Diabetes in Pregnancy: Keeping You and Your Child Healthy

Monica Freidline, RN, NP, CNM is a Certified Nurse Midwife.  She is a registered nurse, nurse practitioner, and certified nurse midwife (CNM) in the Commonwealth of Virginia.  Before becoming a CNM, she was a labor and delivery nurse for 15 years.  Her scope of practice includes prenatal care, childbirth for low-risk patients, postpartum care, and gynecologic care.

November is National Diabetes Awareness Month in the United States. Diabetes is a significant health problem in the U.S., with more than 100 million Americans living with either diabetes (30.3 million) or prediabetes (84.1 million).

There are three main types of diabetes: type 1, type 2, and gestational diabetes (diabetes while pregnant). According to the CDC, 2 to 10 percent of pregnancies in the United States are affected by gestational diabetes each year.

Gestational diabetes usually develops between 24 and 28 weeks of pregnancy when the body is unable to produce and use the necessary amount of insulin required to keep blood sugar levels in a normal range. Uncontrolled gestational diabetes may result in a large baby, difficult vaginal delivery, and the need for a cesarean section. Uncontrolled diabetes during pregnancy is associated with premature delivery, preeclampsia, and stillbirth.

Women with gestational diabetes also have a higher chance of developing Type 2 diabetes later in life.  Infants of mothers with uncontrolled gestational diabetes are at an increased risk for obesity and developing Type 2 diabetes.

Ethnicity and a family history of diabetes are two unavoidable risk factors for diabetes. However, there are steps women can take to help reduce the risk of developing gestational diabetes:

• Achieve a healthy weight prior to becoming pregnant. This makes it much easier to maintain healthy glucose levels during pregnancy.
• Perform some type of daily physical activity, such as walking or swimming, to prevent excessive weight gain during pregnancy.
• Maintain a diet composed of lean proteins, whole grains, fruits, vegetables, and low-fat dairy. Avoid excess sugars.
• Keep all prenatal appointments. This allows your care team to appropriately monitor for early warning signs of gestational diabetes.

Who should be tested for gestational diabetes early in pregnancy?

Women who should be tested early in their pregnancy include:

• women who have delivered a large baby in the past
• anyone with a history of gestational diabetes in a previous pregnancy
• women with an elevated BMI, high blood pressure, or Polycystic Ovary Syndrome (PCOS).

I have gestational diabetes — how can I keep my baby healthy?

Women with gestational diabetes can still play an active role in working towards a healthy baby.

Collaborate with your healthcare provider to learn how monitor daily blood sugars, maintain a healthy diet, and exercise.  In some instances, medication will also be required to control blood sugar levels.

If you’re in the pre-pregnancy, pregnancy, or postpartum stage this November, make a year-end goal to take control of your health. You and your family deserve it!