Pregnancy can be exciting, but also scary at the same time, especially if you’re a woman with diabetes or you develop gestational diabetes throughout your pregnancy. Even though you may be at a greater risk of developing complications during pregnancy, it is entirely possible with good blood sugar control and careful monitoring to have a healthy baby and a successful pregnancy. Endocrinologist Dr Bobby Huda talks about how this can be achieved.
A woman with pre-existing diabetes, whether that be type 1 or type 2 diabetes may experience problems in the earlier part of pregnancy and around the time of conception. A different type of diabetes, that we call “ gestational diabetes ” is a form of diabetes that only develops once the woman is pregnant. This type of diabetes tends to affect the middle and latter parts of pregnancy.
What are the symptoms of gestational diabetes?
- Extreme fatigue
- Chronic thirst
- Regularly needing to pass urine, sometimes very clear urine in large amounts
- Blurred vision
- Weight loss outside of pregnancy
However, gestational diabetes is normally quite mild and most women won’t experience any symptoms at all. For this reason, it can be difficult to detect, but screening tests are available in the UK and internationally to test for its presence.
The test involves a blood test before and after consuming a glucose drink to compare blood glucose levels before and after. If the level of glucose in the blood is abnormally high after the drink, this helps to convey that there is glucose intolerance and the presence of gestational diabetes.
What health risks may I face?
The risks faced will be different for women who already have diabetes and those who have gestational diabetes. Risks are a bit higher for women who already have diabetes, this is because at the beginning of pregnancy, in the first 12 weeks, the baby’s major organs like the heart and brain are being developed. If blood sugars are high at this time, it can cause damage to these vital organs.
High blood sugars can also mean that the baby receives too much glucose and becomes quite big, making labour difficult and leading to an increased chance of needing a caesarean section. There is also a slight chance of any existing kidney or eye conditions worsening during pregnancy.
Women with gestational diabetes will only experience high blood sugars later in the pregnancy after all the major organs have been developed, which puts the baby at less of a risk of complications. However, if blood sugar levels are not balanced early on in the pregnancy, the same complications can ensue.
There is also an increased chance of gestational hypertension, which is raised blood pressure, which may need treatment. A condition called preeclampsia, which is rare, is another possible complication. This is where blood pressure becomes so high that it affects blood vessels and organs and can be quite dangerous.
How can I ensure a successful pregnancy?
A successful pregnancy is really about good blood sugar control and stopping any harmful medications that might not be safe during pregnancy. It’s ideal to start planning pregnancy three months in advance, so that blood sugars are under control when pregnancy happens. It’s also important to start folic acid at a high dose.
During pregnancy, the growth of the baby will be monitored very closely, along with blood sugar levels, either using a meter or a glucose sensor. A big part of control involves following a healthy, balanced diet and depending on the type of diabetes, taking a tablet called metformin or insulin injections. The patient should expect to see their endocrinologist two to three times a week throughout the pregnancy, who will work closely with their obstetrician to ensure the pregnancy is successful.