The impact of Diabetes on pregnancy

Diabetes is a chronic disease that affects how the body processes blood sugar (glucose), and it affects millions worldwide. Pre-existing diabetes (Type 1 and Type 2) becomes tough to manage during pregnancy. Proper management becomes even more critical during this time, as uncontrolled blood sugar levels can lead to serious health complications for both mother and baby. Let's take a look at how pre-existing diabetes affects pregnancy.

Pre-existing diabetes, sometimes referred as 'pregestational diabetes', refers to diabetes that a woman has before becoming pregnant. This includes both Type 1 and Type 2 diabetes.

Type 1 diabetes is an autoimmune condition in which the body doesn’t produce insulin. This condition usually develops in childhood or early adulthood.

Type 2 diabetes, on the other hand, affects how the body uses sugar (glucose) for energy. It stops the body from using insulin properly, which can lead to high levels of blood sugar if not treated.

Pre-existing diabetes is different from gestational diabetes, as the women get the latter during pregnancy (it usually goes away after childbirth).

Both Type 1 and Type 2 diabetes are risk factors that increase the chances of pregnancy complications. When the blood sugar levels are consistently high, it increases the risk of certain complications such as:

• Having a large baby, which could lead to a difficult childbirth

• Miscarriage

• Birth defects, aka congenital anomalies, such as heart and neural tube defects

• Fetal macrosomia, which means a situation where the newborn weighs over 9 pounds, which increases the risk of injury at delivery.

• Increased amount of amniotic fluid in the sac, which can lead to pre-term labour and delivery.

• Increased risk of preterm birth.

• Stillbirth.

Children born to diabetic mothers may face a slightly increased risk of certain health complications. While most are born healthy, there is a higher likelihood of health concerns such as low blood sugar immediately after birth, breathing difficulties, and jaundice. In some cases, these conditions may require specialized care in the neonatal intensive care unit (NICU). Additionally, babies born to people with diabetes may have a greater chance of developing obesity later in life.

Having diabetes during pregnancy can increase the risk of several health complications. One of the most concerning conditions is preeclampsia, which is marked by high blood pressure and protein in the urine, for which diabetes is a major risk factor. There's also a higher chance of requiring a C-section instead of vaginal child birth, due to the increased likelihood of delivering a larger baby. Managing tight blood sugar levels can lead to frequent or severe episodes of low blood sugar (hypoglycemia). The growing insulin resistance during pregnancy increases the risk of diabetes-related ketoacidosis (DKA), a serious complication.

The best way to reduce the risk is indeed to ensure the diabetes is well-controlled before getting pregnant. Some other steps you can take are:

• Monitor your blood sugar levels often as your doctor advises.

• Keep your blood sugar within the target range.

• Follow your doctor’s instructions on insulin, medications, and other treatments.

• Do not miss any of your prenatal appointments and tests.

• Stay physically active. You can ask your doctor what’s safe for you.

• Eat healthy, balanced meals and snacks.

• Avoid alcohol and tobacco products.

• Take care of your mental health.