How Might Diabetes Affect My Pregnancy? – Diabetes during pregnancy—including type 1, type 2, or gestational diabetes—can negatively affect the health of women and their babies. For women with type 1 or type 2 diabetes, high blood sugar around the time of conception increases babies’ risk of birth defects, stillbirth, and preterm birth,
Can a pregnant woman with diabetes have a healthy baby?
Planned pregnancy – If you can, visit your doctor or diabetes educator at least 6 months before you start trying to fall pregnant. You will be given advice and guidance on controlling your blood sugars as tightly as possible, and taking necessary supplements like folate,
Does diabetes cause birth defects?
What is preexisting diabetes? Diabetes is a condition in which your body has too much sugar in the blood (called blood sugar or glucose). Preexisting diabetes (also called pregestational diabetes) means you have diabetes before you get pregnant. This is different from gestational diabetes, which is a kind of diabetes that some women get during pregnancy.
- Women with diabetes can and do have healthy pregnancies and healthy babies.
- But untreated diabetes can cause complications for both moms and babies.
- In the United States, about 1 to 2 percent of pregnant women have preexisting diabetes.
- The number of women with diabetes during pregnancy has increased in recent years.
When you eat, your body breaks down sugar and starches from food into glucose to use for energy. Your pancreas (an organ behind your stomach) makes a hormone called insulin that helps your body keep the right amount of glucose in your blood. When you have diabetes, your body doesn’t make enough insulin or can’t use insulin well, so you end up with too much sugar in your blood.
This can cause serious health problems, like heart disease, kidney failure and blindness. High blood sugar can be harmful to your baby during the first few weeks of pregnancy when his brain, heart, kidneys and lungs begin to form. Treatment for diabetes can help prevent problems like these. There are two types of preexisting diabetes.
Managing them before and during pregnancy can help reduce your risk of complications:
Type 1 diabetes. This is when your body doesn’t make insulin. This is because your immune system destroys the cells in your pancreas that make insulin. If you have type 1 diabetes, you need to take insulin every day. Type 1 diabetes is usually diagnosed in children and young adults, but you can get it at any age. Type 2 diabetes. This is the most common kind of diabetes. If you have type 2 diabetes, your body makes insulin but doesn’t make or use it well. It most often is diagnosed in adults, but you can develop it at any age.
Can preexisting diabetes cause problems during pregnancy? Yes. If it’s not managed well, diabetes can increase your risk for complications during pregnancy, including:
Birth defects, like heart defects and birth defects of the brain and spine called neural tube defects (also called NTDs). Birth defects are health conditions that are present at birth. Birth defects change the shape or function of one or more parts of the body. They can cause problems in overall health, how the body develops, or in how the body works. Cesarean birth, Cesarean birth (also called c-section) is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus (womb). You may need to have a c-section if you have complications during pregnancy, like your baby being very large (called macrosomia). High blood pressure and preeclampsia, High blood pressure is when the force of blood against the walls of the blood vessels is too high. It can stress your heart and cause problems during pregnancy. Preeclampsia is when a pregnant woman has high blood pressure and signs that some of her organs, like her kidneys and liver, may not be working properly. Signs of preeclampsia include having protein in the urine, changes in vision and severe headaches. Macrosomia or fetal growth restriction, These conditions have to do with your baby’s weight. Macrosomia is when a baby weighs more than 8 pounds, 13 ounces (4,000 grams) at birth. Weighing this much makes your baby more likely to get hurt during labor and birth. And you may need to have a c-section to keep you and your baby safe. Fetal growth restriction (also called small for gestational age) is when a baby doesn’t gain the weight he should before birth. Miscarriage and stillbirth, Miscarriage is when a baby dies in the womb before 20 weeks of pregnancy. Stillbirth is the death of a baby in the womb after 20 weeks of pregnancy. Perinatal depression, This is depression that happens during pregnancy or in the first year after having a baby (also called postpartum depression ). Depression is a medical condition that causes feelings of sadness and a loss of interest in things you like to do. It can affect how you feel, think and act and can interfere with your daily life. It needs treatment to get better. Preterm labor and premature birth, Preterm labor is labor that starts too early, before 37 weeks of pregnancy. Premature birth is birth that happens before 37 weeks of pregnancy. Premature babies are more likely than full-term babies to have health problems at birth and later in life. Women with diabetes are at increased risk for a condition called polyhydramnios, This is when there’s too much amniotic fluid in the sac around your baby. This can lead to preterm labor and premature birth. If there are problems with your pregnancy, your provider may induce your labor, sometimes earlier than your due date. Inducing labor means your provider gives you medicine or breaks your water (amniotic sac) to make your labor begin. Shoulder dystocia or other birth injuries (also called birth trauma). Shoulder dystocia happens when a baby’s shoulders get stuck inside the mother’s pelvis during labor and birth. It often happens when a baby is very large. It can cause serious injury to both mom and baby. Complications for moms caused by shoulder dystocia include postpartum hemorrhage (heavy bleeding). For babies, the most common injuries are fractures to the collarbone and arm and damage to the brachial plexus nerves. These nerves go from the spinal cord in the neck down the arm. They provide feeling and movement in the shoulder, arm and hand.
Most babies born to women with preexisting diabetes are healthy after birth. But preexisting diabetes can increase your baby’s risk for health problems, including:
Autism spectrum disorder. A group of developmental disabilities that can cause social, communication and behavior challenges. Developmental disabilities are problems with how the brain works that can cause a person to have trouble or delays in physical development, learning, communicating, taking care of himself or getting along with others. Enlarged organs if your baby is very large Jaundice. This is when a baby’s eyes and skin look yellow because his liver isn’t fully developed or isn’t working. Obesity later in life. Obesity is being very overweight. It means you have an excess amount of body fat and a body mass index (also called BMI) of 30 or higher. To find out your BMI, go to cdc.gov/bmi, Hypoglycemia (also called low blood sugar) and polycythemia. Polycythemia is when the body makes too many red blood cells which causes the blood to be thick. Respiratory distress syndrome (also called RDS). This is a breathing problem caused when babies don’t have enough surfactant in their lungs. Surfactant is a protein that keeps the small air sacs in the lungs from collapsing.
Pregnancy can make health complications associated with diabetes worse. Some can be life-threatening. Getting regular treatment and managing your diabetes during pregnancy can help you prevent severe complications. What kinds of health care providers do you need to treat preexisting diabetes during pregnancy? To best manage your diabetes during pregnancy, you need a team of health care providers who work together to give you the best all-around care.
Your prenatal care provider Your endocrinologist. This is a doctor who treats people with diabetes and other diseases of the endocrine system. The endocrine system is all the glands in your body that produce hormones that control how your body works.,
Your team also may include other providers, including:
A perinatologist. This is a doctor who treats women with high-risk pregnancies. A diabetes educator. This person has training to help you control your blood sugar. A registered dietitian (also called RD). This health professional has training to help you use diet and nutrition to help you stay healthy. Your baby’s health care provider, especially as you get closer to your baby’s birth
Before you try to get pregnant, make sure each provider knows about your pregnancy plans and the other providers you see. All your providers work together with you to help you get ready for pregnancy and stay healthy during pregnancy. They make sure that any treatment you get is safe for your baby.
Manage your diabetes. Get your diabetes under control 3 to 6 months before you start trying to get pregnant. Make sure all the providers on your health care team know you’re trying to get pregnant. Use birth control until your diabetes is under control and you’re ready to get pregnant. Birth control (also called contraception and family planning) is methods you can use to keep from getting pregnant. Also called contraception or family planning. Methods you can use to keep from getting pregnant. Birth control pills and intrauterine devices (also called IUDs) are examples of birth control. Take a multivitamin with 400 micrograms of folic acid in it every day. Folic acid is a vitamin that every cell in your body needs for healthy growth and development. If you take it before pregnancy and during early pregnancy as part of healthy eating, it can help protect your baby from neural tube defects. If you have diabetes, your provider may need more than 400 micrograms of folic acid each day. Talk to your provider about the right amount of folic acid for you. Tell your prenatal provider about any medicine you take. Your provider can make sure the medicine is safe for your baby when you do get pregnant. If not, you may need to change to another medicine. Don’t start or stop taking any medicine during pregnancy without talking to your provider team first. Eat healthy foods and do something active every day. Work with your RD or diabetes educator to create a healthy meal plan to help control your blood sugar.
How is preexisting diabetes treated during pregnancy? If you have diabetes, your prenatal care provider wants to see you often during pregnancy so she can monitor you and your baby closely to help prevent problems. At each prenatal care checkup, you get tests to make sure you and your baby are doing well. Tests can include:
An ultrasound in the second trimester that includes a detailed look at your baby, to check his growth, weight and heart. Ultrasound uses sound waves and a computer screen to show a picture of your baby inside the womb. Tests like the nonstress test and the biophysical profile. The nonstress test checks your baby’s heart rate. The biophysical profile is a nonstress test with an ultrasound.
Your provider tells you how often to check your blood sugar, what your levels should be and how to manage them during pregnancy. Blood sugar is affected by pregnancy, what you eat and drink and how much physical activity you get. What worked for you before pregnancy to control your blood sugar may not work as well during pregnancy.
Go to all your prenatal care checkups, even if you’re feeling fine. And keep seeing all the providers on your health care team who help you manage your diabetes. Follow your provider’s directions about how often to check your blood sugar. Call your provider if your blood sugar is too high or too low. Keep a log that includes your blood sugar level every time you check it. Share the log with your provider at each prenatal checkup. If you take insulin, take it exactly as your provider tells you to. You need more insulin during pregnancy, especially between 28 and 32 weeks of pregnancy. Insulin is safe for your baby during pregnancy and labor. Tell your providers about any medicine you take, even medicine that’s not related to your diabetes. Some medicines can be harmful during pregnancy, so your provider may need to change them to ones that are safer for you and your baby. Don’t start or stop taking any medicine during pregnancy without talking to your provider first. Talk to your provider about taking low-dose aspirin. Low-dose aspirin (also called baby aspirin or 81 mg aspirin) can help prevent preeclampsia. You can start taking low-dose aspirin after 12 weeks of pregnancy (before 16 weeks is best). Don’t start or stop taking low-dose aspirin or any other medicine during pregnancy without talking to your provider first. If you don’t have a dietician, get one. Your provider can recommend one for you. An RD can help you learn what, how much and how often to eat to best control your diabetes. She can help you make meal plans and help you know the right amount of weight to gain during pregnancy. Check to see if your health insurance covers treatment from an RD. Eating healthy foods and being active every day can help you manage your diabetes. Ask your provider if you need to have a c-section. Diabetes increases your chances for needing a c-section. If your provider thinks you need to have your baby by c-section, ask about timing. If your diabetes is well controlled, ask about waiting until at least 39 weeks to have your baby. This gives your baby time to grow and develop in the womb before birth. If you have complications during pregnancy, you may need to have your baby earlier.
During labor and birth, your provider watches your glucose level closely. You can take insulin during labor. What is insulin resistance? Some pregnant women with diabetes become insulin resistant. This means your body makes insulin but doesn’t use it well.
- During pregnancy, the placenta grows in your uterus (womb) and supplies food and oxygen to your baby through the umbilical cord.
- The placenta also makes hormones that help your baby develop.
- But these hormones can make you insulin resistant.
- You may need more and more insulin the longer you’re pregnant—up to 3 times as much as you needed before pregnancy.
You’re most resistant to insulin in your third trimester. If you have preexisting diabetes, is it OK to breastfeed? Yes. If you have diabetes, it’s safe to breastfeed your baby. Breast milk is the best food for a baby in the first year of life. It helps him grow healthy and strong.
Talk to your dietician. She can help create a new meal plan to make sure you get all the calories you need for you and your baby. You need about 500 more calories each day for breastfeeding. She may recommend that you eat a healthy snack before or after breastfeeding. Talk to your providers about the amount of insulin you need. You may need less insulin than usual for a few days after giving birth, and breastfeeding can lower the amount even further. It’s safe to take insulin while breastfeeding. Talk to your providers about how often to monitor your blood sugar. If you’re breastfeeding, your providers may want you to check your blood sugar more often than usual.
What are hypoglycemia and hyperglycemia? Hypoglycemia is low blood sugar and hyperglycemia is high blood sugar. Both of these conditions are common if you have preexisting diabetes. If you have signs or symptoms of either condition, tell your provider.
- Signs of a condition are things someone else can see or know about you, like you have a rash or you’re coughing.
- Symptoms are things you feel yourself that others can’t see, like having a sore throat or feeling dizzy.
- If you have preexisting diabetes, you’re more likely to have low blood sugar (hypoglycemia) during pregnancy.
This can happen if you don’t eat enough or often enough, if you get too much physical activity or if you take too much insulin. It’s usually mild and easily treated by eating or drinking something. But if it’s not treated, it can cause you to pass out.
Being hungry Having a headache Feeling weak, dizzy, shaky, confused, anxious (worried) or cranky Looking pale Sweating Having a fast heart beat
You also may have high blood sugar (hyperglycemia), even if you’re being treated for diabetes. You may have hyperglycemia if:
You don’t take your medicine at the right times. You eat more than usual or at irregular times. You’re less active than normal. You’re sick.
If you have hyperglycemia, you may need to change the amount of insulin you take, your meal plan or the amount of physical activity you get. Signs and symptoms of hyperglycemia include:
Being thirsty Having a headache Needing to urinate often Felling weak or tired Having trouble paying attention Having blurred vision Having a yeast infection
Your provider can check you for these conditions during pregnancy to make sure you and your baby stay healthy. Last reviewed: April, 2019
Is diabetes worse during pregnancy?
What causes diabetes during pregnancy? – Some women have diabetes before they get pregnant. This is called pregestational diabetes. Other women may get a type of diabetes that only happens in pregnancy. This is called gestational diabetes. Pregnancy can change how a woman’s body uses glucose.
- This can make diabetes worse, or lead to gestational diabetes.
- During pregnancy, an organ called the placenta gives a growing baby nutrients and oxygen.
- The placenta also makes hormones.
- In late pregnancy, the hormones estrogen, cortisol, and human placental lactogen can block insulin.
- When insulin is blocked, it’s called insulin resistance.
Glucose can’t go into the body’s cells. The glucose stays in the blood and makes the blood sugar levels go up.
What is the normal sugar level in pregnancy?
How You Can Treat It – The key is to act quickly. As treatable as it is, gestational diabetes can hurt you and your baby. Treatment aims to keep your blood glucose (blood sugar) levels normal. It can include special meal plans and regular physical activity.
Before a meal: 95 mg/dl or less One hour after a meal: 140 mg/dl or less Two hours after a meal: 120 mg/dl or less
Always remember that this is treatable—and working with your health care team can help ensure a healthy pregnancy.
Does insulin affect baby during pregnancy?
Insulin and diabetes pills – Insulin is the traditional first-choice drug for blood sugar control during pregnancy because it is the most effective for fine-tuning blood sugar and it doesn’t cross the placenta. Therefore, it is safe for the baby. Insulin can be injected with a syringe, an insulin pen, or through an insulin pump.
- All three methods are safe for pregnant women.
- If you have type 1 diabetes, pregnancy will affect your insulin treatment plan.
- During the months of pregnancy, your body’s need for insulin will go up.
- This is especially true during the last three months of pregnancy.
- The need for more insulin is caused by hormones the placenta makes to help the baby grow.
At the same time, these hormones block the action of the mother’s insulin. As a result, your insulin needs will increase. If you have type 2 diabetes, you also need to plan ahead. If you are taking diabetes pills to control your blood sugar, you may not be able to take them when you are pregnant.
Because the safety of using diabetes pills during pregnancy has not been established, your doctor will probably have you switch to insulin right away. Also, the insulin resistance that occurs during pregnancy often decreases the effectiveness of oral diabetes medication at keeping your blood sugar levels in their target range.
For women with gestational diabetes, meal planning and exercise often work to keep blood sugar levels in control; however, if blood sugar levels are still high, your doctor will probably start you on insulin. Only a small number of studies have been published analyzing the safety and effectiveness of oral medications during pregnancy.
Can I give birth naturally if I have diabetes?
Will gestational diabetes affect my labor and delivery? – Most women with gestational diabetes can make it to their due dates safely and begin labor naturally. In some cases, though, gestational diabetes could change the way you feel or how your baby is delivered.
Blood Sugar and Insulin Balance —keeping your blood sugar level under control during labor and delivery is vital to your own health and to your baby’s health. If you do not take insulin during your pregnancy, you probably will not need it during labor or delivery. If you do take insulin during your pregnancy, you may receive an insulin shot when labor begins, or you may get insulin through a thin, plastic tube in your arm that goes into your bloodstream during labor. Early Delivery —Gestational diabetes puts women at higher risk than women without the condition for developing preeclampsia (pronounced pree-ee-KLAMP-see-uh), late in their pregnancies. Preeclampsia is a condition related to a sudden blood pressure increase; it can be a serious. The only way to cure preeclampsia is to deliver the baby; but delivery may not be the best option for your health or for the health of the baby. Your health care provider will keep you under close watch, possibly at the hospital, and will run multiple tests to determine whether early delivery is safe and needed. Your health care provider will give you more information about early delivery, should it be necessary. Cesarean Delivery —This is a type of surgery used to deliver the baby, instead of natural delivery through the vagina. Cesarean delivery is also called a cesarean section, or “C” section. Simply having gestational diabetes is not a reason to have a C section, but your health care provider may have other reasons for choosing a cesarean delivery, such as changes in your health or your baby’s health during labor.
Can you pass diabetes to your unborn child?
Effects of Diabetes on the Baby Diabetes Effects on the Baby Diabetes makes a pregnancy high risk. This is because diabetes can cause many potentially negative effects on the baby as well as the mother. Blood sugar is the baby’s food source and it passes from the mother through the placenta to the baby. When a woman has diabetes and her blood sugars are poorly controlled (too high), excess amounts of sugar are transported to the baby. Since the baby does not have diabetes, he/she is able to increase the production of insulin substantially in order to use this extra sugar. This abnormal cycle of events can result in several complications including: Macrosomia (large baby) Macrosomia refers to a baby born weighing more than 4,000g (8.8 pounds) or born at greater than the 90 percentile for the gestational age. In response to the excess amounts of sugar that the baby receives, large amounts of insulin are produced by the baby in order to convert the sugar into body fat. That is, the baby is being “overfed” while inside the uterus. As a result, the delivery can be more difficult for the baby and the mother with increased risk for injury to both. In addition, the odds of requiring a cesarean delivery can be much greater when the baby is too large. Most obstetricians perform an ultrasound to estimate the fetal weight before delivery and to determine if it is safe to attempt a vaginal delivery. Trying to deliver a very large baby vaginally, particularly when the mother has diabetes, can result in one of the most frightening obstetrical emergencies, a shoulder dystocia, where the baby’s head delivers but the shoulders are too large to fit through the birth canal. Neonatal Hypoglycemia Neonatal hypoglycemia is defined as low blood sugars in the baby after birth. If the baby’s pancreas is making large amounts of insulin in response to the mother’s high blood sugars, it will continue to do so for a time after delivery. Since the sugar supply from the mother is no longer present once the baby has delivered, blood sugar can drop too low (hypoglycemia, blood sugar < 40 mg/dl). The baby can become fussy, jittery or may even have a seizure or breathing problems. Because of these possible complications, most babies born to women with diabetes will be monitored very closely for the first few hours of life with frequent heel sticks to check their blood sugars. These babies may require more frequent breast or bottle-feeding to maintain their blood sugars at a normal range and in some cases will require intravenous fluids with glucose. Other Neonatal Metabolic Problems In addition to hypoglycemia, the excess insulin can also infrequently be responsible for other metabolic complications such as jaundice (yellowing of the skin) and imbalances of calcium or magnesium. The chances of a baby being born with diabetes are extremely rare particularly in cases where the mother has gestational diabetes. Type 2 diabetes tends to run in families and offspring may be at increased risk for developing it in adulthood. Children of mothers with Type 1 diabetes have less than a 5% chance of developing diabetes during childhood. In fact, the baby has a greater risk if his/her father has Type 1 diabetes. Stillbirth When blood sugars are persistently high, blood vessel damage in the placenta and poor oxygen and nutrient supply to the baby can occur. This decrease in oxygen may cause health damage to the baby including death or stillbirth. This rarely occurs in pregnancies complicated by gestational diabetes and is more likely to occur if the mother had diabetes (either Type 1 or 2) before the pregnancy (pre-gestational diabetes). Because of this, women with pre-gestational diabetes should be monitored more closely toward the end of pregnancy. Birth Defects In the general population, there is about a 2 to 3% risk for having a baby with a major birth defect. Babies born to mothers with gestational diabetes do not have a greater risk of birth defects than the general population. In women with pregestational diabetes, this risk is increased about three to fourfold particularly if blood sugars are high during the early weeks of pregnancy. This is the developmental time period when the baby is forming its vital organs. The risk for having a baby with one of these birth defects is directly correlated with how poorly the blood sugar was controlled during the first few weeks of pregnancy. The most common birth defects are those of the brain, spinal cord and heart. The majority of these birth defects can be detected during the first half of the pregnancy with ultrasound studies and prenatal diagnostic tests. Having diabetes does not increase the risk for having a baby with a chromosome problem such as Down syndrome over the age-related risk. The key to minimizing the risks for having a baby with a birth defect is to seek preconception medical care in order to optimize blood sugar control before becoming pregnant. : Effects of Diabetes on the Baby
What happens if diabetes is not controlled during pregnancy?
What is gestational diabetes? Gestational diabetes is a condition in which there’s too much sugar in the blood. When you eat, your body breaks down sugar and starches from food into glucose to use for energy. Your pancreas makes a hormone called insulin that helps your body keep the right amount of glucose in your blood.
When you have diabetes, your body doesn’t make enough insulin or it can’t use insulin properly, so you end up with too much sugar in your blood. This can cause serious health problems, such as heart disease, kidney failure and blindness. Pregnant people are usually tested for gestational diabetes between 24 and 28 weeks of pregnancy.
Most of the time it can be controlled and treated during pregnancy. If it’s not treated, gestational diabetes can cause problems for you and your baby. It usually goes away after your baby’s born. Once you’ve had gestational diabetes, you have a higher risk of being diagnosed with diabetes later in life.
- Are older than 25.
- Are overweight or obese and not physically active,
- Have had gestational diabetes or a baby with macrosomia in a past pregnancy.
- Have high blood pressure or you’ve had heart disease.
- Have polycystic ovarian syndrome (also called polycystic ovary syndrome or PCOS). This is a hormone problem that can affect reproductive and overall health.
- Have prediabetes. This means your blood glucose levels are higher than normal but not high enough to be diagnosed with diabetes.
- Have a parent, brother or sister who has diabetes.
- Are a member of a racial or ethnic group that has a higher prevalence of diabetes that isn’t entirely explained by race or ethnicity, such as Black, American Indian or Alaska Native, Asian, Hispanic/Latino or Pacific Islander
Racism and risk of gestational diabetes Being a person of color is not a cause for having gestational diabetes. Researchers aren’t exactly sure why people in these groups are more likely to have gestational diabetes, but they have noticed some patterns in studies about gestational diabetes.
- For example, many people of color experience chronic stress and lack access to fresh and healthy food.
- These factors are known as social determinants of health.
- They are the conditions in which you are born, grow, work, and live.
- In many cases, the social determinants of health are related to racism.
- Racism and unequal living conditions affect health and well-being and increases the risk of pregnancy complications, including gestational diabetes.
Racism refers to the false belief that certain groups of people are born with qualities that make them better than other groups of people. Racism isn’t limited to personal attacks such as ethnic slurs, bullying, or physical assault. In a racist culture, one group of people has more power than other groups.
- Have better education and job opportunities
- Live in safer environmental conditions
- Be shown in a positive light by media, such as television shows, movies, and news programs.
- Be treated with respect by law enforcement
- Have better access to health care
In contrast, people from racial or ethnic minority groups who live in a racist culture are more likely to:
- Experience chronic stress
- Live in an unsafe neighborhood
- Live in areas that have higher amounts of environmental toxins, such as air, water, and soil pollution
- Go to a low-performing school
- Have limited access to healthy foods
- Have little or no access to health insurance and quality medical care
- Have less access to well-paying jobs
March of Dimes recognizes that racism and its effects are factors in the health disparities in pregnancy outcomes and babies’ health. We must work together to bring fair, just and full access to health care for all moms and babies. Can gestational diabetes increase your risk for problems during pregnancy? Yes.
- Macrosomia, This means your baby weighs more than 8 pounds, 13 ounces (4,000 grams) at birth. Babies who weigh this much are more likely to be hurt during labor and birth, and can cause damage to his or her mother during delivery.
- Shoulder dystocia or other birth injuries (also called birth trauma). Complications for birthing parents caused by shoulder dystocia include postpartum hemorrhage (heavy bleeding). For babies, the most common injuries are fractures to the collarbone and arm and damage to the brachial plexus nerves. These nerves go from the spinal cord in the neck down the arm. They provide feeling and movement in the shoulder, arm and hand.
- High blood pressure and preeclampsia, High blood pressure (also called hypertension) is when the force of blood against the walls of the blood vessels is too high. It can stress your heart and cause problems during pregnancy. Preeclampsia is when a pregnant person has high blood pressure and signs that some of their organs, such as the kidneys and liver, may not be working properly.
- Perinatal depression, This is depression that happens during pregnancy or in the first year after having a baby (also called postpartum depression ). Depression is a medical condition that causes feelings of sadness and a loss of interest in things you like to do. It can affect how you think, feel, and act and can interfere with your daily life.
- Preterm birth, This is birth before 37 weeks of pregnancy. Most women who have gestational diabetes have a full-term pregnancy that lasts between 39 and 40 weeks. However, if there are complications, your health care provider may need to induce labor before your due date. This means your provider will give you medicine or break your water (amniotic sac) to make your labor begin.
- Stillbirth, This is the death of a baby after 20 weeks of pregnancy.
- Cesarean birth (also called c-section). This is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus. You may need to have a c-section if you have complications during pregnancy, or if your baby is very large (also known as macrosomia). Most people who have gestational diabetes can have a vaginal birth. But they’re more likely to have a c-section than people who don’t have gestational diabetes.
Gestational diabetes also can cause health complications for your baby after birth, including:
- Breathing problems, including respiratory distress syndrome. This can happen when babies don’t have enough surfactant in their lungs. Surfactant is a protein that keeps the small air sacs in the lungs from collapsing.
- Jaundice. This is a medical condition in which the baby’s liver isn’t fully developed or isn’t working well. A jaundiced baby’s eyes and skin look yellow.
- Low blood sugar (also called hypoglycemia)
- Obesity later in life
- Diabetes later in life
How do you know if you have gestational diabetes? Your health care provider tests you for gestational diabetes with a prenatal test called a glucose tolerance test. If your provider thinks you’re at risk, you may get the test earlier. If the glucose screening test comes back positive, you’ll have another test called a glucose tolerance test.
- After this test, your doctor will be able to tell whether you have gestational diabetes.
- How is gestational diabetes treated? If you have gestational diabetes, your prenatal care provider will want to see you more often at prenatal care checkups so they can monitor you and your baby closely to help prevent problems.
You’ll probably have tests to make sure you and your baby are doing well. These include a nonstress test and a biophysical profile. The nonstress test checks your baby’s heart rate. The biophysical profile is a nonstress test with an ultrasound, Your provider also may ask you to do kick counts (also called fetal movement counts).
- Every day, time how long it takes for your baby to move 10 times. If it takes longer than 2 hours, tell your provider.
- See how many movements you feel in 1 hour. Do this 3 times each week. If the number changes, tell your provider.
If you have gestational diabetes, your provider tells you how often to check your blood sugar, what your levels should be and how to manage them during pregnancy. Blood sugar is affected by pregnancy, what you eat and drink, and how much physical activity you get.
You may need to eat differently and be more active. You also may need to take insulin shots or other medicines. Treatment for gestational diabetes can help reduce your risk for pregnancy complications. Your provider begins treatment with monitoring your blood sugar levels, healthy eating, and physical activity.
If this doesn’t do enough to control your blood sugar, you may need medicine. Insulin is the most common medicine for gestational diabetes. It’s safe to take during pregnancy. Here’s what you can do to help manage gestational diabetes:
- Go to all your prenatal care checkups, even if you’re feeling fine.
- Follow your provider’s directions about how often to check your blood sugar. Your provider shows you how to check your blood sugar on your own. They tell you how often to check it and what to do if it’s too high. Keep a log that includes your blood sugar level every time you check it. Share it with your provider at each checkup. Most parents can check their blood sugar four times each day: once after fasting (first thing in the morning before you’ve eaten) and again after each meal.
- Eat healthy foods. Talk to your provider about the right kinds of foods to eat to help control your blood sugar.
- Do something active every day. Try to get 30 minutes of moderate-intensity activity at least 5 days each week. Talk to your provider about activities that are safe during pregnancy, like walking.
- If you take medicine for diabetes, take it exactly as your provider tells you to. If you take insulin, your provider teaches you how to give yourself insulin shots. Tell your provider about any medicine you take, even if it’s medicine for other health conditions. Some medicines can be harmful during pregnancy, so your provider may need to change them to ones that are safer for you and your baby. Don’t start or stop taking any medicine during pregnancy without talking to your provider first.
- Check your weight gain during pregnancy. Gaining too much weight or gaining weight too fast can make it harder to manage your blood sugar. Talk to your provider about the right amount of weight to gain during pregnancy,
If you have gestational diabetes, how can you help prevent getting diabetes later in life? For most people, gestational diabetes goes away after giving birth. But having it makes you more likely to develop type 2 diabetes later in life. Type 2 diabetes is the most common kind of diabetes. Here’s what you can do to help reduce your risk of developing type 2 diabetes after pregnancy:
- Get tested for diabetes 4 to 12 weeks after your baby is born. If the test is normal, get tested again every 1 to 3 years.
- Get to and stay at a healthy weight.
- Talk to your provider about medicine that may help prevent type 2 diabetes.
Last reviewed: March 2022
What should I do if I have diabetes during pregnancy?
A healthy diet – Making changes to your diet can help control your blood sugar levels. You should be referred to a dietitian, who can give you advice about your diet and how to plan healthy meals. You may be advised to:
eat regularly – usually three meals a day – and avoid skipping mealseat starchy and low glycaemic index (GI) foods that release sugar slowly – such as wholewheat pasta, brown rice, granary bread, all-bran cereals, pulses, beans, lentils, muesli and plain porridgeeat plenty of fruit and vegetables – aim for at least 5 portions a day avoid sugary foods – you do not need a completely sugar-free diet, but swap snacks such as cakes and biscuits for healthier alternatives such as fruit, nuts and seedsavoid sugary drinks – diet or sugar-free drinks are better than sugary versions. Fruit juices and smoothies can also be high in sugar, and so can some “no added sugar” drinks, so check the nutrition label or ask your health care teameat lean sources of protein, such as fish
It’s also important to be aware of foods to avoid during pregnancy, such as certain types of fish and cheese. Diabetes UK: What can I eat with gestational diabetes? Diabetes UK: Glycaemic index (GI) and diabetes
Are diabetics more likely to miscarry?
Miscarriage – Women with diabetes are at a much greater risk of miscarriage, stillbirth, and neonatal fatalities than women without diabetes. So, if you have diabetes and are planning on getting pregnant, it’s best to partner with us early so we can help you prepare your body for what’s ahead.
Is 7.8 blood sugar high in pregnancy?
Routine screening for gestational diabetes – Screening tests may vary slightly depending on your health care provider, but generally include:
Initial glucose challenge test. You’ll drink a syrupy glucose solution. One hour later, you’ll have a blood test to measure your blood sugar level. A blood sugar level of 190 milligrams per deciliter (mg/dL), or 10.6 millimoles per liter (mmol/L), indicates gestational diabetes. A blood sugar level below 140 mg/dL (7.8 mmol/L) is usually considered within the standard range on a glucose challenge test, although this may vary by clinic or lab. If your blood sugar level is higher than expected, you’ll need another glucose tolerance test to determine if you have gestational diabetes. Follow-up glucose tolerance testing. This test is similar to the initial test — except the sweet solution will have even more sugar and your blood sugar will be checked every hour for three hours. If at least two of the blood sugar readings are higher than expected, you’ll be diagnosed with gestational diabetes.
What is the highest sugar level in pregnancy?
Target Blood Sugar Levels for Women During Pregnancy – The American Diabetes Association recommends these targets for pregnant women who test their blood sugar:
Before a meal: 95 mg/dL or lessAn hour after a meal: 140 mg/dL or lessTwo hours after a meal: 120 mg/dL or less
When is blood sugar highest during pregnancy?
At 15 weeks, another hormone—human placental growth hormone—also increases and causes maternal blood glucose level to rise. This hormone is also supposed to help regulate the mother’s blood glucose level to be sure that the baby gets the right amount of needed nutrients.
Can I inject insulin in my stomach when pregnant?
P REGNANCY – Insulin is required in about 10-20% of all antenatal women with diabetes, which complicates about one-sixth of all pregnancies. Patients should be reassured that insulin is not only safe in pregnancy, but also contributes to maternal and fetal well-being.
- The abdomen is a safe site for insulin administration in pregnancy.
- First trimester: Women should be reassured that no change in insulin site or technique is needed.
- Second trimester: Lateral parts of the abdomen can be used to inject insulin, staying away from the skin overlying the fetus.
- Third trimester: As mentioned in the FIT India guidelines, insulin can be injected over the abdomen while ensuring the skin fold is properly raised.
Apprehensive patients may use the thigh or upper arm to inject themselves.
Does insulin make baby bigger?
Possible complications for the baby – Unlike type 1 diabetes, gestational diabetes generally occurs too late to cause birth defects. Birth defects usually originate sometime during the first trimester (before the 13th week) of pregnancy. The insulin resistance from the contra-insulin hormones produced by the placenta does not usually occur until approximately the 24th week.
Macrosomia, Macrosomia refers to a baby who is considerably larger than normal. All of the nutrients the fetus receives come directly from the mother’s blood. If the maternal blood has too much glucose, the pancreas of the fetus senses the high glucose levels and produces more insulin in an attempt to use this glucose. The fetus converts the extra glucose to fat. Even when the mother has gestational diabetes, the fetus is able to produce all the insulin it needs. The combination of high blood glucose levels from the mother and high insulin levels in the fetus results in large deposits of fat which causes the fetus to grow excessively large. Hypoglycemia, Hypoglycemia refers to low blood sugar in the baby immediately after delivery. This problem occurs if the mother’s blood sugar levels have been consistently high, causing the fetus to have a high level of insulin in its circulation. After delivery, the baby continues to have a high insulin level, but it no longer has the high level of sugar from its mother, resulting in the newborn’s blood sugar level becoming very low. The baby’s blood sugar level is checked after birth, and if the level is too low, it may be necessary to give the baby glucose intravenously.
Blood glucose is monitored very closely during labor. Insulin may be given to keep the mother’s blood sugar in a normal range to prevent the baby’s blood sugar from dropping excessively after delivery. : Gestational Diabetes Mellitus (GDM)
Does insulin harm placenta?
Is It Safe to Take Insulin for Gestational Diabetes? Medically Reviewed by on July 23, 2021 Eating healthy foods and getting plenty of may be all you need to control your during your, But when that’s not enough, you may need to take insulin, too. is a hormone that helps your cells take in and use glucose. Your makes insulin, but the kind you take is made in a lab.
- Your doctor may prescribe it when your body doesn’t make enough on its own to keep your in a normal range.
- That will help prevent problems for you and your,
- Doesn’t cross the, which means it can’t get to your, so it’s safe to use as prescribed.
- You inject it under your with a syringe or,
- You can’t take insulin as a pill or drink it.
How much you’ll need and how often you’ll need it will probably change during your pregnancy. Some kinds of insulin work in just a few minutes; others work more slowly but last longer. You take fast-acting insulin with a meal, so it goes to work right away to help your body use the glucose from the food you ate.
Your doctor will probably prescribe this type, along with one that lasts about 12 hours or overnight. Longer-acting (24-hour) insulin hasn’t been studied with pregnant women. You might get sore and have hard lumps where you inject the insulin. To prevent this, try not to give yourself the shot in the same place every time.
Insulin can also cause (hypoglycemia) when there’s not enough glucose in your for your body to work right. You’re more likely to have this if you skip a meal or use too much insulin. Be sure you know the warning signs:,, shaking, and blurry, The best treatment is a quick- food like raisins, honey, or glucose tablets or gel.
- Can be dangerous for you and your, so do something about it right away.
- The hospital will before you leave.
- If it’s normal, you can stop taking insulin.
- But because you’ve had, you’re more likely to get later.
- To be safe, you should have a test 6 months after you give birth and then usually every 3 years, or as often as your doctor recommends.
If you have trouble taking insulin or don’t want to use it, talk to your doctor about your options. You may be able to take a pill instead to control your blood sugar. The FDA hasn’t approved other than insulin for pregnant women because they cross the placenta.
Can diabetics have C sections?
C-Section (Cesarean Section) – A C-section is an operation to deliver the baby through the mother’s belly. A woman who has diabetes that is not well controlled has a higher chance of needing a C-section to deliver the baby. When the baby is delivered by a C-section, it takes longer for the woman to recover from childbirth.
When do diabetic mothers give birth?
Current Recommendations – Expert recommendations suggest that women with uncomplicated GDM take their pregnancies to term, and deliver at 38 weeks gestation, Such a decision is not as simple as it seems. These recommendations differ from earlier findings, which suggested earlier induction of labor, but are consonant with secular trends in obstetrics, which support longer periods of gestation.
- Guidelines also state that GDM per se is not a factor in determining mode of delivery,
- The American College of Obstetricians and Gynecologists and the Society for Maternal Fetal Medicine have proposed new recommendations for terminology of gestational age and delivery timing,
- For women with well-controlled diabetes, whether pregestational or gestational, a late preterm or early term birth, i.e., before 39 completed weeks of gestation, is not indicated.
In a setting of poorly controlled diabetes, an individualized decision aiming for late preterm or early term delivery (before 38 weeks + 6 days gestation) is recommended. An early term or term delivery (38–39 weeks + 6 days gestation) is suggested if vascular complications are present in women with pregestational diabetes.
- In practice, however, these gestational ages may be difficult to attain.
- It must also be remembered that these recommendations assume 24/7 availability, accessibility, and affordability of optimal maternal and fetal monitoring, including seven-point glycemic profiles and regular cardiotocography for all women with GDM.
They also take certain attributes of physical environment, such as ease of travel and communication, for granted.
Can diabetic mother have normal baby?
7 Tips for Women with Diabetes – If a woman with diabetes keeps her blood sugar well controlled before and during pregnancy, she can increase her chances of having a healthy baby. Controlling blood sugar also reduces the chance that a woman will develop common problems of diabetes, or that the problems will get worse during pregnancy. Steps women can take before and during pregnancy to help prevent problems:
Plan for Pregnancy Before getting pregnant, see your doctor. The doctor needs to look at the effects that diabetes has had on your body already, talk with you about getting and keeping control of your blood sugar, change medications if needed, and plan for frequent follow-up. If you are overweight, the doctor might recommend that you try to lose weight before getting pregnant as part of the plan to get your blood sugar in control. See Your Doctor Early and Often During pregnancy, a woman with diabetes needs to see the doctor more often than a pregnant woman without diabetes. Together, you and your doctor can work to prevent or catch problems early. Eat Healthy Foods Eat healthy foods from a meal plan made for a person with diabetes. A dietitian can help you create a healthy meal plan. A dietitian can also help you learn how to control your blood sugar while you are pregnant. Tasty Recipes for People with Diabetes and Their Families » To Find a Dietitian: American Dietetic Association 1–800–877–1600 www.eatright.org (click on “Find an Expert”) Exercise Regularly Exercise is another way to keep blood sugar under control. It helps to balance food intake. After checking with your doctor, you can exercise regularly before, during, and after pregnancy. Get at least 30 minutes of moderate-intensity physical activity at least five days a week. This could be brisk walking, swimming, or actively playing with children. Learn more about physical activity during pregnancy » Take Pills and Insulin as Directed If diabetes pills or insulin are ordered by your doctor, take them as directed in order to help keep your blood sugar under control. Control and Treat Low Blood Sugar Quickly Keeping blood sugar well controlled can lead to a chance of low blood sugar at times. If you are taking diabetes pills or insulin, it’s helpful to have a source of quick sugar, such as hard candy, glucose tablets or gel, on hand at all times. It’s also good to teach family members and close co-workers or friends how to help in case of a severe low blood sugar reaction. Monitor Blood Sugar Often Because pregnancy causes the body’s need for energy to change, blood sugar levels can change very quickly. You need to check your blood sugar often, as directed by your doctor. It is important to learn how to adjust food intake, exercise, and insulin, depending on the results of your blood sugar tests. Learn how to take control of your diabetes »
Will my baby be born if I have gestational diabetes?
An Extra-Large Baby – Diabetes that is not well controlled causes the baby’s blood sugar to be high. The baby is “overfed” and grows extra-large. Besides causing discomfort to the woman during the last few months of pregnancy, an extra-large baby can lead to problems during delivery for both the mother and the baby.
Can I have a normal birth with gestational diabetes?
You should be able to. Having gestational diabetes (GD) doesn’t necessarily mean that you can’t have your baby vaginally, You’ve got a better chance of having a birth without any interventions, such as induction or caesarean section, if you can keep your blood sugar levels stable during pregnancy.
- However, your obstetrician will recommend that you don’t go past your due date, even if you’ve been able to control gestational diabetes well.
- She’ll recommend that your labour is induced if it hasn’t started by 40 weeks.
- If you’ve had complications in your pregnancy, or if you’ve needed medication to control your GD, you’ll have a check-up with your doctor at 38 weeks.
Depending on how things are going, your doctor may recommend that you have an induction, or a planned caesarean, between 38 weeks and 39 weeks. The reason for your doctor’s caution is that with poorly controlled GD, you’re more likely to:
develop pre-eclampsia have a big baby (macrosomia), with a birth weight of 4.5kg (9lb 15oz) or more
Expecting a big baby doesn’t rule out vaginal birth. Almost two thirds of big babies are born vaginally. Getting into the right labour positions can help your baby to be born without needing an episiotomy, or assisted birth, It’s sensible to have a discussion with your doctor and midwife, though, because there are risks involved in giving birth vaginally to a big baby.
- The biggest worry is shoulder dystocia,
- Shoulder dystocia happens when your baby’s shoulders get stuck behind the bones in your pelvis as she’s being born.
- This is a particular risk for mums with poorly controlled GD, because the extra blood sugar makes babies grow big around their shoulders and chest.
If your baby is over 4.5kg (9lb 15oz), there is a one in 13 chance of shoulder dystocia happening during birth. This increases to a one in seven chance if your baby is over 5kg (11lb). Giving birth to a big baby can also leave you with problems. It raises your risk of:
having a bigger tear in the area around your vagina (perineum) losing a lot of blood having damage to your tailbone (coccyx)
An advantage of having your labour induced a little before your due date is that it will stop your baby putting on too much weight in the final weeks of your pregnancy. Not all women with GD have big babies, especially when blood sugar is well-controlled. There is plenty you can do now to make sure your blood sugar stays stable:
eat a healthy diet for GD exercise regularly keep pregnancy weight gain under control
Talk to other mums who have gestational diabetes in our friendly community, Jenny Leach is an editor and writer specialising in evidence-based health content.