Diabetes and pregnancy: What you need to know

Megan Schellinger, DO

Maternal and Fetal Medicine

Women with diabetes need special care before, during and after pregnancy. If you are diabetic and pregnant or are considering getting pregnant, Megan M. Schellinger, DO, said there are steps you can take to reduce the risks for you and your baby.

What to do first

If you have type 1 or type 2 diabetes, the first step to a healthy pregnancy is working with your doctor to get your blood sugar levels within your target range before you become pregnant. “The critical stages of development for a baby begin within the first eight weeks, when a woman may not know she is pregnant,” said Dr. Schellinger. Achieving blood sugar targets is important throughout pregnancy. High blood sugar increases the risks of complications for both mother and baby.

Dr. Schellinger said even though women with diabetes are at higher risk for complications, you can have a successful pregnancy and healthy baby with diabetes care and close monitoring. “It’s important for women with diabetes to have a team of healthcare professionals guiding her through her pregnancy. Your care team should include your OBGYN, a maternal-fetal medicine specialist, a diabetes educator and an endocrinologist, when appropriate,” said Dr. Schellinger.

How to lower your risk of complications

You can help control your glucose level with a combination of a healthy diet, exercise and taking medications as directed by your doctor. You may need to see your provider more often than usual during your pregnancy to check your glucose level and for any additional monitoring.

“Eating a well-balanced, healthy diet is a critical part of any pregnancy. Your baby depends on the food you eat for growth and nourishment. In women with diabetes, diet is even more important. Not eating properly can cause your glucose level to go too high or too low,” said Dr. Schellinger.

Exercise helps keep your glucose level in the normal range and has many other benefits, including controlling your weight, boosting your energy, aiding sleep, reducing backaches, constipation and bloating.

What to expect when it’s time to deliver

“Don’t be surprised if your doctor suggests that labor be induced earlier than your due date, especially if problems with the pregnancy arise,” said Dr. Schellinger. While you are in labor, your glucose level will be monitored closely – typically every hour. If needed, you may receive insulin through an intravenous (IV) line. If you use an insulin pump, your provider will review glycemic control in labor with you and formulate a plan.

After your baby arrives

Breastfeeding is highly recommended for women with diabetes. Breastfeeding gives the baby the best nutrition to stay healthy, and it is good for mom, too. “It can also help new mothers shed the extra weight they may have gained during pregnancy and causes the uterus to return to its pre-pregnancy size more quickly,” said Dr. Schellinger.