Consult with the maternal-fetal medicine team.
Diabetes during pregnancy carries risks for you and your baby, but careful management with the help of your obstetrician, maternal-fetal medicine specialist and, when necessary, your endocrinologist, can help ensure a healthy pregnancy and newborn.
Managing diabetes during pregnancy — whether you had the condition before you conceived or developed it while pregnant — can help you and your baby be healthy during and after delivery.
If you already have Type 1 or Type 2 diabetes, discuss it with your medical provider before getting pregnant. People with diabetes can have healthy pregnancies. If left untreated, however, the condition can have complications for you and your baby.
Norton Women’s Care provides a multidisciplinary approach to treating diabetes during pregnancy. We can help you if you are planning to get pregnant, are pregnant now with preexisting diabetes, developed gestational diabetes or have had gestational diabetes previously.
We provide a comprehensive evaluation and treatment plan for each patient. Pregnant patients are seen by a maternal-fetal medicine specialist for a consultation and, if needed, an ultrasound. They also meet with a certified diabetes educator and nutritionist who can help with nutrition, meal planning and more.
Gestational diabetes is different from the more common Type 1 or Type 2 diabetes. The key differences are that with Type 1 diabetes, your body doesn’t produce insulin, the hormone that helps blood sugar get into your cells to provide energy; with Type 2 diabetes, your body produces insulin, but doesn’t use it well to provide energy.
With gestational diabetes, your body produces high amounts of insulin, but it doesn’t effectively lower your blood sugar levels. The changes your body undergoes during pregnancy, including natural weight gain, can affect how well your body uses insulin. Gestational diabetes has been increasing in recent years, and as many as 10% of pregnancies in the United States are affected, according to the Centers for Disease Control and Prevention.
The extra blood sugar increases fetal blood sugar, triggering your baby’s little pancreas to create more insulin. Extra blood sugar is stored as fat, increasing your risk of having a large baby (9 pounds or more), which can make delivery more difficult.
Gestational diabetes can develop after your 20th week of pregnancy. Obesity, advanced maternal age (35 years or older), hypertension, a family history of diabetes and having a previous gestational diabetes diagnosis are all risk factors. Ethnicity can be a factor, with women of African, Asian, Hispanic, Native American and Pacific Islander descent more often affected.
There are no symptoms of gestational diabetes. Healthy eating, exercising and taking medication, if necessary, can help control gestational diabetes and prevent complications when you deliver.
Your blood sugar generally returns to normal after your delivery, but about half those with gestational diabetes will go on to develop Type 2 diabetes. You’ll need more frequent glucose tests to stay on top of it.
Your obstetrician may refer you to a gestational diabetes class that covers topics such as nutrition, blood sugar management, meal planning and additional ways to help you manage your blood sugar levels. This class requires a referral from your obstetrician. Call(502) 629-2604 for more information.
If you are already living with diabetes when you get pregnant or plan to get pregnant, you will likely need specialized care with a maternal-fetal medicine specialist. Left untreated, diabetes at the time of conception risks complications for you and your baby.
Pre-gestational diabetes occurs in about 1% to 2% of pregnancies in the United States, but cases have increased as Type 2 diabetes diagnoses have increased broadly.
Insulin is often part of pre-gestational diabetes treatment, as it doesn’t cross the placenta to the fetus. It has been shown to be safe and very effective at lowering glucose levels.
Managing pre-gestational diabetes starts before conception by working on a healthy weight and controlling your blood sugar. You also may be tested for obstructive sleep apnea, which has been linked to gestational hypertension (high blood pressure), preeclampsia and preterm birth. You may need to work with a dietician to reduce your weight before conception. Prenatal vitamins, including folic acid, are especially important for patients with pre-gestational diabetes.
While you are pregnant, you’ll need to monitor your glucose more closely — at least seven times per day. Your insulin sensitivity will be especially high early in your pregnancy, and you’ll risk hypoglycemia.
Fetal echocardiogram may be part of your pregnancy care. This special ultrasound will show images of your developing baby’s heart.
After delivery of the placenta, your need for insulin may drop dramatically, possibly to lower than pre-pregnancy levels. Breastfeeding has advantages of weight loss for you and bonding with your baby. Because you’ll express carbohydrates through breast milk, hypoglycemia is a risk and may require lower insulin doses.
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