Diabetes is on the rise in America. We’re seeing an increased number of pregnant women who come to us with type 1 or type 2 diabetes. We see even more patients who have been diagnosed with diabetes in their second or third trimester. This condition, called gestational diabetes, is now estimated to affect as many as 14 percent of all pregnancies.
While diabetes has serious risks for both mom and baby, if you have it, your risks of pregnancy complications related to the disease can be decreased — if you manage it well. This article is designed to give you the information you need to stay healthy during your pregnancy and have the best outcome possible.
1. Find an experienced specialist.
Not all doctors and obstetricians can offer the kind of support you may need. Look for someone who offers both education and management so you have all the support you need.
- Determine how often you need to come in for checkups. Women with diabetes may need to see their doctor three times as often as normal.
- Discuss your current medications with your doctor to make sure they’re safe to take during pregnancy.
- If you have type 1 or type 2 diabetes, ask if you need to adjust your insulin dose over the nine months of pregnancy.
- Learn what your glucose levels should be during pregnancy.
- Determine how much weight you should gain with the pregnancy.
2. Understand what is happening to your body.
Diabetes is a condition that occurs when your body develops high levels of blood sugar (glucose). Your body needs the right amount of glucose as fuel for energy and growth. However, if your body can no longer produce enough insulin to move the glucose from your blood into your body’s cells to produce the energy you need to stay healthy, your blood sugar will stay high, possibly causing many complications for you and your baby
If you don’t manage your blood sugar levels properly during pregnancy, your body delivers an excess of glucose to the developing fetus, which can over-nourish it and cause excess growth and other long-lasting problems.
3. Learn about the complications.
Diabetes can affect your own health, your pregnancy and the physical and cognitive health of your child as he or she ages. Knowledge gives you power — and a strong incentive to take care of yourself! If you do, you can avoid complications that include:
- Preterm delivery
- High blood pressure, preeclampsia or eclampsia
- Having a larger than normal baby that requires a cesarean section (C-section) delivery.
- Your baby developing low blood sugar (hypoglycemia) after birth
- Your baby having jaundice
- Birth defects
- Long-term complications for yourself including eye, kidney, nerve and heart damage
- An increased chance that your child develops obesity
- An increased chance your child develops diabetes
- A possible decrease in your child’s intelligence
4. Create a healthy environment for your baby in utero
Every lifestyle choice you make before and during pregnancy can affect your baby. Fetal programming is the concept that everything that happens in the uterine environment can impact your baby, not just before and at birth, but also for the rest of your child’s life (see complications above). Healthy children and adults come from healthy moms.
- Monitor your blood glucose levels using a glucose meter (glucometer). Make sure your diabetes educator/manager has shown you exactly how to use it to keep your levels within the recommended range.
- Take prenatal vitamins.
- Eat often. You are what you eat. Under-nutrition and over-eating throughout pregnancy can put your child at greater risk for health problems in later life. Eat healthy foods often: including 3 small meals and 3 small snacks a day.
- Eat the right foods. Your diabetes manager will work with you to develop a food plan that is right for you, with plenty of fresh vegetables, fruits, whole grains and lean animal protein.
- Increase your intake of folic acid. The easiest way to get folic acid is through prenatal vitamins. You can also eat foods rich in it, including dark leafy greens, broccoli, asparagus, avocado, beans, lentils, sunflower seeds and citrus fruits.
- Stay away from food that could make you sick. Don’t eat raw or undercooked meat, eggs or fish (including sushi). Don’t eat unpasteurized milk or cheese. Avoid fish that contains high amounts of mercury (shark, swordfish, king mackerel).
- Check your blood pressure often. Call your doctor if it is too high.
- Exercise! New studies show that exercise may affect the genetic makeup of your baby. Be active at least 150 minutes a week (which you can do in 10 minute increments). Your doctor or diabetes manager can help you develop the best workout program for you.
- Sleep. Get 7 or 8 hours of sleep each night.
- Do not smoke or drink alcohol during pregnancy. Ever.
- Relax. Stress can complicate a pregnancy, causing preterm labor, low birth weight and possible mental health problems. If necessary, reduce your workload, rest, mediate and/or take a regular yoga class.
- Get your flu vaccine if appropriate. Your doctor may recommend other vaccines as appropriate.
5. Call your doctor if your health changes.
Don’t ignore small changes that could be a sign that your diabetes is out of control. Contact your doctor if you notice any possible signs of a problem, including:
- Increased blood pressure
- Weight loss
- Excessive weight gain
- Extreme fatigue
- Blurry vision
- Frequent urination or pain during urination
- Cuts and bruises that are slow to heal
- Tingling pain or sensation in your hands, fingers or feet
- Red, swollen or tender gums
When you have diabetes, you have to work harder than the average mom to take care of yourself throughout your pregnancy. But you don’t have to do it alone. Having an experienced diabetes health management team that includes your doctor, obstetrician and high-risk pregnancy specialist is critical for managing your diabetes. Family, friends and even a mental health worker (if needed) can give you the emotional support you need along the way.
Our diabetes counselors are available to answer your questions if you live in the Las Vegas, Nevada area. You can find other high-risk pregnancy experts through the Society for Maternal-Fetal Medicine.