For years the norm was to tell women who were diabetic not to get pregnant. The bodily changes that occur during pregnancy, as well as the potential risks to the fetus and mother led many doctors to take this overly cautious position on pregnancy. Today, pregnancy is risky for diabetics, but can be successful if careful monitoring and attention to health is followed.

 

Good blood sugar control is essential for women thinking about becoming pregnant. Sugar levels should remain in the ideal range, which is 70 to 100 mg/dL before meals, less 

than 120 mg/dL two hours after eating, and 100-140 mg/dL before the bedtime snack. Women considering pregnancy should work with a doctor to be sure glucose levels are in check. That's because many times women become pregnant without knowing it and the early weeks of embryo formation are essential. High levels of sugar early in pregnancy can lead to birth defects, say doctors.

 

All women need more rest, an increase in nutrients and periodic monitoring to grow a healthy baby. The same can be said for diabetics. Women who have diabetes may find that being pregnant causes abrupt changes in their blood-glucose levels. In fact, non-diabetics often experience changes in blood sugar as well, which is why a blood-glucose test is recommended in the midpoint of a pregnancy. Some women develop gestational diabetes when they had no previous types of diabetes.

 

In addition to the normal problems high blood sugar could present in diabetics, pregnant women can be at risk for miscarriage or problems during labor. Too much sugar may contribute to an excessive amount of amniotic fluid forming, forcing a fetus into preterm labor. What's more, infants born to diabetics tend to be larger in size, called "macrosomia," meaning "large body." This can present discomfort during pregnancy and lead to complications during delivery and may necessitate a cesarean section. With macrosomia, the fetus receives too much sugar via the placenta. The fetus' pancreas senses the high sugar levels and produces more insulin in an attempt to use up all the extra sugar. That extra sugar is converted to fat, making a large baby.

 

An infant just born may experience very low blood-sugar levels from all the insulin being produced. The baby may have to be given glucose intravenously to restore sugar levels.

 

During the entire pregnancy more insulin or oral drugs may be needed to control the diabetes, and diet will need to be more carefully monitored. An obstetrician also may require frequent check-ups to ensure both mother and baby are doing well.

 

While it is possible to deliver at term, many OBs prefer that diabetic women give birth a few weeks in advance of their due dates because of the larger size of the fetus. Also, diabetes can contribute to high blood pressure or pre eclampsia during delivery. It might lead to the baby being born early and also could cause seizures or a stroke (a blood clot or a bleeding in the brain that can lead to brain damage) in the woman during labor and delivery, according to the Centers For Disease Control and Prevention.

 

With proper diet, frequent check-ups and extreme control of blood-glucose levels, diabetic women can give birth to healthy children. TF10B036

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