Pregnant and diabetic? What you need to know..

Posted on 6 November 2018

Two situations can occur: a woman with pre-existing diabetes wants to have a baby or, diabetes presents itself during the pregnancy of an otherwise healthy mother (this is referred to as gestational diabetes). Dr Andre Diedericks, an Ob-Gyn at Mediclinic Bloemfontein, explains these two situations.

Getting ready for baby when you’re diabetic

When you’re diabetic, getting ready to have a baby looks a lot different than when you’re not. Dr Diedericks recommends consulting with your Ob-Gyn when you’re planning to conceive, as well as having meticulous control of your diabetes for at least three months before falling pregnant, with normalised HBA1C test results and folic acid supplementation.

So why is all this so important if you’re diabetic and want to start a family? According to Diabetes South Africa, it’s vital to have normal glucose control during the first seven weeks of your pregnancy as this is the time your baby’s organs are formed. Abnormal glucose control during this period increases the risk of birth defects and miscarriages.

Dr Diedericks explains that multidisciplinary care with your gynaecologist and endocrinologist is key – and recommends level 3 scanning (an advanced anatomical detailed ultrasound) for congenital abnormalities during your pregnancy.

A happy healthy pregnancy with diabetes

Developing diabetes when pregnant

Sometimes, an otherwise healthy mother develops gestational diabetes, usually during her second trimester.

Due to hormonal changes, the body can become insulin resistant much like type 2 diabetes. An expecting mother might need to use insulin during the last few weeks if her insulin resistance worsens.

Risk factors for developing gestational diabetes

• Being older than 35
• Having a close family member with type 2 diabetes
• Having had gestational diabetes in a previous pregnancy
• Being overweight with a BMI of over 30
• Having PCOS (Polycystic Ovarian Syndrome).
• Having complications in a previous pregnancy with a baby larger than 4,5kg, a stillborn baby or a baby with malformations.

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What are the risks?

Blood glucose control is extremely important during pregnancy. In order to keep your blood glucose under control, you have to eat properly and maintain a healthy weight with daily exercise.

Complications for a mother with abnormal glucose control include:

• Worsening of diabetic eye problems
• Worsening of diabetic kidney problems
• Increase in infections in the bladder and vaginal area, which can cause early labour
• Pre-eclampsia
• Difficult delivery or caesarean section

Complications for the baby:

• Premature delivery
• Birth defects
• A larger weight than average
• Possible damage to the nerves of the arms if the baby is big and delivered vaginally
• Low blood glucose at birth
• Prolonged jaundice
• Difficulty breathing
• Twitching of the hands and feet due to low calcium and magnesium

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