Pregnant with diabetes? How to keep you and your baby safe

October 19, 2010 By Manmeet Kaur, M.D.

Having a baby brings feelings of joy and excitement—but complications can occur for both mother and child if diabetes is present or develops.

Some women may develop gestational diabetes, when excess sugars from digested foods build up in the bloodstream instead of being used by the body for energy. This condition occurs in the late stages of pregnancy, and although it usually disappears after delivery, women need to care for themselves and their unborn babies. Untreated, gestational diabetes may cause delivery complications and lead to sick, overweight newborns.

Detection is key. Some women have no symptoms and learn they have gestational diabetes through a routine screening for blood-sugar levels in the urine. Expectant mothers should be tested for diabetes during the 24th to 28th week of pregnancy.

Gestational diabetes risk increases in women who are overweight, over age 25 or have a family history of diabetes. Certain ethnic groups are also at higher risk.

Gestational diabetes cannot be prevented but can be controlled. Pregnant women must restrict their sweets and carbohydrates intake, exercise and visit their doctor regularly.

For women who already have diabetes, high blood sugar may result in high blood pressure or worsening of existing complications, such as heart or kidney disease, or the eye disease retinopathy. For the baby, uncontrolled blood sugar increases the risk of birth defects, miscarriage, preterm delivery, stillbirth, excessive growth in the womb and low blood sugar at birth. The good news: If your diabetes is under control, birth defects risk is about the same as a woman without diabetes.

What to do: If you suspect you're pregnant, see your healthcare provider right away and follow these healthy pregnancy tips:

• Check your blood sugar often. Your provider may tell you to check levels upon waking, before and after meals and during the night.
• Take your medication. Diabetes pills usually aren't recommended during pregnancy, so you may have to switch to insulin. Discuss alternatives with your healthcare provider.
• Eat healthfully. Your provider can recommend diet changes to control your blood sugar. Eating smaller meals with snacks in-between can be helpful.
• Exercise. But first ask your provider about the best activities, since exercise can cause blood-sugar drops.
• Get checkups. Prenatal exams allow your provider to monitor your baby's growth and ensure you're doing well.

Gestational diabetes does not mean you will be a diabetic after the birth of your baby but does increase your risk for future development of diabetes, so a follow-up visit with your physician after the birth of the baby is important.

Manmeet Kaur, M.D., is an endocrinologist at the Joslin Diabetes Center Affiliate at The Hospital of Central Connecticut. For more information about diabetes care at the hospital, call 1.888.4 JOSLIN (888.456.7546).