How does diabetes affect pregnancy?

Diabetes is a problem with the way your body makes or uses insulin. Insulin is made by the pancreas, which is an organ in your upper belly. Your body uses insulin to help move sugar from the blood into the cells. When your body does not have enough insulin or has trouble using insulin, sugar builds up in your blood and cannot get into your cells.

If you have diabetes, it may get harder for you to control your sugar levels during pregnancy. Pregnancy hormones can change the way insulin works. During pregnancy your pancreas needs to make more insulin than normal. You may have both high and low blood sugar levels more often. You may need to change your insulin dosage. If you were not using insulin before the pregnancy, you may need to use it while you are pregnant. You will probably go back to your previous treatment plan after your baby is born.

What are the risks?

If diabetes is not treated well before and during pregnancy, and your sugars are poorly controlled:

• You might have high blood pressure during the pregnancy, which can cause problems for both you and the baby.
• You may develop a buildup of acids in the blood. This can cause a very serious, life-threatening condition called diabetic ketoacidosis.
• You might have a miscarriage early in the pregnancy, or the baby might die in the uterus before delivery.
• You might go into labor early or the baby might need to be delivered early.
• Your baby may get too big before birth. Very large babies may need to be delivered by C section. If delivered vaginally, a big baby is slightly more likely to have an injury at the time of delivery.
• Your baby might have birth defects, such as problems with the heart, kidney, spine, or brain. Some of these problems may be life-threatening.
• After delivery your baby’s blood sugar may be too low.
• Your baby might have jaundice (yellowish skin).
• If you have eye, kidney, heart, blood vessel, or nerve problems caused by diabetes, they may get worse.

How can I have a healthy pregnancy?

High blood sugar levels can harm your baby during the first weeks of pregnancy. You may not even know you are pregnant.

If you have diabetes and are planning to get pregnant, talk with your healthcare provider before you try to get pregnant. You need to have good control of your blood sugar before you get pregnant. Until your diabetes is under good control, use a reliable method of birth control. Keep your blood sugar in the normal range for 3 months before you get pregnant.

While you are pregnant you may need extra care such as:

• More frequent checks of your blood sugar at home and by your healthcare provider
• A change in your diet, including taking folic acid to help prevent birth defects
• Changes in your medicine while you are trying to get pregnant and during pregnancy
• More frequent visits with your obstetric healthcare provider and with your diabetes care provider
• More checks of your heart, eyes, and kidneys

Follow the full course of treatment prescribed by your healthcare provider. In addition:

• Keep good control of your blood sugar. You may need to check your blood sugar 1 or more times a day.
• Make sure you and your family members know how to treat low blood sugar. Keep all of your appointments with your healthcare provider and diabetes care provider.
• Eat healthy meals that include whole grains, fresh fruits and vegetables, and calcium-rich foods, such as milk, cheese, and yogurt. Choose foods low in saturated fat. Ask your provider if there are foods you should not eat or if you should limit how much you eat.
• Drink plenty of water each day.
• Take vitamins, other supplements, and medicines as recommended by your healthcare provider. Talk to your provider before you take any medicine, including nonprescription and herbal medicines. Some medicines are not safe during pregnancy.
• Unless your healthcare provider tells you not to, try to be physically active for at least 30 minutes a day, most days of the week. You might find it easier to exercise 10 minutes at a time, 3 times a day. You may want to take a prenatal exercise class.
• Do not smoke, drink alcohol, or take illegal drugs.