Know How does Diabetes Affect Pregnancy?
Metabolic Health

Effect of  Diabetes on Pregnancy

Diabetes is a condition that affects how the body uses blood sugar. There are many types of diabetes, the most common being type 2 diabetes, also called adult-onset diabetes. However, did you know that there is another kind of diabetes? Gestational or pregnancy diabetes occurs during pregnancy, causing women without a prior diagnosis of diabetes to have high blood sugar levels. Almost all women with gestational diabetes deliver healthy babies. Still, it is essential to understand the effects of diabetes on pregnancy and how this type of diabetes can impact your baby.

In some cases, babies will have to be treated in the neonatal intensive care unit after birth. Babies of mothers with gestational diabetes are also at risk of developing type 2 diabetes, obesity, and heart disease. In many cases, diabetes in pregnancy treatment can help reduce the risks discussed below. There are a few key symptoms of diabetes during pregnancy. These include excessive thirst and urination, extreme hunger, weight loss, fatigue, and blurred vision. If you are experiencing any of these symptoms, it is important to speak with your doctor as soon as possible.

What Should I Do if I Have Diabetes?

Diabetes can be a complicated condition to manage. It can lead to several long-term and short-term problems in the woman who is pregnant and also the child. If you have diabetes, you need to make sure to take extra care of your health and blood sugar levels so that you can prevent the onset of any other issues

a. Before Pregnancy – The most important step for women with type 1 and type 2 diabetes would be to visit their doctor before conception. Preconception care (preventative health care before and between pregnancies can help to discuss any changes in the plan to make adjustments in blood sugar levels, monitor medications, and test for any other issues that may arise.

b. During pregnancy – Managing your diabetes and ensuring that you are in optimal health condition would be vital to have a healthy baby and healthy full-term pregnancy. See your doctor regularly and make sure you are checking your blood sugar levels regularly. Follow a healthy diet plan and make sure you exercise daily to avoid heart-related problems. Take your medication on time.

C. After pregnancy – Women who have gestational diabetes are more likely to develop a diagnosis of type 2 diabetes later in life. Get your tests done 4-12 weeks after your baby is born. Continue to get tested for up to 3 years to ensure that there is no residual effect of high blood sugar levels

Reduce the risk of type 2 diabetes by:

  • Achieving a healthy body mass index. Obesity can be highly linked to diabetes. Losing even a few pounds can help prevent the onset of the condition
  • Increase your physical activity by 30 minutes in a day for at least 5 days a week. You can break down these activities into smaller chunks of 10 minutes
  • Eat healthy foods and limit your carb content so that you do not end up spiking your blood sugar levels drastically contributing to the development of diabetes 

How Common Is Diabetes During Pregnancy?

Type 1 and type 2 diabetes are prevalent in approximately 1-2% of pregnant women and approximately 6% to 9% of pregnant women develop gestational diabetes. The recent incidence has increased over the last few years and recent studies have found that the prevalence has only increased between 2000 and 2010. The rate of pregnant women increased from 37% to 56% for women with type 1 and type 2 diabetes. Additionally, the rate of gestational diabetes and type 1 and type 2 diabetes also varies with race and ethnicity. Incidentally, Asian and Hispanic women have a higher rate of gestational diabetes, and black and Hispanic women have higher rates of type 1 and type 2 diabetes during pregnancy.

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Diabetes and Pregnancy Complications

1. Birth Defects (Congenital Disabilities)

A few specific congenital disabilities are more likely to occur in babies born to mothers with gestational diabetes. These include problems with the baby's heart, brain, spine, and kidneys.

2. An Extra-large Baby

The birth of an extra-large baby is a rare but severe complication in pregnancies with gestational diabetes. These babies are at risk for difficulty breathing, low blood sugar, and jaundice. The baby may need to be delivered early to prevent concerns in some cases. If you are pregnant and have gestational diabetes, get regular prenatal care. This will help ensure that your baby is monitored closely and has a smooth delivery.

3. C-Section (Cesarean Section)

While a C-section is typically a safe procedure, it can carry some additional risks for women with gestational diabetes. In some cases, a C-section may be the only way to deliver the baby safely, and the doctor will help minimise the risk of complications.

4. High Blood Pressure (Pre-eclampsia)

It is a condition that affects some pregnant women and can cause headaches, blurred vision, swelling in the hands and feet, and protein in the urine.

5. Early (Pre-term) Birth

It can cause early delivery, low birth weight, and seizures in the baby.

6. Low Blood Sugar (Hypoglycemia)

It can occur during pregnancy due to the placenta and the foetus's hormones. These hormones can cause the pancreas to produce less insulin and lead to low blood sugar. It can happen when the pregnant woman has not eaten enough, has exercised too much, or has had too much alcohol. Symptoms of low blood sugar include feeling dizzy, lightheaded, or faint; having a headache; feeling shaky or trembling; sweating; and having a rapid or irregular heartbeat.

7. Miscarriage or Stillbirth

It is a genuine risk for pregnant women who have gestational diabetes that their babies may be born prematurely or have low birth weight. If you have gestational diabetes, it is essential to monitor your blood sugar levels carefully and follow your doctor's instructions closely. You should also let your doctor know if you experience any signs of miscarriage or stillbirth, such as vaginal bleeding or cramping.

Blood glucose levels during pregnancy

Blood glucose levels during pregnancy may change as compared to normal. This is due to the hormonal fluctuations that may come into play during pregnancy.

Normal – The recommended target blood sugar level would be”

Before meals/bedtime/overnight – 90mg/dL or lesser

1 hour after eating – 130-140 mg/dL or lesser

2 hours after eating – 120mg/dL or lesser

Dangerous – Dangerous blood sugar levels would be any reading that is consistently and constantly above 200mg/dL. If the recommended medications and doses are not helping these levels come down, it would be vital to visit your doctor so that any further complications can be avoided. Moreover, persistent periods of low sugar levels are known to be even more harmful, even fatal as compared to hyperglycemia. Low sugar episodes can result in a severe lack of glucose in vital organs like the heart which can lead to problems for the baby as well. As important it is to avoid hyperglycemic episodes, doctors often ask women to be more cautious towards hypoglycemia.

What do I need to know about blood glucose testing before and during pregnancy?

How often you check your blood sugar levels might affect your diabetes-related path during pregnancy. You may need to check them more often to achieve a normal sugar level in pregnancy. Your healthcare team should be able to give you all the right techniques and times during which you can measure and test these levels even at home. Your target levels might change during pregnancy. Additionally, you may also be asked to keep a check on your ketone levels if the blood sugar levels are too high.

Have a record of your readings before and after meals so that you can report to your doctor and gain proper guidance after identifying patterns. This will also help you take your insulin dose accordingly. Understanding patterns with the help of self-glucose monitoring tests can be highly helpful in preventing high and low blood sugar levels

Diabetes in pregnancy treatment

Management of diabetes in pregnancy can be a scary thing for both the mother and the baby. However, it can be a relatively easy condition to handle with the proper knowledge and management. Here are some tips on how to manage pregnancy diabetes:

1. Plan for Pregnancy

If you have any symptoms of diabetes, it is advisable to consult your doctor before planning your pregnancy to avoid diabetes and pregnancy complications later on.

2. See Your Doctor Early and Often

Ensure to consult with your doctor regularly to track your blood sugar levels and make any necessary adjustments to your treatment plan. It is always better to monitor your blood pressure and keep it under control. Maintain a chart of your BP reading to share the same with your doctor when required, and be alert as fluctuations in blood sugar levels can impact the health of both baby and mother. 

3. Eat Healthy Foods

Taking care of your diet is one of the best home remedies for gestational diabetes during pregnancy. Ensure that you eat a healthy, balanced diet that includes plenty of fruits, vegetables, and whole grains and is rich in nutrients and low in sugar.

4. Exercise Regularly

Exercise is an essential point in the management of diabetes in pregnancy. Try to be regular in your exercise routine, which can be done as per the instructions from your medical and fitness consultant.

5. Take Pills and Insulin as Directed

Take medication, pills and insulin as prescribed by your doctor. Self-medication should be strictly avoided with symptoms of diabetes during pregnancy. 

Bottomline

Diabetes is a disorder that affects how the body uses blood sugar. When a woman has pregnancy diabetes, it can cause serious health issues for both the mother and baby. There is a lot of information on diabetes and pregnancy, but it can be hard to know where to start. In this article, we discussed the symptoms and effects of diabetes on pregnancy, including congenital disabilities, an extra-large baby, c-section, preterm birth, or miscarriage or stillbirth. This requires great management during diabetes in pregnancy.

Maintaining a regular chart to monitor your glucose levels while discussing with your doctor during regular visits is important. Adhere to the routine of taking prescribed medication, including pills and insulin. During pregnancy, the importance of regular exercise cannot be undermined, and if ignored, it affects both the mother and child. As an initial step, discuss with your doctor and understand if it is a Type 1 diabetes pregnancy or Type 2 diabetes pregnancy to rule out any risk factors.

FAQs

What are the warning signs of gestational diabetes?

Gestational diabetes that is caused in women during their childbearing period causes a person to experience frequent thirst and urination, fatigue, nausea and vomiting, blurred visions, etc. Signs of gestational diabetes also include vaginal, bladder, and skin infections. If a woman with gestational diabetes manages to control her blood sugar levels then she can experience healthy childbirth.

Does gestational diabetes make you high risk?

If you are unable to control your sugar levels then gestational diabetes can cause complications in your pregnancy. A woman with gestational diabetes is at higher risk of developing preeclampsia which is a severe condition caused due to high blood pressure. During the time of pregnancy if the woman is unable to control her blood sugar levels then gestational diabetes mellitus can put her life and her child’s life at stake.

What can cause diabetes while pregnant?

Several causes lead to the diagnosis of gestational diabetes in a pregnant woman. Some of these causes include increased weight, lack of physical activity, conditions like polycystic ovary syndrome, prediabetes, genetic diabetes, etc. Due to these reasons, your body is unable to produce enough insulin during pregnancy leading pregnant women to be diagnosed with gestational diabetes.

What is the normal blood sugar level for a pregnant woman?

For a woman who is pregnant, unless she is diagnosed with gestational diabetes, the normal range of sugar would be between 90 – 140mg/dL. There would be no reason for the pre and post-meal levels to be out of range, however, with gestational diabetes, certain fluctuations are observed. The normal range of blood sugars would be the same. A slight fluctuation is expected and normal, however, frequent and uncontrolled levels of blood sugars can be a cause for concern and would need to be treated. 

Can you have a healthy pregnancy with diabetes?

Women who have type 1 or type 2 diabetes can have a healthy and safe pregnancy. They can also deliver a healthy baby. The most important factor for this to happen would be regular monitoring of blood sugar levels and keeping them in check. Since hormonal fluctuations can cause irregularities in blood sugars too, keeping them in range using different devices like the CGM would also help.

What is the best diet for a pregnant woman with diabetes?

For a woman who has diabetes (T1D, T2D, or gestational) and is expecting a child, a wholesome diet that can give her an ample amount of nutrients would be ideal. Whole fruits and vegetables, lean proteins and healthy fats, whole grains, fewer sugary drinks, and high-carb foods would most often be recommended. Ensuring that the body is also hydrated by having a lot of water and keeping the electrolytes in balance with the help of lemonade can also be done. Buttermilk, plain curd, etc are good choices too. 

How can diabetes affect my baby?

Uncontrolled diabetes can cause the baby’s blood sugar levels to be high. Since this would mean that the baby is ‘overfed’ and it can also grow larger than the original size. This can also be highly uncomfortable for the woman during labor. Problems during delivery, premature delivery, etc are also some common issues if the pregnancy glucose levels are not maintained. 

How can my diabetes affect me during pregnancy?

Diabetes can affect you during pregnancy even more as hormonal fluctuations might be erratic. This can also lead to problems in sugar control and you may notice your diabetes symptoms being seemingly out of control. Some of the other complications could be – breathing difficulties, low blood sugar episodes, fatigue, high blood pressure, etc.

What health problems could I develop during pregnancy because of my diabetes?

If your pregnancy sugar level is not under control and you are dealing with frequent and untreated high and low blood sugar levels, it can lead to – high blood pressure and preeclampsia, surgical delivery (c-section), premature delivery, stillbirth, etc. These are the reasons why doctors play a lot of stress on proper blood sugar control during diabetes and pregnancy.

How can I prepare for pregnancy if I have diabetes?

Knowing how does diabetes affect pregnancy and planning for it would be the primary step. Speak to your doctor – endocrinologist, and gynaec to get all the information. Get your HbA1c levels down and keep them constantly in the recommended range. Keep monitoring your blood sugar levels and take your medication timely. Additionally, get your eyes, kidneys, feet, etc checked to avoid any further complications. 

What tests will check my baby’s health during pregnancy?

Certain tests can be done for the baby to check their health. In the first trimester- a blood test and an ultrasound exam can be helpful to check for any abnormalities or birth defects. Another non-invasive prenatal screening can check for chromosomal disorders. Thyroid tests, hepatitis, toxoplasmosis, tuberculosis, etc may also be some other tests that doctors may recommend based on the history, situation, and other factors.

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