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How Can Diabetes Affect My Baby
A babys organs, such as the brain, heart, kidneys, and lungs, start forming during the first 8 weeks of pregnancy. High blood glucose levels can be harmful during this early stage and can increase the chance that your baby will have birth defects, such as heart defects or defects of the brain or spine.
High blood glucose levels during pregnancy can also increase the chance that your baby will be born too early, weigh too much, or have breathing problems or low blood glucose right after birth.
High blood glucose also can increase the chance that you will have a miscarriage or a stillborn baby.1 Stillborn means the baby dies in the womb during the second half of pregnancy.
What Are The Risks Of Diabetes To My Unborn Child
There are a few potentially negative health risks to the baby when the mother has diabetes.
- Macrosomia is a condition in which your baby grows too large due to excess insulin crossing the placenta. A large baby can make vaginal delivery difficult and increase the risk of injury to the baby during the birth process.
- Hypoglycemia, or low blood sugar, can develop shortly after birth due to high insulin levels. Controlling your own blood sugar can help to lower the risks of hypoglycemia for your baby.
- Jaundice is a yellowish discoloration of the skin and eyes and can sometimes be attributed to diabetes while pregnant. Your pediatric care provider will assist you with a plan to alleviate this condition for your newborn.
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Women Often Say That Managing Diabetes When Theyre Pregnant Is Like A Full
There are so many appointments, tests and scans. And as your baby grows inside you, it takes a lot of effort to keep blood sugar levels in a safe range.
Its a lot of work, but its worth it. This will reduce the risk of complications and mean youre more likely to have a successful pregnancy and a healthy baby.
And while all the scans and appointments take time and effort, it also means that your doctor and diabetes team are closely monitoring the health of you and your baby.
If I Have Diabetes What Should I Do To Prepare For Pregnancy
If you have type 1 or type 2 diabetes and are considering becoming pregnant, we recommend you make an appointment with your primary care physician, a maternal-fetal medicine specialist and your endocrinologist to put the steps in place to ensure a healthy pregnancy. These steps include bringing your blood sugar control into a good range for pregnancy, making sure your medication regimen is safe for pregnancy, addressing any complications or co-morbidities you may have , and working on diabetes self care, exercise and diet.
If you do not have an endocrinologist, our maternal-fetal medicine specialists and endocrinologists can provide preconception counseling, regardless of where you will be receiving your obstetrical care. Once it is confirmed you are pregnant, you will be evaluated by our endocrinology team as soon as possible to ensure good control of blood sugar in the critical early weeks of pregnancy. You also will meet with maternal-fetal medicine specialists during your first trimester to discuss symptoms, evaluate any concerns you have, and ensure your pregnancy is developing healthily.
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Work With Your Health Care Team
Regular visits with members of a health care team who are experts in diabetes and pregnancy will ensure that you and your baby get the best care. Your health care team may include
- a medical doctor who specializes in diabetes care, such as an endocrinologist or a diabetologist
- an obstetrician with experience treating women with diabetes
- a diabetes educator who can help you manage your diabetes
- a nurse practitioner who provides prenatal care during your pregnancy
- a registered dietitian to help with meal planning
- specialists who diagnose and treat diabetes-related problems, such as vision problems, kidney disease, and heart disease
- a social worker or psychologist to help you cope with stress, worry, and the extra demands of pregnancy
You are the most important member of the team. Your health care team can give you expert advice, but you are the one who must manage your diabetes every day.
What Are Possible Complications Of Diabetes During Pregnancy
Most complications happen in women who already have diabetes before they get pregnant. Possible complications include:
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Need for insulin injections more often
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Very low blood glucose levels, which can be life-threatening if untreated
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Ketoacidosis from high levels of blood glucose, which may also be life-threatening if untreated
Women with gestational diabetes are more likely to develop Type 2 diabetes in later life. They are also more likely to have gestational diabetes with another pregnancy. If you have gestational diabetes you should get tested a few months after your baby is born and every 3 years after that.
Possible complications for the baby include:
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Great Expectations Pregnancy Classes
Get ready for the baby! Choose from a variety of classes that prepare moms and partners for pregnancy, birth, baby care, breastfeeding and parenting.
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Women’s Health Resource Center
Access free health resources here, from classes and webinars to support groups and medical referrals, plus pregnancy, birth and breastfeeding services.
How Can I Prepare For Pregnancy If I Have Diabetes
If you have diabetes, keeping your blood glucose as close to normal as possible before and during your pregnancy is important to stay healthy and have a healthy baby. Getting checkups before and during pregnancy, following your diabetes meal plan, being physically active as your health care team advises, and taking diabetes medicines if you need to will help you manage your diabetes. Stopping smoking and taking vitamins as your doctor advises also can help you and your baby stay healthy.
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What Food Lower Blood Sugar Levels
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Avoiding Highly Starchy Foods
Starchy foods are high in carbohydrates and can have a significant effect on blood sugar, so it is important to eat them only in small portions. It is best to avoid or limit very starchy foods, including:
- white potatoes
- white rice
- white pasta
Although whole grains, such as whole wheat pasta and brown rice, are more nutritious, they are still high in carbohydrates. As a result, these foods may also be best in moderation.
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What Are The Complications
Gestational diabetes can cause concerns for both you and baby, but dont let it make you anxious. Here are some complications you may encounter that can be avoided by managing your health with your doctor.
Extra glucose in your body can make your baby gain weight. A bigger baby puts you at risk for having a more difficult delivery because:
Gestational diabetes also increases your risk of high blood pressure during pregnancy.
In most cases, gestational diabetes disappears after your baby is born. However, for some people, high blood sugar may persist after pregnancy. This is called type 2 diabetes.
Having gestational diabetes does put you at an increased risk of developing diabetes later on in life, too. Both you and your baby will be checked for diabetes after birth.
To make sure you decrease your risk for complications, talk with your doctor about continued care before and after baby is born.
Healthy Diet For Diabetic Pregnancy
Eating a healthy and well-planned diet should be your mantra during pregnancy. Try eating small, frequent meals throughout the day. Choose your food wisely as it must contain the correct balance of fiber, vitamins, minerals, proteins, carbohydrates, and fats. A few food articles that can be really beneficial in your condition are bitter gourd, cucumber, radish, fenugreek leaves, and broccoli.
For you, its better to avoid greasily, fried, and sugary food like cookies, ice creams, chocolates, soda, and cakes. Also, drink plenty of water approximately 9-10 glasses during the day. To keep a tab on your glucose level, its very important not to skip meals, especially your breakfast.
All the diet regimes can be a little difficult to follow, but dont think of it as a restrictive diet, be positive and think of it as a healthier way for your eating habits. Find out the Indian diet plan for pregnancy with diabetes here.
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Impact Of Adoption Of Iadpsg Criteria
Since the publication of the IADPSG consensus thresholds, there have been numerous retrospective studies that have examined the impact of adoption of these criteria. It is difficult to apply the results of these studies to clinical practice due to their retrospective nature and the wide variation in the comparison groups used. In all of these studies, adoption of IADPSG criteria has led to an increase in the number of cases diagnosed while the impact on perinatal outcomes is inconsistent . Studies comparing pregnancy outcomes before and after changing from a variety of different GDM diagnostic criteria to the IADPSG criteria show differing results. LGA was lower in 1 study and caesarean delivery was lower in several studies after adoption of the IADPSG criteria. However, others did not find reductions in LGA , and 1 study found an increase in primary caesarean section rate .
Given this lack of evidence, it is possible that the decision regarding the recommended screening method will be determined by the economic implications on health-care resources. Decision analysis modelling studies done in other countries have yielded a variety of results and many are of questionable applicability in the Canadian setting because of differing cost and screening and diagnostic strategies.
Managing Diabetes During Pregnancy
Imagine wanting to get pregnancy and bring discouraged from doing so. About 25 years ago, this was the case for many women with diabetes. Fortunately, with recent advances in diabetes management and careful planning, the chances of having a successful pregnancy are excellent!
Preconception Planning
If you have diabetes and are thinking about becoming pregnant, it is recommended that you start preparing about 6 months prior to conception. The most important thing to do before conception is to have your diabetes in good control and to learn how to continue managing your diabetes during pregnancy.
Once youve decided you want to become pregnant, you should make an appointment with your endocrinologist to review your health status and pregnancy plans. If you dont have an endocrinologist, your primary care provider can refer you to one.
In addition to an endocrinologist, there are other who can help you during your pregnancy: an obstetrician, of course but other members of your healthcare team my include a registered nurse and/or dietitian who focus on the management of diabetes and an ophthalmologist who will be sure your eyes stay healthy. While you will be the one in charge of your pregnancy, it is still necessary to have a medical team as well as loved ones to support you during this time.
The Joslin-Beth Israel Deaconess Pregnancy Program recommends the following goals and medical assessments before pregnancy:
If You Are Already Pregnant
Glucose Management in Pregnancy
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Glycemic Control In Labour And Delivery
Planning insulin management during labour and delivery is an important part of care and must be adaptable given the unpredictable combination of work of labour, dietary restrictions and need for an operative delivery. The goal is to avoid maternal hypoglycemia while preventing significant hyperglycemia which, in turn, may increase the risk of neonatal hypoglycemia . Options for peripartum BG control include watchful waiting until BG rises above a specified threshold , presumptive initiation of intravenous insulin infusions or continuing with CSII therapy. In a retrospective study of 161 consecutive women with type 1 diabetes, women who chose to continue on CSII during labour had better glycemic control than women using CSII during pregnancy but who chose to convert to intravenous insulin infusion during labour. There was no increase in maternal hypoglycemia, suggesting that the continuation of CSII during labour and delivery appears safe and efficacious . Similarly, another retrospective study found that women using CSII had excellent glycemic control without hypoglycemia . Observational studies comparing the use of CGM to SMBG during labour and delivery identified improved glycemic control with CGM however, neonatal hypoglycemia was comparable between groups . Each centre should establish protocols which include BG targets, monitoring frequency, insulin regimen and intravenous glucose, based on nursing, medical and anaesthesia expertise available, and patient choice .
When And How To Give Birth
During your antenatal appointments, your healthcare team will talk to you about the best time and way to deliver your baby.
You can still have a natural birth, but its more common to have your labour induced or have a caesarean . This is because of the risks involved, such as your baby becoming too large. Your team will talk to you about this and why they think its the best thing to do for you and your baby.
If you havent had any health complications during your pregnancy, your doctor will recommend youre induced or have a caesareanbetween 37 weeks and up to a day before week 39. If youve had some complications, you may be offered an even earlier delivery.
Your healthcare team will explain all the options to you and the risks involved. If you dont understand anything or are worried about something, ask them questions and talk it all through before deciding anything. You may want someone with you, like a partner, friend or family member, so they can ask questions too.
We have more information to help you find out what to expect after delivery and how to take care of yourself and your baby.
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S To Controlling Blood Sugar
Most women who have gestational diabetes will give birth to perfectly healthy babies. But, in order to do so, you may need to make changes to your lifestyle to promote a healthy pregnancy and avoid any risks to your baby .
The management of gestational diabetes involves making healthy choices. This involves five key steps:
- Eating a healthy diet
- Knowing your blood sugar level and keeping it under control
- Taking insulin, if needed
What Do I Need To Know About Blood Glucose Testing Before And During Pregnancy
How often you check your blood glucose levels may change during pregnancy. You may need to check them more often than you do now. If you didnt need to check your blood glucose before pregnancy, you will probably need to start. Ask your health care team how often and at what times you should check your blood glucose levels. Your blood glucose targets will change during pregnancy. Your health care team also may want you to check your ketone levels if your blood glucose is too high.
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