The following is a guest post from Cheretta A Clerkley of Hormone Health Network.
Pregnancy is an exciting yet frightening time for most women — but for women with diabetes, pregnancy brings a whole new level of apprehension. Controlling blood sugar levels well is essential to maintaining a healthy pregnancy, and serious complications can occur when women do not maintain their blood sugar levels. A safe pregnancy for the diabetic woman is possible, but it requires careful monitoring and planning prior to conception for the best result.
Risks of Diabetes to Your Baby
Why is diabetes a problem during pregnancy? According to the American Diabetes Association, diabetes increases the risk of several complications for your baby, including:
• Premature delivery
• Birth defects
• Macrosomia (large birth weight)
• Low glucose levels at birth
• Respiratory distress
• Prolonged jaundice
Risks for pregnant moms with diabetes include: worsening diabetic eye and kidney problems, as well as a preeclampsia and difficult deliveries.
Planning Before Pregnancy
Many women know they want to become pregnant long before they actually do. The time period between deciding to start a family and actually becoming pregnant is a good time to get proper control over your health. This planning starts with a thorough checkup with a team of health care providers who understand the risks of diabetes during pregnancy, including your diabetes specialists and endocrinologist, as well as an obstetrician and, if possible, a dietitian.
At this meeting, the health care team will discuss healthy blood sugar ranges and hemoglobin A1C levels. The health care providers will offer suggestions on how to maintain healthy blood sugar and A1C levels throughout pregnancy.
Women on insulin therapy may need to make a change to their insulin routine. Sometimes an insulin pump or changing to multiple injections per day will help keep blood sugar levels more stable. Women who are diabetic and overweight may also be advised to lose weight to help prevent further complications. Finally, your team may encourage you to get an eye exam to check for retinopathy, which should be treated before trying to conceive.
Because diabetes can affect other parts of a woman’s health, your doctor may also recommend a thyroid function test and a screening test for blocked arteries. Ruling out thyroid problems and heart problems, or treating them if they are present before pregnancy decreases the risk of complications.
Diabetes Care During Pregnancy
After making the necessary changes to your health before conception, your health care team will give you the OK to start trying to conceive. Once you are pregnant, you will be monitored closely for any signs of complications or danger to your baby.
First, your doctor will want you to carefully check your blood glucose levels, often asking you to test more frequently than you did before you became pregnant. Follow the testing protocol carefully, so you are aware of any problems that arise that could put your baby at risk.
Next, make sure to use your insulin exactly as prescribed by your doctor. Continue using the delivery mechanism you were using prior to getting pregnant — unless it proves to be ineffective. Remember, pregnancy can throw your blood sugar levels off, so you may need to make some changes as the pregnancy progresses, but only do so under the care of an obstetrician or endocrinologist.
Your diet will also be closely monitored during pregnancy. You will work with a dietician to create a healthy eating plan customized to your needs. You may be asked to limit the number of carbs you consume while pregnant to maintain stable blood sugar levels.
As with all pregnant women, you will take an additional vitamin with high levels of folic acid, which help your baby’s brain development.
Throughout the pregnancy, you may be monitored more closely, particularly if you have signs of trouble or are having difficulty maintaining your blood sugar levels. As your due date nears, you may have more ultrasounds and non-stress-tests performed by your obstetrician to detect any signs of distress from the baby before they can cause permanent damage.
Diabetes Care After Pregnancy
Once your baby is born, your diabetes care will continue. Hormone fluctuations post birth can cause blood sugar fluctuations, so you will need to check your blood sugar levels closely until your body balances from the stresses of birth. If you plan to breastfeed your baby, go ahead and do it! It is healthy for you and your baby, and can help with post-pregnancy weight loss. You can continue to take your diabetes medications while breastfeeding.
Entering pregnancy while dealing with diabetes requires careful planning. Check with your endocrinologist now, and start making the changes you need to protect the health of your pregnancy right away. Soon you will be holding a new bundle of joy — a tribute to all of your hard work.
Cheretta A Clerkley is a strategic marketing health care professional for Hormone Health Network where she oversees patient education programs and services. These education programs focus on diabetes and other hormonal conditions.