Having diabetes doesn’t mean that you can’t enjoy a safe and happy pregnancy. Whether you already have diabetes (type 1 or type 2) or have just been diagnosed with gestational diabetes, there are some things you can do to ensure that you and your baby remain healthy.
If you have type 1 or type 2 diabetes, it’s important to plan your pregnancy. If you are thinking about getting pregnant, visit your healthcare team to ensure that you get your pregnancy off to a healthy start. A pre-pregnancy exam typically includes measuring your A1C level to make sure blood glucose levels are under control, as well as an assessment of complications (for example, high blood pressure, heart disease, and kidney, nerve, and eye damage).
You should also review all your medications and supplements with your doctor to make sure they are safe to continue using with pregnancy. Insulin is safe for both mother and baby during pregnancy. If you take insulin, your diabetes healthcare team will work with you very closely to manage your insulin needs during your pregnancy.
You can increase your chances of delivering a healthy baby by keeping your blood glucose under control before conception and throughout your pregnancy. Good blood sugar control is especially important during the first five to 11 weeks of pregnancy, when the baby’s organs are beginning to develop. If a mother’s blood sugar levels are high during this time, the baby’s spinal cord and heart could be affected. That’s why it’s important for you to:
- Take your diabetes medications as prescribed by your healthcare team
- Eat healthy meals and snacks, and spread them out throughout the day
- Exercise regularly
If you have type 1 diabetes, you may be at higher risk of hypoglycemia during pregnancy. That’s why it’s important to test your blood sugar often, and carry a source of fast-acting carbohydrate with you at all times (for example, Life Savers or sugar packets).
Gestational diabetes is a type of diabetes that happens during pregnancy. It occurs when a woman’s body cannot produce enough insulin to handle the effects of a growing baby. Gestational diabetes is usually diagnosed in the second or third trimester of pregnancy.
If gestational diabetes is not diagnosed or treated, it can increase the risk that your baby will weigh more than 4 kilograms (9 pounds), which may result in a difficult delivery. Gestational diabetes can also increase the risk of your baby becoming overweight and developing type 2 diabetes in the future.
Depending on how high their blood sugar levels are at diagnosis, a woman with gestational diabetes may be treated through lifestyle alone. This means:
- Eating healthily. Spreading out your food intake by eating smaller meals and snacks will help you manage your blood sugar levels and provide the best nutrition for you and your growing baby.
- Being physically active. Regular exercise can help control your blood glucose levels. As well, it can boost your energy, help you sleep better and reduce stress levels.
Your healthcare team can help you develop a nutrition plan and an exercise regimen that are appropriate for you and your baby.
Women whose gestational diabetes is not controlled within 2 weeks through lifestyle alone will be prescribed insulin. Insulin is very safe for both mother and baby during pregnancy. If it is determined that you need medication to control your gestational diabetes, your healthcare team will select a regimen that’s right for you.
After the baby is born, blood sugar levels in women with gestational diabetes usually return to normal. However, women who have had gestational diabetes in a previous pregnancy are at higher risk of getting the disease in future pregnancies; they’re also at higher risk of developing type 2 diabetes.
Blood glucose targets during pregnancy
The recommended targets during pregnancy – whether you have type 1 or type 2 diabetes, or gestational diabetes – are as follows:
- Fasting blood glucose (blood glucose before a meal): less than 5.3 mmol/L
- One hour after a meal: less than 7.8 mmol/L
- Two hours after a meal: less than 6.7 mmol/L
With a little planning – plus paying close attention to diet, exercise and medication needs – women with diabetes can enjoy a happy and healthy pregnancy!