Many women with type 1 or type 2 diabetes have healthy, successful pregnancies, which are still considered high-risk. Some of the risks that increase due to diabetes and pregnancy include pre-eclampsia, miscarriage, premature birth, congenital defects, stillbirth, neonatal death, and having a baby who will have diabetes.
Some diabetes symptoms such as blood glucose fluctuations and diabetic retinopathy may also become worse during pregnancy. You'll need to work closely with your health team, including your endocrinologist and OB/GYN to improve the outcome for you and your baby. In the meantime, here are seven things you need to know about pregnancy and diabetes.
1. Get a Physical Exam
If you're planning to become pregnant and have diabetes, the American Diabetes Association (ADA) recommends getting a physical exam to catch any problems that may affect either your health or your baby's, such as hypertension, heart disease or kidney problems.
2. Get Your Diabetes under Control
It's essential to get your blood glucose levels as close to normal as possible before conception, preferably at least three to six months in advance, advises the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). High blood glucose levels in early pregnancy are dangerous to your baby's development, and may even trigger a miscarriage.
Additionally, your doctor will advise you to create a stricter regimen for your insulin therapy - you'll have to increase your insulin injections and have your A1C levels tested more often. If you take oral medications for type 2 diabetes, you'll need to give them up and start insulin therapy. There is still no consensus on the safety of taking metformin (Glucophage®) during pregnancy.
If you're accustomed to managing diabetes without medications, the ADA advises that you may need to start taking insulin for the duration of your pregnancy.
3. Increase Blood Glucose Monitoring
Blood glucose levels tend to be higher during pregnancy. Once you and your doctor have determined the optimal blood glucose targets for your pregnancy, you #39;ll have to monitor your levels more often. According to the NIDDK, research shows that when diabetic women control blood glucose levels before and during pregnancy, the risk of birth defects is similar to babies born to women without diabetes.
4. Lose Weight If You Need To
Being overweight or obese exacerbates diabetes, but it spells double trouble when you're pregnant. According to the March of Dimes, women who are overweight also face greater risks of pre-eclampsia, hypertension, gestational diabetes and premature labor. Their babies are also more likely to have birth defects, need neonatal intensive care, suffer fetal or neonatal death, or develop childhood diabetes.
Consult with your endocrinologist, diabetes educator, or nutritionist about a safe diet plan and starting a fitness program.
5. Exercise
Health organizations from the NIDDK to the American College of Obstetricians and Gynecologists recommend that women exercise during pregnancy. It preps your body for all the physical changes of pregnancy and the delivery. Plus, it lowers your blood pressure and anxiety levels. When you have diabetes, physical activity helps to stabilize blood glucose levels and increases insulin sensitivity.
A good goal is about 30 minutes or more of moderate exercise such as walking, swimming or casual biking. Before starting an exercise program during pregnancy, consult with your endocrinologist. If you're already exercising, lower the intensity when you have diabetes. Your doctor can advise you on extra precautions to take when exercising, such as monitoring your blood glucose levels, adjusting your insulin dosage, and snacking.
6. Don't Skip Prenatal Appointments
Women coping with diabetes and pregnancy require more frequent doctor's visits and tests. This helps ensure that your baby is developing normally, and that you're also healthy and the diabetes is well-controlled. You'll undergo the standard tests such as maternal blood screening and ultrasounds, plus additional blood glucose and blood pressure tests, and eye exams (for diabetic retinopathy). You urine will also be checked for protein and ketones.
7. Take Precautions When Breastfeeding
The World Health Organization advises that breast milk is the most nutritious food for babies. However, breastfeeding when you have diabetes can increase your risk of low blood glucose. NIDDK recommends eating a snack before baby feeds and checking your blood glucose level. The silver lining is that breastfeeding lowers the amount of insulin you'll need to take. Finally, you'll have to stop taking any oral medications when you're breastfeeding.
