It’s been said any health problem already existing can become worse during pregnancy. This is particularly true regarding type 1 and type 2 diabetes, even prediabetes. Women who have never had a diagnosis of diabetes can get what is called gestational diabetes, “gestational” referring to pregnancy. Women who already have been diagnosed, often find their blood sugar levels become more difficult to control.

The fetus starts to develop right after conception… waiting until you are already pregnant may be too late to prevent some problems. Good blood sugar control can reduce the risk of any of the following:

• miscarriage
• birth defects
• stillbirths
• macrosomia (a large baby which could lead to a cesarean section)
• premature delivery
• complications to both yourself and your unborn baby, during pregnancy and afterwards

So the best idea is to keep your blood sugar levels as close to normal as possible before conception and throughout your pregnancy. Vitamin supplements… particularly folic acid, a B vitamin, have been shown to reduce the likelihood of birth defects. Usually iron and calcium supplements are also prescribed.

Many complications of diabetes, including retinopathy, can worsen during pregnancy and then return to normal after your baby’s birth. This would need to be checked following the birth, by a specialist.

Ideal Blood Sugar Levels During Pregnancy are:

Fasting… <95 mg/dL (5.3 mmol/L)

2 hrs following a meal… <120 mg/dL (6.7 mmol/L)

Treatment of gestational diabetes is with maintenance of these blood sugar levels through:

• diet
• moderate exercise
• sometimes insulin

Gestational diabetes is not treated with hypoglycemic medications, because their effects have not been studied enough. It is generally believed that hypoglycemic medications could harm the fetus or result in poor blood sugar control. If your blood sugar levels are too high, insulin will be required. Insulin does not harm the fetus or cross the placental barrier.

An oral glucose tolerance test is usually given from six to twelve weeks following delivery of your baby, to check if the diabetes, which is similar to type 2, has disappeared.

If you have had gestational diabetes, even it has disappeared after your pregnancy, the odds are it will return with your next pregnancy. And within five to ten years, providing you control your weight, your odds of developing type 2 diabetes are less than one in four.

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