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November 14, 2022

Diabetes During Pregnancy

Dr. Lana du Plessis

Pregnant women with Diabetes will usually have a healthy baby. However, careful planning, monitoring and understanding how pregnancy affects diabetes and vice versa is of vital importance.

When a person has diabetes, they have high blood sugar, which can cause major problems with blood vessels and nerves, this in turn can lead to damage to the eyes, kidneys, and heart. There are 3 types of diabetes: Type 1 Diabetes, is an autoimmune disorder where the immune system damages the pancreatic cells that produce insulin. Type 2 Diabetes (not an autoimmune disease) is when the body cannot produce enough insulin or use it efficiently. Gestational diabetes, occurs during pregnancy in mothers not previously diagnosed with diabetes, when the blood glucose level goes up and other diabetic symptoms also appear. This type of diabetes occurs in 3 to 9 in 100 pregnant women. Gestation diabetes is caused by pregnancy hormones that cause the body to be resistant to the action of insulin, a hormone made by your pancreas that helps your body use the fuels supplied by food.

Some of the risk factors for Diabetes in pregnancy can be women with previous Gestational Diabetes, women with a family member with Type 2 Diabetes, women with twin or multiple births, glucose in the urine, and overweight women (linked to Type 2 Diabetes or Gestational Diabetes).  

All pregnant women are screened for Diabetes between 24 and 28 weeks of pregnancy. If the test is positive, the mother will be treated according to age, how healthy she is and the seriousness of the condition. The mother will be treated with limitations to her diet, exercise, blood glucose monitoring, insulin injections and oral hypoglycemia medication to keep the blood glucose in the normal range.

Complications for a mother with diabetes might include; preeclampsia (high blood pressure during pregnancy), more often insulin injections, very low blood glucose levels and keto-acidosis (where high levels of ketones building up in the body). In addition, women with Gestational Diabetes will often get Type 2 Diabetes later in life and also develop Gestational Diabetes in the next pregnancy.

Complication to the baby might include; preterm birth, stillbirth, birth defects, macrosomia (very large babies), which in itself may lead to birth injury due to the large size of the baby. After birth babies that are born to Diabetic mother’s might have hypoglycemia and trouble breathing.

Mother’s that have Diabetes during pregnancy are specially tested and monitored by fetal movement counting, ultrasound and doppler flow (to check the blood vessels, tissues, and organs as they function, and to look at blood flow through blood vessels), nonstress testing (measuring the heart rate response) and biophysical profile (a combination of the ultrasound, heart rate and amniotic fluid).

Therefore, careful planning before, during and after your pregnancy is of utmost importance. By listening to your GP and diabetes team, you can decrease the risk factors involved and ultimately enjoy a healthy pregnancy and give birth to a healthy baby.

References

No references were used in the creation of this article.

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