Diabetes is a condition that leads to increased blood glucose levels, the sugar that acts as your body’s main source of fuel. More than nine million women in the United States have diabetes and it affects 2% to 10% of all pregnancies. But with proper medical care, the risk of complications for the diabetic patient and her baby are similar to a non-diabetic woman.
Three types of diabetes exist: type I, type II and Gestational. In type I diabetes the body’s pancreas cannot produce enough insulin, the hormone that controls blood sugar levels. It usually develops early in life and patients require insulin injections to maintain normal sugar levels. Type II diabetes tends to develop later in life and is often without symptoms, which explains why one third of women do not know that they have diabetes. In type II diabetes, the pancreas produces insulin but the body becomes resistant to it. People with type II diabetes can often control their blood sugar levels by altering their diet, increasing their physical activity, and losing weight; but in some cases oral medications or insulin shots may be necessary.
If you have type I or II diabetes and want to have a baby, it’s very important to get counseling and medical care beforehand so you can achieve normal sugar levels before getting pregnant. If you have uncontrolled diabetes at the time of conception, there is an increased risk of miscarriage and birth defects. You also should get a physical exam to check for complications commonly associated with diabetes including high blood pressure, kidney disease, and eye disease as these are all factors that increase the risk for pregnancy complications like preeclampsia, poor growth of the baby, and premature delivery.
The third type of diabetes is Gestational and it is the most common type of diabetes seen in pregnancy. Gestational diabetes occurs because the placenta (afterbirth) produces hormones that make the body resistant to insulin and the pancreas cannot produce enough insulin to overcome this resistance. Similar to type II, patients are usually without symptoms.
Since Gestational diabetes can be recognized first at any point during the pregnancy, non-diabetic pregnant women are usually screened for the disease between 24 and 28 weeks. Although some women may need oral medications or insulin shots to control their sugars, many can control it through diet and exercise alone. Normal sugar levels also must be maintained during labor to prevent maternal and fetal complications. Approximately 50% of women with gestational diabetes will develop type II diabetes within 10 to 15 years after the pregnancy, so it’s important to be tested regularly.
Although higher risk, women with diabetes usually have pregnancy outcomes similar to non-diabetic patients; however, education is a vital component to delivering a healthy baby. The key to managing risk will always be dietary and lifestyle modifications. Eat well. Stay active. Live healthy.
Stephen S. Crane, MD