tract infections, premature delivery, the buildup of harmful acids in the blood, progression of kidney disease or eye disease, the need for Cesarean delivery and other possible serious complications.
• Complications for the baby, such as low blood sugar, jaundice — a yellowish discoloring of the skin and eyes, low levels of calcium and magnesium, a higher risk for obesity and type-2 diabetes later in life and other problems.

As with all pregnant women, it’s also important to monitor stress levels and get extra support and rest.

As long as blood glucose is controlled throughout the pregnancy, women with diabetes can have healthy babies while maintaining their own health.

 

Becky Gregory, RNC-OB is a case manager in the Partners in Pregnancy program at Optima Health that serves members throughout their pregnancy.