Consult with the maternal-fetal medicine team.

Diabetes during pregnancy, whether gestational or preexisting (Type 1 or Type 2), can be managed effectively with the right care for a healthy pregnancy. Proper management helps minimize risks to both mother and baby, ensuring a healthier pregnancy and delivery.

At Norton Women’s Care, we offer a multidisciplinary approach to managing diabetes, whether you are planning to conceive or currently pregnant, our team has expertise to provide personalized care to ensure the healthiest outcomes for both mother and baby.

Wendy Novak Diabetes Institute Perinatal Program

The Wendy Novak Diabetes Institute Perinatal Program, the first of its kind in Louisville and Southern Indiana, provides specialized support for managing diabetes before, during, and after pregnancy. Integrated within the Norton Children’s Perinatal Center, our program brings together a team with diabetes expertise, specializing in complex pregnancies. This includes maternal-fetal medicine specialists, diabetes educators and clinical dietitians, working collaboratively to develop a personalized care plan that addresses your unique needs and ensures the best possible outcomes for both you and your baby. We also collaborate with endocrinologists and primary care providers when needed to ensure seamless care and support. Our services include prepregnancy counseling, pregnancy monitoring and postpartum care, providing a full spectrum of care designed to help you thrive throughout your pregnancy.

Wendy Novak Diabetes Institute is part of Norton Healthcare and Norton Children’s.

How We Support You and Your Baby

  • Preconception care: Personalized support for women with preexisting diabetes, those in the prediabetes range, and women with polycystic ovary syndrome (PCOS), ensuring you’re prepared for a healthy pregnancy
  • Specialized diabetes care: Expertise in management of Type 1, Type 2, or gestational diabetes during pregnancy, ensuring your needs are met with compassion and care.
  • Guidance every step of the way: Feel confident throughout your pregnancy with tailored plans that address your nutrition, blood sugar control and overall health. Our coordinated care ensures you’re supported and informed from start to finish.

Access to advanced services: Take advantage of innovative resources focused on health equity, patient education and the latest in diabetes care, all designed to support you and your baby’s health.

Gestational Diabetes

With gestational diabetes, your body produces high amounts of insulin, but that 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), high blood pressure, 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.

Gestational Diabetes Class

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.

Pregestational Diabetes

If you are already living with diabetes when you get pregnant or plan to get pregnant, you likely will need specialized care with a maternal-fetal medicine specialist. Left untreated, diabetes at the time of conception risks complications for you and your baby.

Pregestational 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 pregestational 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 pregestational 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 pregestational 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 prepregnancy 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.

Pregestational Diabetes Risks for Mother

  • High blood pressure and preeclampsia
  • Cesarean section delivery
  • Perinatal depression
  • Hemorrhage after delivery if the baby’s shoulders get stuck in the pelvis (shoulder dystocia)

Pregestational Diabetes Risks for Baby

  • Congenital anomalies of the heart, brain and spine
  • Macrosomia (birth weight greater than 8 pounds, 13 ounces), which increases the risk of injury during labor
  • Fetal growth restriction, also called small for gestational age
  • Miscarriage and stillbirth
  • Preterm labor and premature birth
  • Trauma from shoulder dystocia or other injuries, such as a broken collarbone and arm

How We’ll Care for Your Complex Pregnancy, Delivery and Newborn

  • Our caring team of over 10 highly experienced maternal-fetal medicine physicians ensures easier access to expertise for your complex pregnancy.
  • Our compassionate patient navigators who are registered nurses provide one-on-one support and guide you through your pregnancy care, including coordinating appointments.
  • Maternal-fetal medicine offices in downtown Louisville and  St. Matthews, as well as in the Kentucky cities of Bowling Green, Elizabethtown and Paducah, all provide the same level of specialized care.
  • Deliver down the hall from the Norton Children’s Hospital’s Level IV neonatal intensive care unit (NICU) — the highest level in Louisville and Southern Indiana — or the Level III NICU at Norton Women’s & Children’s Hospital.
  • Norton Children’s Perinatal Center offers expertise in care for high-risk pregnancies, including neonatal follow-up, ultrasounds, the Norton Maternal Opiate and Substance Treatment Program and the Wendy Novak Diabetes Institute Perinatal Program.
  • We bring together a team of experienced specialists from Norton Children’s to prepare for your baby’s specialized care after birth. The team will review your baby’s development and create a comprehensive plan to ensure the best possible care.
  • Depending on your condition, you may deliver at your home hospital; if necessary, the Norton Children’s Hospital  “Just for Kids” Transport Team will bring your baby to a Norton Children’s NICU in Louisville.
  • You can keep your OB/GYN for your delivery while getting the expertise of the maternal-fetal medicine team caring for your health and the health of your baby or multiples.
  • Medicaid and most commercial insurance plans are accepted.
  • Communicate with your medical provider, manage appointments and get alerts if an earlier appointment becomes available through your free Norton MyChart account.

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