Pregnancy can be a wonderful gift for many women but a source of worry for others. For people with chronic health issues, pregnancy presents an array of challenges for both mom and baby. We absolutely believe that diabetics can do anything with the right preparation, so here are some things to consider before putting a bun in the oven.
While diabetes is a very treatable condition, it can cause issues during pregnancy. As is often the case with diabetes, keeping careful control of your blood sugar is key to maintaining the health of mother and child throughout the pregnancy. Uncontrolled blood sugar can result in complications, such as premature delivery, difficult deliveries, and a slightly elevated chance of miscarriage.
Because about 1 in 5 infants of mothers with type 1 diabetes are born prematurely, it’s important to be ready for potential challenges for the baby. The chances of premature delivery rise as A1C levels increase. Complications can include birth defects, high blood sugar, high blood pressure, low blood iron, an enlarged heart, and poor lung and nervous system development.
Because of these risks, it is important to manage your diabetes carefully during pregnancy. Your healthcare provider can help you evaluate your health and the challenges you might face during your pregnancy.
Many women with Type 1 diabetes choose to use an insulin pump during pregnancy. The pump ensures that blood glucose remains in an optimal range. Those who prefer to do their own injections may use a CGM or Continuous Glucose Monitor to keep track of their blood sugar. Modern devices can pair with smartphones or even smartwatches via Bluetooth to provide real-time data and alerts when glucose levels rise too high or drop too low.
While finger-prick tests can be used, most prefer a CGM to pricking their fingers multiple times a day. The CGM, such as the Dexcom G6 or Freestyle Libre, is adhered to the back of the arm with an adhesive patch or tape. Once adhered to, many units will monitor blood sugar for up to 14 days. This ease of application is why many prefer the CGM over daily finger sticks.
If blood glucose remains consistently high throughout the pregnancy, the infant may have an unusually high birth weight, which can result in complications during delivery. Because of this, C-sections are quite common among diabetic mothers. Using insulin and other medications to control blood sugar is an important step in preventing such complications.
In addition to managing blood sugar via insulin, lifestyle can play a significant role. While some women may be able to eat a gallon of ice cream when the pregnant cravings strike, women with diabetes must be more regimented in their approach to food and cravings. Moderating food intake can allow cravings to be indulged without sacrificing a healthy diet. A small daily treat is a perfect way to feed the craving without going overboard. If your insurance permits, a dietitian can help you and your family find appropriate foods and meal plans that will support your health during pregnancy.
Regular exercise, for almost all people, is a key component to a healthy life. For women with diabetes, exercise can improve mood, moderate blood sugar, and improve some of the discomforts of pregnancy. While some believe exercise during pregnancy puts the baby at risk, this is generally not true. For nearly all women, moderate exercise is completely safe and will not harm the infant. For women with particular conditions, such as preeclampsia, anemia, or preterm labor, exercise may need to be avoided.
Talking to your doctor about exercise throughout your pregnancy can help you determine how much and what kinds of activities are appropriate to perform. Pregnant women participate in marathons, CrossFit, and all sorts of other activities, so don’t feel like a pregnancy means lying in bed for nine months. Consult your doctor and get active!
Lastly, establish a good relationship with your doctor as soon as possible. In addition to monitoring for complications and risk factors for you and the baby, doctors can give you advice or put you in contact with support groups that can help you remain as healthy and active as possible throughout your pregnancy. Asking questions during visits can help you evaluate your own behavior and lifestyle choices.
As many people with diabetes are aware, one of the best ways to get better healthcare is to stay proactive in the provider-patient relationship. Asking as many questions as possible, and searching for as many resources as you can access, can help patients find solutions for the daily consequences of their particular health conditions. As diabetes and pregnancy are both incredibly complex to begin with, pregnant women with diabetes need to be particularly communicative with their healthcare providers to receive the best care possible, free from as many complications as possible.