Diabetes and Pregnancy

If you are living with diabetes, the best time to control your blood glucose, also called blood sugar, is before you get pregnant. High blood glucose levels can be harmful to your baby during the first weeks of pregnancy—even before you realise you are pregnant.

At least 5% of pregnant women develop diabetes during pregnancy. This disorder is called gestational diabetes. Gestational diabetes is more common among obese women, women with a family history of diabetes, and certain ethnic groups. After delivery, gestational diabetes usually disappears. However, many women who have gestational diabetes develop type 2 diabetes as they become older.

When you eat, your digestive system breaks most of your food down into a type of sugar called glucose. The glucose enters your bloodstream and then, with the help of insulin (a hormone made by your pancreas), your cells use the glucose as fuel. However, if your body doesn't produce enough insulin – or your cells have a problem responding to the insulin – too much glucose remains in your blood instead of moving into the cells and getting converted to energy.

When you're pregnant, hormonal changes can make your cells less responsive to insulin. For most moms-to-be, this isn't a problem: When the body needs additional insulin, the pancreas dutifully secretes more of it. But if your pancreas can't keep up with the increased insulin demand during pregnancy, your blood glucose levels rise too high, resulting in gestational diabetes.

How will I know if I have gestational diabetes?

Gestational diabetes usually has no symptoms. That's why all pregnant women should have a glucose-screening test between 24 and 28 weeks.

However, if you're at high risk for diabetes or are showing signs of it, your caregiver will recommend this screening test at your first prenatal visit and then repeat the test again at 24 to 28 weeks if the initial result is negative.

Pregnancy and new motherhood are times of great excitement and change for any woman. If you have type 1 or type 2 diabetes and are hoping to get pregnant soon, you can learn what to do to have a healthy baby. You can also learn how to take care of yourself and your diabetes before, during, and after your pregnancy. If you have diabetes and are already pregnant, don't panic! Just make sure you are doing everything you can to take care of yourself and your diabetes during pregnancy. Pregnancy causes a number of changes in your body, so you might need to change how you manage your diabetes. Even if you've had diabetes for years, you may need to change your meal plan, physical activity routine, and medications. As you get closer to your expected delivery date, your needs might change again. Glucose in a pregnant woman's blood passes through to the baby. If your blood glucose level is too high during pregnancy, likewise your baby's glucose level before birth. After delivery, however, the baby's glucose level may drop quickly and go too low.

Whether you have type 1 or type 2 diabetes, you can manage your blood glucose levels and lower the risk of health problems. A baby's brain, heart, kidneys, and lungs form during the first 8 weeks of pregnancy. High blood glucose levels are especially harmful during this early stage. To protect your baby's health, work with your health care team to get your blood glucose under control before you get pregnant. Before you get pregnant, talk with your doctor about having a baby. Your doctor can help you make sure your blood glucose levels are on target and give you the care and information you need to prepare for pregnancy.

If you have questions or worries, discuss them with your health care team.

If you're overweight, talk with your doctor about losing extra weight before you get pregnant. 

Regular visits with members of your health care team who are experts in diabetes and pregnancy will ensure you get the best care. 

Your health care team should include:

A medical doctor who specialises in diabetes care, such as an Endocrinologist or a Diabetologist. You will need monitoring and advice on glucose control during and after your pregnancy.

An Obstetrician-Gynaecologist, or OB/GYN, who has experience treating women with diabetes. Ask for a referral if your current gynaecologist does not also deliver babies. It is recommended you see your OB/GYN regularly throughout your pregnancy.

A Registered Dietitian to help with meal planning. A healthy diet - for glucose control and nutrition - has never been more important than now. The phrase "You're eating for two" is not about quantity as much as food choices.

You are the captain of the team. Your health care team can only give you expert advice, but you'll be responsible for adhering to and keeping your diabetes under control every day.

During your pregnancy, you are to check your blood glucose levels using a blood glucose meter several times a day. Most doctors recommend testing at least four times a day. Talk with your doctor about when you should check your blood glucose levels.

The daily target blood glucose numbers recommended by the American Diabetes Association & the Diabetes Association of Nigeria:

For Women with Diabetes planning to become pregnant:

Test Periods	Target Blood Glucose Numbers(mg/dL)
Before meals & when you wake up	80 - 110
1 – 2 hours after eating	100 - 155

For Women with Diabetes who become pregnant:

Test Periods	Target Blood Glucose Numbers(mg/dL)
Before meals, at bedtime and overnight	60 - 99
1 – 2 hours after eating	100 - 129

The A1C Test

Another way to see whether you're meeting your targets is to have an A1C blood test. Results of the A1C test reflect your average blood glucose levels during the past 3 months. The American Diabetes Association now recommends that most women with diabetes should aim for an A1C target as close to normal as possible—below 7%, and ideally below 6% before getting pregnant and during pregnancy. Your doctor can help you set an A1C target that is most suitable for you.

We recommend you see your doctor often after childbirth in order to avoid developing type 2 diabetes later in life.

We would love to hear from you.

remember Healthy People…… Wealthy Nation.