A woman with diabetes can usually become a healthy and normal mother. But sometimes some complications may arise, which need awareness and proper steps to avoid. Therefore, if diabetic women want to become pregnant, it is necessary to take more careful preparations regarding these possible complications.
This article details what to do for those who have type 1 diabetes or type 2 diabetes before becoming pregnant .
Some women may develop temporary diabetes during pregnancy, even if they have not previously had diabetes. This causes the blood sugar level to rise for the first time. However, it usually returns to normal levels after delivery. This type of diabetes is called Gestational Diabetes Mellitus. Read the article Gestational Diabetes Symptoms and Dos to know more about it .
What are the possible complications of a diabetic pregnancy?
If a pregnant woman has type 1 or type 2 diabetes, both the mother and the unborn child are at increased risk of some complications during pregnancy. Below is a discussion of the pregnancy and delivery risks of diabetics and the possible effects on the unborn child.
Risks of Diabetic Pregnant Mothers
Diabetics are at higher risk of certain health complications. Pregnancy can increase these risks. Or if you already have these health problems, they can get worse. These complications include—
- Eye complications (diabetic retinopathy)
can range from blurred vision to blindness due to uncontrolled diabetes. - Kidney problems (diabetic nephropathy)
You can read the article Diabetes Health Complications and Dos to know more about the problems
In addition, in some patients with type 1 diabetes, the accumulation of harmful chemicals called ketones in the blood can lead to a complex problem called diabetic ketoacidosis . This problem occurs when the blood sugar level increases excessively due to lack of insulin and requires urgent treatment.
Pregnancy and delivery risks in diabetic patients
If you have type 1 or type 2 diabetes —
- Chances of miscarriage increase
- The baby may be larger than normal in size. As a result, various complications during childbirth are likely to occur. In many cases, the process of labor must be induced artificially with the help of drugs and other methods, or the baby needs to be delivered by caesarean section.
Risks to the unborn child of a diabetic patient
If diabetes is not under control, there is a risk of some complications in the unborn child of a diabetic patient. For example –
- There is a slightly increased chance of being born with various birth defects. Eg: heart and nervous system defects.
- A number of other health problems, including heart problems or breathing problems, may require hospitalization after birth.
- A stillborn child may be born or die shortly after birth.
- Obesity or diabetes may occur later in life .
These risks can be reduced if diabetes is properly controlled before and during pregnancy.
How to reduce the health risks of pregnant and unborn children?
The most effective way to reduce pregnancy risk due to diabetes is to control diabetes before conception. That is why proper planning and preparation should be done before getting pregnant.
So if you decide to get pregnant, you should consult your doctor first. If necessary, he can refer to a specialist doctor.
1. Preparation for pregnancy
Control of blood sugar levels
- Doctors may recommend an HbA1C test to measure blood sugar levels. This test will give an idea of how blood sugar control has been in the last 2-3 months.
- A pre-conception HbA1C level of less than 6.5% is optimal. Try to keep this level as close to 6.5% as possible to reduce the risk of complications for the mother and fetus.
- If the HbA1C level is 10% or higher, it is safest not to get pregnant at this time. Once the diabetes is controlled by lowering the sugar level, pregnancy can be attempted again.
- Birth control should be used until blood sugar levels are under control. Talk to your doctor about which method is best for you.
- If you have type 1 diabetes, monitor blood ketone levels for diabetic ketoacidosis. Test strips and monitors can be purchased to measure ketone levels in the blood. Talk to your doctor about this to know the details.
Measure ketone levels at home if, 1) blood sugar levels are elevated and 2) vomiting or diarrhea occurs
Folic acid intake
A diabetic patient should take 5 mg of folic acid daily from the time they start trying to conceive until the 12th week of pregnancy. As this dosage is much higher than the normal dosage, they should not be taken without a doctor's advice.
Folic acid protects your baby from various birth defects like spina bifida .
2. Things to do during pregnancy
Diabetes medication
Diabetes medications may need to be changed during pregnancy. Medications for other health problems with diabetes, such as high blood pressure, may also need to be changed.
If you have been taking tablets for diabetes for a long time, they are usually stopped after pregnancy. Insulin injections are recommended instead. A drug called metformin may also be added.
If you are already taking insulin injections to control your diabetes, you may need to take a different type of insulin instead.
Regular blood sugar measurement
Because blood sugar levels are affected by morning sickness and vomiting during pregnancy , regular blood sugar measurements at home should be done during this period. Talk to your doctor to find out more about this.
Keeping blood sugar levels under control can lead to repeated hypoglycemia. Many call it hypo for short , which means too low blood sugar. It is not harmful to your baby but you and your family need to be aware of it for the sake of health. Talk to a doctor or diabetes specialist about this.
Eye exam for gestational diabetes
If you have diabetes, you should have regular eye exams during pregnancy. This checkup is done to detect signs of diabetic retinopathy.
Pregnancy increases the risk of serious eye problems, so getting this test is very important. Diabetic retinopathy can be cured with treatment if caught early.
Regular pregnancy checkups
Regular pregnancy checkups are very important. The doctor can monitor your condition. Also, any changes that may affect your and your child's health will enable prompt action to be taken.
3. To be done during childbirth
Diabetic patients must choose a hospital during childbirth, where skilled doctors and nurses, managed by specialists, can take proper care of mother and child.
Take your blood sugar monitor and any medications you take with you when you go to the hospital for delivery. Usually, before the onset of labor or surgery, or until the doctor prohibits the use of medication, it is necessary to continue to take medication or insulin with regular sugar measurements.
A longer pregnancy can increase the risk of complications for you and your baby. So the doctor may suggest artificial induction of labor through medication or other procedures. If the baby is larger than normal, the doctor may also suggest caesarean section operation for safe delivery.
Your blood sugar will be monitored throughout the delivery process. If needed, intravenous insulin and glucose can be given to control blood sugar.
4. After childbirth
You can usually hold or breastfeed the baby soon after giving birth. It is important to breastfeed the baby as soon as possible (within 30 minutes) after birth. He should then be fed regularly every 2-3 hours until his blood sugar levels are safe and stable.
A few hours after birth, blood from the ankle may be tested to see if the newborn's blood sugar levels are normal. If the amount of sugar is not within the safe range or if the child is not eating properly, then extra care is needed.
The child may need to be temporarily fed through a tube or drip to raise blood sugar, or even intravenous glucose. If the baby is sick or needs close monitoring, he or she may be placed in a special neonatal unit (such as the neonatal ICU) for care.
After giving birth, your dose of insulin or oral medication to control diabetes will change. You may be able to go back to the dose of insulin you were taking before pregnancy or the way you took oral tablets. The doctor will talk to you and decide on the right medicine and dosage.
Blood sugar levels will be checked once before going home after delivery and again at the 6-week follow-up checkup. Along with this, advice will also be given on healthy postnatal diet and exercise.
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