If you're a woman with diabetes and would love to be a mom some day, here's good news: diabetic women can give birth to a beautiful, healthy baby.Careful planning, however, is crucial. High blood sugar in a mother can harm a developing fetus, and since most of the vital organs, like the brain, heart and spine, are formed in the first month after conception, before a woman even knows she is pregnant, it's important to get levels under control before even trying to conceive.
The brain, spine, and heart are all vulnerable to birth defects in the presence of high blood sugars, explains Brita Boyd, MD, assistant clinical professor in the division of maternal fetal medicine at Duke University's Department of OB/GYN. "A planned pregnancy is important for women with diabetes," she says. "With an unintended pregnancy, if the blood sugars are high, it's more likely for birth defects to occur."
Potential Risks
Cardiac malformations, vascular malformations, and skeletal abnormalities are the most common birth defects. The good news is that a diabetic woman with good blood sugar control has nearly the same chance as a non-diabetic woman to deliver a healthy baby.
For all women, diabetic or non diabetic, the risk of having a baby with a birth defect is about three percent. If you find out you are pregnant and your hemoglobin A1C is below seven, your risk for having a baby with a birth defect is just very slightly higher than a woman without diabetes, Boyd says. For a woman who's been running an average blood sugar in the 300s, that risk could be as high as 1 in 3, Boyd says.
Birth defects aren't the only possible consequence of high blood sugars. Keeping levels in the normal range also will help ensure that your baby will not be born too large. Infants born to women with poorly controlled diabetes can have low blood sugar and low calcium at birth, Greene explains. "If they have low blood sugar, they usually have to get intravenous glucose for a couple of weeks," she says.
Vital Information
● Pay rigorous attention to blood sugar levels and maintain good control, says Loren Wissner Greene, MD, an endocrinologist at NYU Langone Medical Center in New York City and the author of The Unofficial Guide to Living with Diabetes. Women with type 2 diabetes should lose weight and get their blood sugars under control so they won't need to take oral medications during a pregnancy. "It's generally recommended that you not use any medications except insulin to control diabetes during pregnancy," Greene says.
● Ideally, your hemoglobin A1C should be at around six percent or lower, says Michael Bergman, MD, clinical professor at NYU School of Medicine and an endocrinologist at NYU Langone Medical Center.
● Consider an insulin pump. Very often, women who are trying to conceive will go on an insulin pump, Greene says. Additionally, your doctor may recommend one of the new sensors that provide continuous glucose readings throughout the day. These are called CGMs--or continuous glucose monitoring devices.
● Consult your doctor if did not control your levels properly when you got pregnant. It's still possible for your doctor to make an impact in terms of the fetus growing too large, says Boyd. And during the pregnancy, an anatomy ultrasound also can be performed to assess the fetal anatomy and check for possible birth defects, she says.
