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Patient education: Care during pregnancy for people with type 1 or type 2 diabetes (The Basics)

Patient education: Care during pregnancy for people with type 1 or type 2 diabetes (The Basics)

Can people with type 1 or type 2 diabetes have a healthy pregnancy? — Most people with type 1 or type 2 diabetes can have a healthy pregnancy. But if you have diabetes and want to get pregnant, it's important to make sure your blood sugar levels are under control. This will lower your risk of having problems during pregnancy.

Is there anything I should do before trying to get pregnant? — Yes. If you are thinking about getting pregnant and have type 1 or type 2 diabetes, talk with your doctor or nurse before you start trying. He or she can:

Help you get your blood sugar levels under control

Make changes to your medicines, if they need to be changed – This is especially important since some medicines used in people with diabetes might not be safe to take during pregnancy.

Treat any medical problems you have – Some people with diabetes also have other problems, such as eye problems, obesity, high blood pressure, or kidney disease. Your doctor or nurse can talk to you about how to treat these problems and how they might affect your pregnancy.

What problems can diabetes cause during pregnancy? — Many of the problems that can happen are related to having high blood sugar levels. These include problems that can happen during pregnancy and after the baby is born:

Early on, high blood sugar levels can increase the chance of miscarriage. A miscarriage is when a pregnancy ends on its own before a person has been pregnant for 20 weeks.

High blood sugar levels early on can also increase the chance that a baby will be born with a problem, such as a spine or heart problem.

Later on, high blood sugar levels can increase the chance that a baby gets too big (heavier than 9 pounds). That is a problem, because a big baby can get hurt if it cannot easily fit through the birth canal. A big baby can also damage its mother's body during a vaginal delivery. Sometimes, a c-section is needed (surgery to get the baby out).

High blood sugar levels at the end of pregnancy can sometimes cause the baby to have problems right after birth. This can include blood sugar levels that are too low, or other issues.

Other problems people with diabetes can have during pregnancy include:

A higher risk of preterm birth –This is when the baby is born before 37 weeks of pregnancy.

A higher risk of problems called "preeclampsia" and "gestational hypertension" – People with these problems have high blood pressure during pregnancy. They might also have too much protein in their urine, or problems with organs like the liver, kidneys, brain, eyes, or placenta. (The placenta is the organ that brings the baby nutrients and oxygen and carries away waste.) Plus, the baby might not grow well and be small.

What doctors will take care of me during pregnancy? — Different doctors will take care of you during pregnancy. One doctor will take care of your pregnancy. This doctor might also be able to take care of your diabetes. If not, you will see your diabetes doctor or nurse during pregnancy. He or she will:

Tell you what your blood sugar levels should be and how often to check them – Many people need to check their blood sugar levels every day before and after meals.

Help you make changes to your diet and medicines so that your blood sugar levels stay under control

Why might my diabetes medicines need to be changed? — Your diabetes medicines might need to be changed because:

People who take insulin might need more insulin during pregnancy.

Some diabetes pills might not be safe to take during pregnancy. People who take these pills need to start using insulin or take a different pill during pregnancy. Your doctor will tell you which medicine is right for you.

People who don’t already take medicine for their diabetes might need to start taking a diabetes medicine during pregnancy.

How else might pregnancy affect me? — Sometimes, pregnancy worsens the eye and kidney problems that people with diabetes can get. Pregnancy can also make high blood pressure worse. Your doctor will check you for these problems by:

Doing blood and urine tests to check your kidneys

Doing eye exams

Checking your blood pressure at each visit

Can I have a normal vaginal delivery? — Chances are good that you will have a normal vaginal delivery. But people with diabetes are more likely to have a c-section than people without diabetes.

Will my baby be healthy? — If your blood sugar levels have been under control, chances are good that your baby will be healthy. But your baby's doctor will keep a close eye on your baby. That's because babies whose mothers have diabetes can have problems, including low blood sugar or breathing problems. Most of these problems go away on their own within 1 to 2 days.

Will my baby have diabetes? — Diabetes is very rare in babies. Children whose mothers have diabetes do have a higher chance of getting diabetes later in life, compared with children of mothers without diabetes. But most children whose mothers have diabetes will not get it.

More on this topic

Patient education: Type 1 diabetes (The Basics)
Patient education: Type 2 diabetes (The Basics)
Patient education: Using insulin (The Basics)
Patient education: C-section (cesarean birth) (The Basics)
Patient education: Preeclampsia (The Basics)
Patient education: Preterm labor (The Basics)

Patient education: Care during pregnancy for patients with type 1 or 2 diabetes (Beyond the Basics)
Patient education: Type 1 diabetes: Insulin treatment (Beyond the Basics)
Patient education: Blood glucose monitoring in diabetes (Beyond the Basics)
Patient education: C-section (cesarean delivery) (Beyond the Basics)

This topic retrieved from UpToDate on: Jan 01, 2023.
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