Diabetes During Pregnancy

Diabetes is a condition that causes high levels of glucose in the blood. Glucose is a sugar that is the body's main source of fuel. Health problems can arise when the glucose levels are too high or not well controlled. Diabetes is of special concern during pregnancy.

Diabetes can occur in women who are not pregnant, or it can start during pregnancy. The form of diabetes that occurs during pregnancy is called gestational diabetes. Either type of diabetes requires special care during pregnancy.

In the past, women with diabetes were advised not to become pregnant because the health risks to both mother and baby were very high. Today, because of a better understanding of diabetes and better prenatal care, most women with diabetes can have a successful pregnancy and a healthy baby.

Causes
Diabetes occurs when there is a problem with the way the body makes or uses insulin. Insulin is a hormone that converts the glucose in food into energy. When the body doesn't make enough insulin, or when insulin is not being used properly by the body, the level of glucose in the blood becomes too high. This is called hyperglycemia (high sugar levels in the blood). The opposite is called hypoglycemia (low sugar levels in the blood).

During pregnancy, the hormones produced by the placenta can change the way insulin works. As a result, gestational diabetes may occur or diabetes that existed before pregnancy may be harder to control. Because gestational diabetes can occur even when no risk factors or symptoms are present, many doctors test all pregnant women for diabetes. Gestational diabetes goes away after the baby is born. More than half of women who have gestational diabetes will develop diabetes, although, usually many years later. It's important to tell your doctor if you have had gestational diabetes.

The risk of diabetes increases with age. Other factors are linked with the condition:

• Obesity
• High blood pressure
• One or more family members with diabetes

Testing for Diabetes
The test for diabetes is safe and simple. Samples of your blood are taken after you drink a sugar solution, and the glucose level is measured. A high level suggests that there may be a problem with glucose control. If you have a high level of glucose, you will receive a diagnostic test. This test will diagnose diabetes if you have it.

Many doctors test for diabetes only in women with risk factors. Other doctors find that diabetes is common in the women they care for, so they test all women. In some groups of people, like Native Americans, diabetes is so common that some doctors go right to the diagnostic test.

Having these risk factors does not mean you will develop diabetes. but that the chance is higher.

Effects During Pregnancy

The risk of problems during pregnancy is greatest when diabetes is not well controlled. Some of these problems include:

• An increased chance of a cesarean delivery
• Miscarriage
• Macrosomia
• Fetal Demise
• Anomolies of the fetus
• Hypoglycemia in the newborn

This is why you need good blood sugar control during pregnancy. Good control of glucose levels, before and during pregnancy, can lower the risks.

Source: Patient education material from the American College of Obstetrics and Gynecology was used as a source of information to develop the content for this topic.

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