Motherhood & Diabetes: The Journey to a Healthier Baby

Diabetes During Pregnancy
Diabetes is a condition in which blood sugar (glucose) levels are too high — a condition known as hyperglycemia. If left unchecked, high blood sugar can cause serious health problems over time. However, by following a healthy diet, staying active, and taking prescribed medications, diabetes can be effectively managed, and complications can often be prevented.
Types of Diabetes During Pregnancy
Two main types of diabetes can affect pregnancy:
1- Gestational Diabetes
This type of diabetes develops during pregnancy in someone who did not previously have diabetes. It usually resolves after the baby is born, but it increases the risk of developing type 2 diabetes later in life.
2-Pregestational diabetes
This refers to diabetes that exists before pregnancy. It can be either:
- Type 1 diabetes, in which the body does not produce insulin. People with this type must take insulin injections.
- Type 2 diabetes, in which the body does not use insulin properly or does not produce enough of it. This type is usually managed with medication, lifestyle changes, and sometimes insulin.
Why blood sugar control is important in pregnancy
Maintaining healthy blood sugar levels is important during pregnancy. Poorly controlled diabetes increases the risk of complications for both mother and baby. Proper management helps ensure a healthy pregnancy and reduces the risk of problems for the newborn.
How diabetes during pregnancy can affect your baby
During pregnancy, the placenta provides your baby with nutrients and water and produces hormones necessary for a healthy pregnancy. However, some of these hormones interfere with the way insulin works — a condition called insulin resistance. This usually begins around 20 to 24 weeks of pregnancy.
As the placenta grows, it produces even more of these insulin-inhibiting hormones. To keep blood sugar levels normal, the pancreas must produce extra insulin. If it can’t make enough insulin, gestational diabetes develops.
Pregnancy can also change insulin needs in women who already have diabetes.
- If you have type 1 diabetes, you may need more insulin than before.
- If you have type 2 diabetes, you might need to start using insulin or increase your dosage.
Risks to the Baby
When blood sugar is not well controlled during pregnancy, it can harm your baby. High blood sugar levels can increase the risk of complications both before and after birth, including:
- Excessive birth weight
- Premature birth
- Low blood sugar (hypoglycemia) after birth
- Breathing problems
- Increased risk of obesity and type 2 diabetes later in life
Keeping your blood sugar within the target range is one of the most important things you can do to protect your baby’s health.
Who Is at Risk for Gestational Diabetes?
Certain factors can increase your chances of developing gestational diabetes during pregnancy. These include:
- Being over the age of 25
- Being overweight or obese
- Having had gestational diabetes in a previous pregnancy
- Having a family history of diabetes
- Having previously given birth to a large baby (9 pounds or more)
- Having experienced a stillbirth
- Belonging to certain racial or ethnic groups, including African American, American Indian, Asian American, Hispanic/Latina, or Pacific Islander
If you have one or more of these risk factors, your healthcare provider may monitor you more closely during pregnancy and recommend early screening for gestational diabetes.
What Symptoms or Problems Can Your Baby Have If You Have Diabetes During Pregnancy?
When diabetes is not well controlled during pregnancy, it can affect your baby’s health both before and after birth. The risks vary depending on whether diabetes began before pregnancy (pregestational) or developed during pregnancy (gestational).
Possible Problems During Pregnancy
- Birth defects and miscarriage – Especially in women with diabetes before pregnancy. Commonly affects the heart, brain, spine, and blood vessels.
- High blood sugar levels in the baby
- Low oxygen levels
- Low iron levels in the blood
- High blood pressure
- Enlarged heart
- Poor development of the lungs and nervous system
- Stillbirth
Possible Problems After Birth
- Large body size (macrosomia) – Increases the risk of delivery complications, such as shoulder injuries.
- Low blood sugar (hypoglycemia)
- Low blood calcium levels
- Low iron levels
- High red blood cell count, which can cause thickened blood
- High bilirubin levels, which may lead to jaundice
- Premature birth
- Enlarged heart
- Breathing difficulties
Long-Term Health Risks
- Babies born to mothers with diabetes are at greater risk of developing obesity and type 2 diabetes later in life.
Proper blood sugar management during pregnancy is key to reducing these risks and supporting a healthy start for your baby. Let me know if you’d like this turned into a patient handout or infographic.
How Is Diabetes Diagnosed During Pregnancy?
Your healthcare provider will test you for diabetes at some point during your pregnancy.
If you have certain risk factors for type 2 diabetes, such as being overweight, your provider may screen you early, possibly during your first prenatal visit.
For most pregnant individuals, screening for gestational diabetes typically occurs between 24 and 28 weeks of pregnancy. This is done using an oral glucose tolerance test (OGTT), which measures how your body processes sugar after consuming a glucose drink. There are two types of OGTT:
- One-Step Test: After fasting, you’ll drink a solution containing 75 grams of glucose. Your provider will then measure your blood sugar at specific time intervals.
- Two-Step Test: You’ll first drink 50 grams of glucose without needing to fast. Your blood sugar will be checked after a set time. If the result is high, you’ll return for a second test, where you’ll drink 100 grams of glucose (after fasting), and your blood sugar will be measured at several intervals.
These tests help determine whether you have gestational diabetes or another form of diabetes that needs to be managed during pregnancy.
How Are Pregnant Women with Diabetes and Their Babies Treated?
If you have diabetes during pregnancy, your healthcare provider will closely monitor both you and your baby. You may also be referred to a specialist who focuses on managing diabetes during pregnancy.
Keeping your blood sugar levels within a healthy range is essential—it’s the most effective way to lower the risk of complications for your baby. To manage your diabetes during pregnancy, you may need to:
- Monitor your blood sugar regularly. Your provider may ask you to check your blood sugar levels at home multiple times a day.
- Take insulin as directed. Insulin needs often change during pregnancy, so your dosage may be adjusted over time.
- Manage your weight. If you are overweight or obese, your provider may recommend limiting weight gain to reduce risks.
Your baby’s care will depend on how well your blood sugar was controlled throughout pregnancy and during labor. Treatment for your newborn will also be based on their symptoms, age, overall health, and the severity of any issues that may arise.
Can complications from gestational diabetes be prevented?
Yes, managing gestational diabetes effectively can help prevent complications for both you and your baby. Following a healthy diet, checking your blood sugar levels regularly, and taking insulin when needed are important steps to keep this condition under control.
Gestational diabetes also increases your risk of developing type 2 diabetes later in life. Because of this, your healthcare provider will check you for diabetes after your baby is born, usually between 6 and 12 weeks after delivery, and continue to monitor you over time.
Your baby’s healthcare provider should also keep an eye on your baby’s blood sugar levels after birth. Regular monitoring helps with early diagnosis and treatment, which can reduce the risk of long-term health problems.
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