To get pregnant with diabetes, you need to control your blood sugar levels before conception and throughout the pregnancy. This gives you the best chance of having a trouble-free pregnancy, a smooth delivery, and a healthy baby.

How Can Diabetes Affect You During Pregnancy?

Pregnancy leads to a lot of hormonal changes, which can cause blood glucose levels to fluctuate. So, before you get pregnant, you may need to change the way you manage your condition. You may also need to change your diet, lifestyle, medications, and routine as per your doctor’s advice. Each woman’s body responds differently, so you should ask a doctor before modifying your medications or your lifestyle.

What are the complications encountered for pregnant women with diabetes?

In a pregnant woman with type -2 diabetes, if blood sugar levels are high, there can be a series of complications both for the mother and baby.

• Large baby: Ill-managed diabetes can lead to high blood sugar in the baby. This causes the baby to grow larger than usual. An extra-large baby can cause discomfort during the last few months of pregnancy and may lead to complications during delivery. You might even need to undergo a C-Section to deliver the baby. There could also be nerve injury to the baby if there is excess pressure on the shoulders during delivery.
• High blood pressure (Preeclampsia): Preeclampsia is a condition characterised by high blood pressure and can occur in pregnant women with diabetes. The signs of preeclampsia are high blood pressure, protein in urine, and swelling of fingers and toes. It may lead to premature delivery or can cause a seizure or a blood clot in the brain during labour that can lead to brain damage. Women with type 2 diabetes have high blood pressure more often than women without diabetes.
• Hypoglycaemia: Diabetic women who take insulin or oral diabetic medication can experience low blood sugar. Low blood sugar or hypoglycaemia can be critical, or even fatal, if not treated in time.

Premature delivery, stillbirth, and miscarriage are the other grave complications of untreated diabetes during pregnancy.

Can Diabetes Affect Your Baby?

The first two months of pregnancy are crucial as the development of major organs like the lungs, brain, kidneys, and heart of the baby takes place during this time. If blood glucose levels are high during this time, then it can lead to birth defects in the baby. Moreover, high blood sugar levels in the mother can lead to premature birth, stillbirth, or neurological defects in the baby.

Preparing For Pregnancy With Type 2 Diabetes:

The first step in preparing for pregnancy when you have diabetes is to speak to your doctor. 

Ask a doctor or diabetes team a few months before you plan to conceive so that you can plan ahead. Your doctor will ask you to undergo a few tests like:

• HbA1c to check your blood sugar status over the past few months.
• Blood and urine tests to check for diabetes-related kidney complications.
• A lipid profile to check for your cholesterol and triglycerides levels.
• An eye check-up to screen for cataract, glaucoma, or retinopathy.
• Refer you for preconception counselling.
• Your doctor will need to review every medication you are taking before you become pregnant. There may be some medication that will need to be discontinued or changed during pregnancy.

When you are preparing for pregnancy, blood sugar management becomes more important than ever. Maintaining your blood sugar levels is the key to avoiding any diabetes-related complications.

A few things that can help you manage Diabetes:

Healthy eating:

It is advisable to eat a balanced diet that includes plenty of fruits, vegetables, nuts, and whole grains. Do not fall prey to fad diets or crash diets. These may disrupt your insulin levels. If you want to lose weight before pregnancy or if you are unable to keep your blood sugars within the target range, consult a registered dietitian. A dietitian can help you customise your meal plan to meet your pre-pregnancy needs.

Stay active:

Another important aspect of staying healthy with diabetes is to stay active. During your preconception appointment, ask a doctor about the exercises you can perform. Choose the activities you enjoy, such as walking or swimming, and include them in your daily regime.

Physical activity can affect your sugar levels, so check your blood glucose level before and after any activity, especially if you are on insulin.

Take vitamin and mineral supplements:

Your doctor will recommend you to take a folic acid supplement daily before conception. Folic acid is important for preventing neural tube birth defects, such as spina bifida. Folic acid needs to be started at least one month before conceiving. Ask a doctor if you need to take other vitamin supplements, such as iron or calcium, or a multivitamin.

Maintain a healthy weight:

Try to reach your ideal body weight before you get pregnant with diabetes. If you have a few extra pounds, losing them will help prevent complications that can result from diabetes. Staying physically active and eating a balanced diet will help you lose excess weight.

Watch your habits:

If you smoke or drink alcohol, you need to quit now. Smoking during pregnancy can affect the baby before, during, and after birth. Smoking causes nicotine, carbon monoxide, and other toxins to travel through your bloodstream and go directly to your baby. Drinking alcohol during pregnancy can lead to a series of birth defects like intellectual disability and other physical complications. There is no amount of alcohol consumption known to be safe while pregnant, and there is no safe time to drink during pregnancy.

Pregnancy with diabetes is tough to handle and demands the utmost care. The consequences of improper management are potentially fatal for both you and the baby. But, as mentioned above, all of the concerns and catastrophic outcomes of pregnancy with diabetes are manageable with the right guidance and a good regime. 

Most women with diabetes have a healthy baby. Planning for pregnancy when you have diabetes is essential. By planning and getting support from your doctor, you can reduce the risks involved. You should also stay informed and be aware of what you should and shouldn’t do. Even though discomfort during pregnancy is normal, ask your doctor about it as it can help you deal with issues at an early stage. So, do not dread your pregnancy even if you have diabetes, as it can be managed and requires little effort.