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All About Pregnancy and Diabetes

Many women begin pregnancy with preexisting problems, such as diabetes. In fact, about one in every 100 women of childbearing age has some form of diabetes. This includes Type 1 (insulin dependent) and Type 2 (non-insulin dependent) diabetes. In either case, most women with diabetes can have a successful pregnancy and healthy baby if the condition is well controlled.

If you have diabetes, it is important for you to see your doctor before conceiving to discuss your care. You should have good control of your blood sugar levels for at least several weeks before becoming pregnant. This is because you might not even know you are pregnant until the baby has been growing for two to four weeks.

The baby's organs begin to form very early in pregnancy, and development can be affected by a mother's poorly controlled blood sugar levels. High blood sugar levels early in the pregnancy can increase the risk for birth defects. Good control of blood sugar is just as important during the pregnancy as it is before pregnancy to decrease risk of other potential problems.

If diabetes is not well controlled before and during pregnancy, problems that may arise include a higher risk of birth defects, a very large baby, preeclampsia, miscarriage, urinary tract infections, respiratory problems for the baby after birth, and too much amniotic fluid surrounding the baby, which can lead to preterm labor. Beyond possible problems for the baby, people who do not control their diabetes can end up with both short and long-term health problems.

If you have diabetes, it is essential to meet with your doctor before you become pregnant. You may be advised to wait to become pregnant until you have your blood sugar under control. This can take time, so be patient. Your diabetes health-care provider needs to first determine if your diabetes is controlled well enough to decrease the risk for possible complications during pregnancy. A blood test, called a glycosylated hemoglobin test (HbA1c), is used to evaluate how well your diabetes has been controlled over the past six to twelve weeks. This blood test may also be used during pregnancy to monitor how well you are controlling your blood sugars.

Your diabetes health-care provider may also perform other tests before deciding that it is safe for you to conceive. These tests may include a urinalysis to screen for any possible diabetic kidney complications, a blood test to evaluate cholesterol and triglyceride levels, and an eye exam to screen for common diabetic problems including glaucoma, cataracts, and retinopathy. All of these tests can help your health-care provider determine whether your diabetes is under control. Your doctor will help you to properly monitor your blood sugar levels both before and during your pregnancy.

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