All your pregnancy questions answered
Diabetes and pregnancy
Diabetes is a condition where
your body is unable to maintain the blood sugar within the upper limits of
normal. This may be either because your body is unable to produce the required
quantity of insulin, or because even though your body may be producing adequate
insulin your body may have developed a degree of insulin resistance.
Diabetes involve pregnancy in 3
You may be a known diabetic
who is planning a pregnancy
You have diabetes and not know
it and it may be picked up after you become pregnant
You may develop diabetes in
the later part of pregnancy and this is known as gestational diabetes or
If you are a known
diabetic what should you do before pregnancy?
Despite advances, babies born to women with
diabetes, especially women with poor diabetes control, are still at greater risk
for birth defects. High blood glucose levels and ketones (substances that in
large amounts are poisonous to the body) pass through the placenta to the baby.
These increase the chance of birth defects.
For this reason, good blood glucose control before you get pregnant is very
important. Most women do not know they are pregnant until the baby has been
growing for two to four weeks. During the first six weeks of pregnancy, the
baby's organs are forming. Your blood glucose levels during these early weeks
affect the baby's growing organs. High blood glucose levels can lead to birth
Because these early weeks are so important to your baby, you need to plan your
pregnancy. If your blood glucose levels are not in good control, work to bring
your diabetes under control before getting pregnant. It is a good idea to be in
good blood glucose control three to six months before you plan to get pregnant.
You'll want to keep excellent blood glucose control during pregnancy, and after
must meet and consult with both your diabetologist as well as your
gynaecologist about 3-4 months before you get pregnant. This is for many
To check your levels of
control with both fasting as well as post prandial [after meal] sugars
To check your level of control
over the last 4 months with a test called 'glycosylated Hb'
If you are on oral medication
you will need to be switched to insulin before you get pregnant as oral
medication can cause harm to your baby
Counseling regarding the
possible risks of your pregnancy
To chart out the plan of
You would also need to consult
a dietician for your dietary advise.
How do high blood glucose levels cause problems?
When extra sugar is in your blood, the baby is "fed" extra sugar, too. All this
excess sugar can make the baby too big and fat. Delivery of big babies is harder
on mom and baby.
Because your baby is getting extra sugar, your baby's pancreas makes extra
insulin. After birth, it's hard for the baby to stop putting out extra insulin.
The baby must be watched, and treated if the blood glucose level drops too low.
For some reason, jaundice happens more often in babies of women with diabetes.
Jaundice is a build-up of old red blood cells that the body can't process fast
enough. This problem goes away rapidly with treatment.
Gestational diabetes is a type
of diabetes that starts during pregnancy. If you have diabetes, your body
isn't able to use the sugar (glucose) in your blood as well as it should, so
the level of sugar in your blood becomes higher than normal.
Gestational diabetes affects
about 3% of all pregnant women. It usually begins in the 20th-24th week of
pregnancy. Most often, gestational diabetes goes away after the baby is born.
Diabetes could cause a number of problems for
- Macrosomia-large babies leading to difficult
- Low blood sugars in the baby after delivery
- Polycythemia-excess Hb in the baby
- Congenital abnormalities in the baby
- Increased levels of jaundice after delivery
- Increased risk of sudden fetal loss later in
- Hydramnios-excessive liquid in the uterus