Pregnancy
If you have diabetes and wish to become pregnant, then it is necessary to plan ahead. It is very important to keep your blood glucose within the normal limits 3-6 months before you become pregnant and during the pregnancy.
Your doctor may give you lower goals for your blood glucose readings and your diabetes care plan is likely to change.
Both blood glucose and blood ketones can reach the fetus. Glucose and ketones can harm the fetus and increase the risk for birth defects, especially in the first trimester. High glucose levels later in pregnancy may result in large babies causing both the baby and mother risk during birth.
Pregnancy in women with diabetes can still be a very enjoyable experience with proper planning and good prenatal care.
Women with Type 1 diabetes will need more insulin during pregnancy. Women with Type 2 diabetes will need to change from oral medication to insulin during pregnancy (we are still learning if diabetes pills are safe to take during pregnancy). Pregnancy causes a lot of highs and lows. For this reason, it is important to monitor their blood glucose as often as 8 times a day.
Following delivery, remember to care for yourself in addition to your baby. If you wish to breastfeed, then discuss this with your health care team. Since breastfeeding uses calories, you may need to have a snack before breastfeeding to avoid hypoglycemia.
Gestational Diabetes
If you are like most women, then you never heard of gestational diabetes until you were told you had it. Gestation is another word for pregnancy; gestational diabetes is a form of diabetes that occurs during pregnancy. You have a lot to look forward to with the arrival of your new baby. You should not let gestational diabetes get in the way; however, you can't forget about it either. Special care is needed during this time to keep you and your baby healthy.
Women who are obese (BMI greater than or equal to 30 View BMI chart) have a personal history of gestational diabetes, or have a strong family history of diabetes are considered high risk and should be screened for gestational diabetes at their first prenatal visit. If the first test is normal, then testing should occur again between 24 and 48 weeks.
Women who are 25 years or older, are overweight (BMI greater than 25 or equal to 25 View BMI chart), are of an ethnicity at higher risk for diabetes, have a family history of diabetes, or have a history of pre-diabetes are considered to be at an average risk for gestational diabetes and should be screened between 24 and 28 weeks of gestation.
How is gestational diabetes diagnosed?
Gestational diabetes is diagnosed using a test called an Oral Glucose Tolerance Test (OGTT). An Oral Glucose Tolerance Test involves drinking a sugary liquid containing 100 grams of glucose. Your doctor will then test how your body reacts to the drink by measuring your blood glucose levels at 1 hour, 2 hours, and 3 hours after ingestion. If two or more of the readings are greater than those listed in the chart below, then a diagnosis of gestational diabetes can be made.
Blood Glucose following Oral Glucose Tolerance Test
| Fasting |
95 mg/dL |
| 1 hour |
180 mg/dL |
| 2 hours |
155 mg/dL |
| 3 hours |
140 mg/dL |
View chart larger
How is gestational diabetes managed?
Managing gestational diabetes involves meal planning, exercise, self-monitoring, and possibly insulin. Your health care team will work with you to create a diabetes care plan that will focus on keeping your blood glucose level as close to normal as possible.
Your blood glucose levels will most likely return to normal following your delivery. Healthy eating, exercise, and weight loss may still be recommended, as having gestational diabetes places you at risk for developing Type 2 diabetes later in life.
