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 General Information About Diabetes
Diabetes and Pregnancy
Type 1 and Type 2 Diabetes and Pregnancy
Gestational Diabetes
Prevention of Problems
Diabetes is often detected in women during their
childbearing years and can affect the health of both the mother and her
unborn child. Poor control of diabetes in a woman who is pregnant
increases the chances for birth defects and other problems for the baby.
It might cause serious complications for the woman, also. Proper health
care before and during pregnancy will help prevent birth defects and
other poor outcomes, such as miscarriage or stillbirth.
What is diabetes?
Diabetes is a condition in which the body cannot use the sugars and
starches (carbohydrates) it takes in as food to make energy. The body
either makes too little insulin in the pancreas or cannot use the
insulin it makes to change those sugars and starches into energy. As a
result, the body collects extra sugar in the blood and gets rid of some
sugar in the urine. The extra sugar in the blood can damage organs of
the body, such as the heart, eyes, and kidneys, if it is allowed to
collect in the body too long. The 3 most common types of diabetes are
Type 1, Type 2, and gestational.
- Type 1 diabetes is a condition in which the pancreas makes so
little insulin that the body can’t use blood sugar for energy. Type 1
diabetes must be controlled with daily insulin shots.
- Type 2 diabetes is a condition in which the body either makes too
little insulin or can’t use the insulin it makes to use blood sugar
for energy. Often Type 2 diabetes can be controlled through eating a
proper diet and exercising regularly. Some people with Type 2 diabetes
have to take diabetes pills or insulin or both.
- Gestational diabetes is a type of diabetes that occurs in a
pregnant woman who did not have diabetes before she was pregnant.
Often gestational diabetes can be controlled through eating a proper
diet and exercising regularly, but sometimes a woman with gestational
diabetes must also take insulin shots. Usually gestational diabetes
goes away after pregnancy, but sometimes it doesn’t. Also, many women
who have had gestational diabetes develop Type 2 diabetes later in
life.
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What are some
common problems caused by diabetes?
People with diabetes can get high blood pressure, kidney disease, nerve
damage, heart disease, and blindness. Young women with diabetes might
not have these problems yet. The damage caused by these problems often
happen in people whose blood sugar has been out of control for years.
Keeping blood sugar under control can help prevent the damage from
happening.
People with diabetes can go into “diabetic coma” if their blood sugar is
too high. They can also develop blood sugar that is too low
(hypoglycemia) if they don’t get enough food, or they exercise too much
without adjusting insulin or food. Both diabetic coma and hypoglycemia
can be very serious, and even fatal, if not treated quickly. Closely
watching blood sugar, being aware of the early signs and symptoms of
blood sugar that is too high or too low, and treating those conditions
early can prevent these problems from becoming too serious.
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How does a person get
diabetes?
We don’t know exactly how people get diabetes. However, it appears that
both genetics and personal lifestyle play a role in who gets diabetes.
Some people have diabetes that “runs” in the family. Lack of exercise,
poor eating habits, and obesity seem to increase the risk of developing
Type 2 diabetes in other people. In some, but not all cases, Type 2
diabetes can be controlled if people lose weight, eat right, and
exercise regularly.
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Can a person
prevent problems from diabetes?
A person with diabetes who keeps her blood sugar as close to normal as
possible has fewer problems than a person who does not keep his blood
sugar in “tight control.” A woman with diabetes who can get pregnant
should watch her blood sugar closely to prevent problems if she should
get pregnant. To keep blood sugar in tight control, a person can manage
her diabetes with a strict plan:
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Eat healthy foods from personal diabetes meal
plan
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Exercise regularly
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Monitor blood sugar often
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Take medications on time, including insulin if
ordered by the doctor.
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Know how to adjust food intake, exercise, and
insulin depending on the results of blood sugar tests
-
Control or treat low blood sugar and high blood
sugar
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Follow up with health care provider regularly
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How does
gestational diabetes differ from Type 1 or Type 2 diabetes?
Gestational diabetes happens in a woman who develops diabetes during
pregnancy. Some women have more than one pregnancy affected by diabetes
that disappears after the pregnancy ends. About half of women with
gestational diabetes will develop Type 2 diabetes later.
If not controlled, gestational diabetes can cause the baby to grow extra
large and lead to problems with delivery for the mother and the baby.
Gestational diabetes might be controlled with diet and exercise, or it
might take insulin as well as diet and exercise to get control.
Type 1 and Type 2 diabetes often are present before a woman gets
pregnant. If not controlled before and during pregnancy, Type 1 and Type
2 diabetes can cause the baby to have birth defects and cause the mother
to have problems (or her problems to worsen if they are already
present), such as high blood pressure, kidney disease, nerve damage,
heart disease, or blindness. Type 1 diabetes must be controlled with a
balance of diet, exercise, and insulin. Type 2 diabetes might be
controlled with diet and exercise, or it might take diabetes pills or
insulin or both as well as diet and exercise to get control.
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Will my baby have diabetes?
Babies born to mothers with diabetes do not come into the world with
diabetes. However, if the mother’s diabetes was not controlled during
pregnancy, the baby can very quickly develop low blood sugar after birth
and must be watched very closely until his or her body adjusts the
amount of insulin it makes.
Extra large babies are more likely to become obese and to develop Type 2
diabetes later in life. They especially need to develop healthy eating
and regular exercise habits as they grow up to lessen the chance of
obesity and Type 2 diabetes.
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If the father of the developing baby has
diabetes, does his diabetes affect the pregnancy?
Diabetes in the father does not affect the developing baby during
pregnancy. However, depending on the type of diabetes the father has,
the baby might have a greater chance of developing diabetes later in
life.
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What can happen to a woman with
Type 1 or Type 2 diabetes who becomes pregnant?
Pregnancy is a time when a woman’s body goes through lots of changes as
it nurtures a developing baby. All women need more nutrients, rest, and
energy to grow the baby when they are pregnant. They also need to be
physically active. When a woman with diabetes is pregnant, changes
happen in her blood sugar, often quickly. If a woman with diabetes does
not keep good control of her blood sugar, she might get some of the
common problems of diabetes, or those problems might get worse if she
already has them. Out of control blood sugar could lead to a woman
having a miscarriage. Out of control blood sugar might also cause high
blood pressure in a woman during pregnancy, and she will need extra
visits to the doctor. High blood pressure during pregnancy might lead to
a baby being born early and also could cause seizures or a stroke (a
blood clot in the brain that can lead to brain damage) in the woman
during labor and delivery. Sometimes, out of control blood sugar causes
a woman to make extra large amounts of amniotic fluid around the baby
which might lead to preterm (early) labor. Another problem common to a
pregnant woman with uncontrolled diabetes is that her baby grows too
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.
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What can happen to the baby of a
woman with Type 1 or Type 2 diabetes during pregnancy?
Diabetes in a pregnant woman can cause the baby to have birth defects,
miscarry, be born early and have a low birth weight, be stillborn, or
grow extra large and have a hard delivery.
A woman who has Type 1 or Type 2 diabetes that is not tightly controlled
has a higher chance of having a baby with a birth defect than does a
woman without diabetes. The organs of the baby form during the first two
months of pregnancy, often before a woman knows that she is pregnant.
Out of control blood sugar can affect those organs while they are being
formed and cause serious birth defects, such as those of the brain,
spine, and heart, or can lead to miscarriage of the developing baby.
If the woman’s blood sugar remains out of control throughout the
pregnancy, the baby likely will grow extra large. Out of control
diabetes causes the baby’s blood sugar to be high. The baby makes more
insulin and uses the extra calories or stores them as fat. The baby is
“overfed” and grows extra large. Extra large babies can occur in women
with any out of control diabetes, including Type 1, Type 2, and
gestational. The extra large baby can cause problems during and after
delivery. Nerve damage to the baby can happen from pressure on the
baby’s shoulder during delivery. A newborn might have quickly changing
blood sugars after delivery. A large baby born to a woman with diabetes
might have a greater chance of being obese and/or developing Type 2
diabetes later in life.
If the woman with diabetes has problems that lead to a preterm birth,
the baby might have breathing problems, heart problems, bleeding into
the brain, intestinal problems, and vision problems. A woman with
diabetes might have a baby born on time with low birth weight. A baby
with low birth weight might have problems with eating, gaining weight,
fighting off infections, and staying warm.
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What can happen to a pregnant
woman with gestational diabetes?
A pregnant woman who does not have diabetes can develop “gestational
diabetes” later in pregnancy. A woman with gestational diabetes will
need to watch her blood sugar closely and balance food intake, exercise,
and, if needed, insulin shots to keep her blood sugar in control. If a
woman with gestational diabetes does not keep her blood sugar in good
control, she could have several problems. She might have an extra large
baby, have high blood pressure, deliver too early, or need to have a
cesarean section (an operation to get the baby out of the mother through
her abdomen). The extra large baby might cause the woman to feel
uncomfortable during the last months of pregnancy. Also, it could lead
to problems for both the woman and the baby during delivery. When the
baby is delivered surgically by a cesarean section (C-section), it takes
longer for the woman to recover from childbirth. High blood pressure
when a woman is pregnant might lead to an early delivery and could cause
seizures or a stroke in the woman.
Sometimes gestational diabetes in women does not go away after delivery.
These women have converted to Type 2 diabetes. A woman whose diabetes
does not go away after delivery will need to manage her diabetes for the
rest of her life.
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What can happen to the
baby of a woman with gestational diabetes?
A woman who has gestational diabetes has less chance of having a
baby with a birth defect than does a woman with Type 1 or Type 2
diabetes. Since gestational diabetes develops later in pregnancy, the
baby’s organs are already formed. If her blood sugar is not controlled,
a woman with gestational diabetes still has a greater chance of having a
stillborn baby than a woman who doesn’t have diabetes.
If the woman’s blood sugar remains out of control throughout the
pregnancy, the baby likely will grow extra large. Out of control
diabetes causes the baby’s blood sugar to be high. The baby makes more
insulin and uses the extra calories or stores them as fat. The baby is
“overfed” and grows extra large. Extra large babies can occur in women
with any out of control diabetes, including Type 1, Type 2, and
gestational.
The extra large baby can cause problems during and after delivery. Nerve
damage to the baby can happen from pressure on the baby’s shoulder
during delivery. A newborn might have quickly changing blood sugars
after delivery. A large baby born to a woman with diabetes might have a
greater chance of being obese and/or developing Type 2 diabetes later in
life.
If the woman with diabetes has problems that lead to a preterm birth,
the baby might have breathing problems, heart problems, bleeding into
the brain, intestinal problems, and vision problems. A woman with
diabetes might have a baby born on time with low birth weight. A baby
with low birth weight might have problems with eating, gaining weight,
fighting off infections, and staying warm.
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Can a woman with diabetes prevent the
problems to herself and to her baby during pregnancy?
If a woman with diabetes keeps her blood sugar in tight control before
and during pregnancy, she can lessen her risk of having a baby with a
birth defect to that of a woman who doesn’t have diabetes. Controlling
her blood sugar also reduces the risk that a woman will develop common
problems of diabetes, or that the problems will get worse during
pregnancy. The baby is less likely to grow extra large during her
pregnancy if a woman keeps her blood sugar in tight control.
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How can a woman with diabetes who
wants to get pregnant prevent problems to herself and her baby?
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Plan the pregnancy. Unplanned pregnancies are
more common among women with diabetes than among women who do not have
diabetes. About 70% of women with diabetes don’t plan their
pregnancies as compared to about 50% of women who don’t have diabetes.
It is very important for a woman with diabetes to get her body ready
before she becomes pregnant.
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See her doctor. Her doctor needs to look at the
effects that diabetes has had on her body already, talk with her about
getting and keeping control of her blood sugar, change medications if
needed, and plan for frequent follow-up. Her doctor will remind her
about the usual steps to get ready for pregnancy, such as to take
prenatal vitamins (with folic acid), stop smoking, avoid alcohol, eat
right, exercise, and avoid stress.
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Eat healthy foods from a meal plan made for her
as a person with diabetes. If a woman is overweight, she might try to
lose weight before getting pregnant as part of her plan to get her
blood sugar in control. Talking with a dietitian can help her plan a
good diet for a person with diabetes, especially if she plans to lose
weight before she gets pregnant. A dietitian can also help her learn
how to control her blood sugar while she is pregnant.
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Exercise regularly. Exercise is another way to
keep blood sugar under control. Exercise helps to balance food intake.
A woman should begin a regular exercise plan before she gets pregnant
and stick with the exercise plan both while she is pregnant and after
the baby comes.
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Monitor blood sugar often. Because pregnancy
causes the body’s need for energy to change, blood sugar levels can
change very quickly. A pregnant woman with diabetes needs to check her
blood sugar more often, sometimes 6 to 8 times a day, which might be
higher than when she is not pregnant. Checking blood sugar levels
often can help a woman keep her blood sugar in control.
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Take medications on time. If insulin is ordered
by a doctor, a pregnant woman with diabetes should take it when it’s
needed. She should know how to adjust food intake, exercise, and
insulin, depending on the results of her blood sugar tests, to keep
the blood sugar in the range of tight control. For more information,
see the American Diabetes Association website at
http://www.diabetes.org/type-1-diabetes/tight-control.jsp.
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Control and treat low blood sugar quickly.
Keeping tight blood sugar control can lead to a chance of low blood
sugar at times. A pregnant woman with diabetes should have a ready
source of carbohydrates, such as glucose tablets or gel, on hand at
all times. It’s helpful to teach family members and close co-workers
or friends how to help in case of a severe low blood sugar reaction.
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Follow-up with the doctor regularly. A pregnant
woman with diabetes needs to see her doctor more often than does a
pregnant woman without diabetes. Together, the woman can work with her
doctor to prevent or catch problems early. Although there are no
guarantees, a woman with diabetes who gets and keeps her blood sugar
in control is more likely to have a healthy pregnancy and a healthy
baby.
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Date: October 5, 2005
Content source: National Center on Birth Defects and Developmental
Disabilities
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