Diabetes and Pregnancy
Pregnancy does involve special risks for women with diabetes, however. This is true even when sugar levels are carefully controlled.
The placenta produces hormones during pregnancy that increase your need for insulin. This means that diabetes requires more treatment. You must closely monitor your diabetes. You should adjust your medicine as needed. If you don't do this, you may develop a dangerous problem called diabetic ketoacidosis.
Some medicines that are taken by people with diabetes need to be stopped during pregnancy. These include ACE inhibitors for kidney protection and pills for blood sugar control. Your doctor also may advise changing some medicines while you try to become pregnant. Insulin is the safest medicine for control of blood sugar during pregnancy.
If you're diabetic, the key to a successful pregnancy is to keep your blood sugar under good control. Uncontrolled diabetes increases risks, such as:
- Birth defects — Birth defects occur more often if the mother's diabetes was not well controlled before and during pregnancy. It is important to have good blood sugar control when the baby is conceived. This can minimize the risk of birth defects.
- Macrosomia (a very big baby) — This is probably the best known effect of poorly controlled diabetes. It occurs when a baby gets too much sugar from the mother's blood. A very large baby can be more complicated to deliver.
Tight control of blood sugar can't protect you from some risks in pregnancy. If your diabetes has begun to damage your eyes or kidneys, then this damage can get worse during pregnancy.
If you have diabetic retinopathy, you should begin tight control of blood sugar before you get pregnant. If you make this change after you are pregnant, the rate of eye damage may slightly increase.
Pregnancy usually doesn't harm kidneys that have normal function. However, pregnancy can make existing kidney damage worse.
If you are thinking about having a child soon, visit your doctor. Discuss your diabetes care and medicines before you attempt to get pregnant.
If you are diagnosed with diabetes for the first time during a pregnancy, you have gestational diabetes. Women with this condition share many care issues and delivery issues with other diabetics. However, birth defects are less common in the babies of women with gestational diabetes. That's because much of the important development of the fetus occurs before sugar levels rise.