Healthy Pregnancy for Women with Diabetes

When you have diabetes, you have special concerns you need to manage in order to stay healthy. When you are pregnant and have diabetes, you also are faced with unique challenges. But it is possible to have a healthy pregnancy, even with diabetes. You just need to take extra care before and during your pregnancy.

What is diabetes?

Diabetes is a disease that occurs when your body doesn’t make or use the hormone insulin properly. It causes too much blood glucose (sugar) to build up in the blood. This can cause serious health problems, such as heart disease, kidney failure, or blindness. The 3 most common types of diabetes are:

  • Type 1. This occurs when your body doesn’t produce any insulin. You have to take insulin to control it.
  • Type 2. This occurs when your body doesn’t produce enough insulin or doesn’t use the insulin as it should. It can sometimes be controlled through diet and exercise. Some people need to take insulin or medicine to manage it.
  • Gestational diabetes. This is a special kind of diabetes that some women develop during pregnancy. It usually goes away soon after the baby is born. It is different than having diabetes before you are pregnant.

How does diabetes affect a pregnant woman?

When diabetes is managed properly and blood sugar levels are controlled, you shouldn’t see many problems. However, if blood sugar levels are not well-controlled, diabetes can lead to problems for a pregnant woman.

  • Pregnancy can make some long-term diabetes problems worse. These include eye problems and kidney disease.
  • You have a greater chance of developing preeclampsia. This is when you develop high blood pressure and too much protein in your urine. It can cause serious or life-threatening problems for you and your baby.
  • High blood glucose levels can increase your risk of having a miscarriage or stillbirth. A miscarriage is the loss of a baby before 20 weeks. A stillbirth means the baby dies in the womb sometime after 20 weeks.
  • You are more likely to need a Caesarean section. Also called a C-section, this is when surgery is done to deliver the baby through the mother’s belly. It takes longer for the mother to recover and comes with risks of complications, as in any surgery.

How does diabetes affect a developing baby?

Having high blood sugar can harm your baby as soon as it starts developing. These problems can include:

  • Birth defects. The baby’s organs form during the first 2 months of pregnancy. Uncontrolled blood sugar can affect those organs and cause birth defects. These include defects in the brain, spine, and heart.
  • A large baby. When your blood sugar is high, the baby’s is too. This causes the baby to grow extra large. It can lead to problems during delivery for both the mother and the baby. Large babies are also more likely to be obese or have diabetes when they are older.
  • Preterm birth. This is when the baby is born too early. Babies born early have a higher chance of having problems with their breathing, heart, intestines, and vision. Women with diabetes are more likely to have their babies early.
  • Low blood sugar. When a mother doesn’t control her diabetes during pregnancy, the baby’s blood sugar can dip very low after birth. This can be serious and must be treated quickly.

Path to improved health

When diabetes is well-controlled and blood sugar levels stay within a healthy range, you increase your chance of having a healthy baby. Follow these steps to have a healthy pregnancy when you have diabetes.

Plan ahead

Make an appointment with your doctor before you become pregnant. He or she will probably run tests to see how diabetes has affected your body. They will help you get your blood sugar levels under control and make sure it is safe for you to become pregnant.

See your doctor

When you have diabetes, you need to see your doctor more often than if you didn’t have diabetes. Go to all of your prenatal appointments and follow up how your doctor instructs.

Eat healthy

See a dietitian if you don’t have one already. He or she can help you create a healthy meal plan that will help keep your blood sugar levels under control. Follow the plan and eat a healthy diet to help your baby be healthy.

Exercise

Exercise is an important part of diabetes management, especially when you’re pregnant. It helps balance food intake and keeps your blood sugar under control. Aim for at least 30 minutes of exercise 5 days a week.

Take your medicine

Whether its vitamins, diabetes pills, or insulin, take your medicine as your doctor prescribes. He or she may adjust what you take once you become pregnant. Some women with both type 1 and type 2 diabetes may need to take insulin during pregnancy. For others, diabetes can be controlled with oral medicines. Even if you were taking insulin before becoming pregnant, the amount you need will change when you are pregnant. Be sure to follow your doctor’s instructions. Medicine amounts may change as your pregnancy progresses.

Monitor your blood sugar often

Your blood sugar levels can change very quickly when you are pregnant. Follow your doctor’s instructions and check your sugar levels often. This will allow you to see how exercise, diet choices, insulin, or other medicines affect your blood sugar. That way you can make adjustments as they are needed. It will also allow you to see when your levels are getting too low before you have a severe reaction.

Follow other healthy pregnancy guidelines

As with any pregnancy, there are certain things you should do for the best health for you and your baby.

  • Don’t smoke. It can increase your chance of having a preterm or stillborn baby. It can also increase diabetes-related health problems, such as eye, heart, or kidney disease.
  • Avoid alcohol. Alcohol can lead to serious problems in your baby that could affect it for the rest of its life.
  • Take your vitamins. Folic acid is an important vitamin to take during pregnancy. You should start taking it before you become pregnant and continue throughout the pregnancy. Ask your doctor how much folic acid you should be taking, or if there are any other vitamins you should take.

Things to consider

Your body goes through many changes when you are pregnant. Any of these changes can affect your blood sugar at any time. They also can affect how you manage your diabetes. Even if your diabetes has been well-controlled in the past, you may need to change your habits. This includes your meal plan, your exercise routine, and the medicines you take. As your pregnancy progresses, you may need to change your management plan again. Be flexible and listen to your doctor. Follow his or her instructions. Take care of yourself, monitor your blood sugar levels, and you should have a healthy pregnancy.

Questions to ask your doctor

  • How can I control my blood sugar?
  • How often should I check my blood sugar?
  • Do I need to take diabetes pills or insulin?
  • Do I need to take any vitamins or supplements?
  • Should I see a dietitian?
  • What exercises can I do to stay active while I’m pregnant?
  • Will I be able to breastfeed my baby?

Resources

National Institute of Diabetes and Digestive and Kidney Diseases, Pregnancy if You Have Diabetes

Centers for Disease Control and Prevention, Diabetes and Pregnancy