Healthy pregnancy in diabetic women

A woman with diabetes can usually become a healthy and normal mother. But sometimes some complications may arise, which need awareness and proper steps to avoid. Therefore, if diabetic women want to become pregnant, it is necessary to make more careful preparations regarding these possible complications.

Some women may develop temporary diabetes during pregnancy, even if they have not previously had diabetes. This causes the blood sugar level to rise for the first time. However, it usually returns to normal levels after delivery. This type of diabetes is called gestational diabetes mellitus.

What are the possible complications of a diabetic pregnancy?

If a pregnant woman has type 1 or type 2 diabetes, both the mother and the unborn child are at increased risk of some complications during pregnancy. Below is a discussion of the pregnancy and delivery risks of diabetics and their possible effects on the unborn child.


Diabetic pregnant mothers face various risks.

Diabetics are at higher risk of certain health complications. Pregnancy can increase these risks. Or if you already have these health problems, they can get worse. These complications include:

  • Eye complications (diabetic retinopathy)
    Uncontrolled diabetes can cause anything from blurred vision to blindness.
  • Kidney problems (diabetic nephropathy)

Furthermore, in some patients with type 1 diabetes, the blood can accumulate harmful chemicals known as ketones, leading to a complex problem known as diabetic ketoacidosis. This problem occurs when the blood sugar level increases excessively due to a lack of insulin and requires urgent treatment.


Pregnancy and delivery risks in diabetic patients

If you have type 1 or type 2 diabetes,

  • Chances of miscarriage increase.
  • The baby may be larger than normal in size. As a result, various complications during childbirth are likely to occur. Artificially inducing labor with the help of drugs and other methods or delivering the baby by caesarean section is often necessary in many cases.


Risks to the unborn child of a diabetic patient include:

If diabetes is not under control, there is a risk of some complications in the unborn child of a diabetic patient. For example,

  • There is a slightly increased chance of being born with various birth defects. e.g., heart and nervous system defects.
  • A number of other health problems, including heart problems or breathing problems, may require hospitalization after birth.
  • A stillborn child may be born or die shortly after birth.
  • Obesity or diabetes may occur later in life.

Properly controlling diabetes before and during pregnancy can reduce these risks.


How can we reduce the health risks for pregnant and unborn children?

The most effective way to reduce pregnancy risk due to diabetes is to control it before conception. Therefore, it is crucial to engage in proper planning and preparation before getting pregnant.

So if you decide to get pregnant, you should consult your doctor first. If necessary, he can refer to a specialist doctor.

1. Preparation for pregnancy

Managing blood sugar levels

  • Doctors may recommend an HbA1C test to measure blood sugar levels. This test will give an idea of how blood sugar control has been in the last 2–3 months.


A pre-conception HbA1C level of less than 6.5% is optimal. Try to keep this level as close to 6.5% as possible to reduce the risk of complications for the mother and fetus.

If the HbA1C level is 10% or higher, it is safest not to get pregnant at this time. Once the sugar level is lowered and the diabetes is controlled, pregnancy can be attempted again.

  • Continue using birth control until blood sugar levels are under control. Talk to your doctor about which method is best for you.
  • If you have type 1 diabetes, monitor your blood ketone levels for diabetic ketoacidosis. You can purchase test strips and monitors to measure ketone levels in the blood. Talk to your doctor about this to get the details.

Measure ketone levels at home if:

1) blood sugar levels are elevated; and

2) vomiting or diarrhea occurs.

Improving folic acid intake

A diabetic patient should take 5 mg of folic acid daily from the time they start trying to conceive until the 12th week of pregnancy. As this dosage is much higher than the normal dosage, it should not be taken without a doctor’s advice.

Folic acid protects your baby from various birth defects, like spina bifida.

2. Things to do during pregnancy

Diabetes medication

During pregnancy, healthcare providers may need to change diabetes medications. During pregnancy, healthcare providers may need to change medications for other health problems associated with diabetes, such as high blood pressure.

Doctors usually stop tablets for diabetes after pregnancy if you have been taking them for a long time. Instead, doctors recommend using insulin injections. Additionally, doctors may prescribe the drug metformin.

If you are already taking insulin injections to control your diabetes, you may need to take a different type of insulin instead.

Regular blood sugar measurements

During this period, pregnant women should regularly measure their blood sugar levels at home due to the impact of morning sickness and vomiting. Talk to your doctor to find out more about this.

Keeping blood sugar levels under control can lead to repeated hypoglycemia. Many call it hypo, which means too low blood sugar. It is not harmful to your baby, but you and your family need to be aware of it for the sake of health. Talk to a doctor or diabetes specialist about this.

An eye exam is necessary for the detection of gestational diabetes.

If you have diabetes, you should have regular eye exams during pregnancy. Regular eye exams during pregnancy detect signs of diabetic retinopathy.

Pregnancy increases the risk of serious eye problems, so getting this test is very important. If caught early, treatment can cure diabetic retinopathy.

Regular pregnancy checkups

Regular pregnancy checkups are very important. The doctor can monitor your condition. Any changes that may affect your and your child’s health will prompt the doctor to take immediate action.

3. Perform these tasks during childbirth.

Diabetic patients must choose a hospital during childbirth where skilled doctors and nurses, managed by specialists, can take proper care of mother and child.

Take your blood sugar monitor and any medications you take with you when you go to the hospital for delivery. Usually, before the onset of labor or surgery, or until the doctor prohibits the use of medication, it is necessary to continue to take medication or insulin with regular sugar measurements.

A longer pregnancy can increase the risk of complications for you and your baby. So the doctor may suggest artificial induction of labor through medication or other procedures. If the baby is larger than normal, the doctor may also suggest a caesarean section operation for safe delivery.

We will monitor your blood sugar throughout the delivery process. If necessary, healthcare providers can administer intravenous insulin and glucose to regulate blood sugar levels.


4. After childbirth

You can usually hold or breastfeed the baby soon after giving birth. It is important to breastfeed the baby as soon as possible (within 30 minutes) after birth. He should then be fed regularly every 2–3 hours until his blood sugar levels are safe and stable.

 A few hours after birth, healthcare providers may test blood from the ankle to determine if the newborn’s blood sugar levels are normal.  If the sugar level is not within the safe range or if the child is not eating properly, then extra care is required.

Temporary feeding through a tube or drip, or even intravenous glucose, may be necessary to raise the child’s blood sugar. If the baby becomes ill or requires close monitoring, healthcare providers may transfer them to a specialized neonatal unit, such as the neonatal ICU, for optimal care.

After giving birth, your dose of insulin or oral medication to control your diabetes will change. You may be able to go back to the dose of insulin you were taking before pregnancy or the way you took oral tablets. The doctor will talk to you and decide on the right medicine and dosage.

Healthcare providers will check your blood sugar levels once before you go home after delivery and again at the 6-week follow-up checkup. Along with this, advice will also be given on a healthy postnatal diet and exercise.

Written by Dr.Umme Fatima Fareen
Dr. Ima Islam does medical review


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