Diabetes During Pregnancy: What You Need to Know

Are you already expecting a little bundle of joy? If so, congratulations! Whether you’re ready to welcome a new member into your family, or you’re just curious about pregnancy and blood glucose, we’re here to help you learn more. The first thing you should remember is that your body is already going through many changes when you’re pregnant. You'll experience everything from morning sickness to weight gain, and if you have diabetes, it can complicate things further. This is especially true when it comes to things like preventing pregnancy complications and managing your blood glucose.

That’s why making smart choices when you’re pregnant can often be the best way to ensure a healthy pregnancy for both you and your baby! But before we dive into the ins and outs of being pregnant with diabetes, it’s important to distinguish between the different types of diabetes, as they can impact pregnancy differently.

Some Basics About Diabetes

There are three types of diabetes, all of which are slightly different from each other. While there’s a lot of talk about type 1 and type 2 diabetes, the third, gestational diabetes, doesn’t get nearly enough attention. But when we’re talking about diabetes during pregnancy, it may be one of the most important. Here’s what you need to know about each one:

1. Type 1 Diabetes: Type 1 diabetes usually develops early in life and is an autoimmune disorder. It’s characterized by a lack of productive insulin-making pancreatic cells, resulting in an inability to turn the food you eat into usable energy for your cells. This type of diabetes usually requires insulin injections. It's also hereditary, so it’s a good idea to know your family history and go over the risk factors for type 1 diabetes as early as possible.
2. Type 2 Diabetes: Type 2 diabetes often develops later in life and can often be attributed to age, diet, or lifestyle. It may be mild (and controlled by lifestyle or medication) or severe (requiring insulin injections). Type 2 diabetes occurs when your body is no longer sensitive to insulin. Even though you continue to make insulin, your body may have difficulty using it to turn food into energy.
3. Gestational Diabetes: Gestational diabetes develops during pregnancy and typically resolves after childbirth. However, for some, it does not resolve and may instead develop into type 2 diabetes later on. Symptom-wise, gestational diabetes looks similar to type 2 diabetes. If diet and lifestyle changes do not control it, you may need oral medication or insulin injections. Your healthcare provider will usually check for this using an oral glucose tolerance test. 

Of course, it's important to remember that there can be exceptions regarding when and why each type of diabetes develops. Type 1 diabetes usually develops due to autoimmune reactions that destroy the cells in your pancreas that make insulin. In type 2 diabetes and gestational diabetes, you will typically see an elevation in blood sugar levels outside of normal ranges. The elevation can occur due to a range of diet and lifestyle factors, as well as physiological changes during pregnancy.

Taking a Look at Pregnancy and Blood Glucose

Even if you don’t have diabetes, your blood glucose levels may fluctuate a bit more than usual due to pregnancy hormones. But your day-to-day blood glucose levels likely won’t change much. If you have diabetes, pregnancy can complicate blood glucose management. 

This is because of pregnancy hormones like estrogen, cortisol, and human placental lactogen. They can block insulin and increase insulin resistance and blood glucose levels, something that is most prevalent in the third trimester. Pregnancy is a time when you’ll need to be in close contact with your healthcare team. So, don't worry if you have frequent adjustments in your insulin ratios and blood glucose corrections.

What to Focus on When You Have Diabetes During Pregnancy 

Whether you have type 1 or type 2 diabetes or you’ve recently developed gestational diabetes, it can change how you approach things during your pregnancy. Any decisions you make now will affect more than just you. And if you don’t keep your blood glucose levels within a healthy range, you may see a host of complications arise. Some risk factors and health problems to watch out for include:

• A high birth weight
• Breathing problems or poor lung development for your infant
• Low blood sugar in your newborn
• Higher risk of obesity and type 2 diabetes later in life for your baby
• Stillbirth

Don’t worry; this doesn’t mean that if you’re diabetic, you’re bound to encounter these issues. But it does mean that managing healthy blood glucose levels may be vital for your health and your baby’s health. 

It’s a good idea to set up a proper prenatal care routine during the first few weeks of pregnancy. Testing your blood glucose levels per recommendations from your healthcare provider is a good idea. It's also essential to schedule regular follow-ups with your health care team to minimize the risk of potential health problems and pregnancy complications. Learning how to manage your diabetes effectively may also help you have a healthier pregnancy.

How Your Diet Factors in Here

Whether you have diabetes, pre-diabetes, or you’re perfectly healthy, controlling glucose levels during pregnancy is beneficial for you and your baby. There’s no one-size-fits-all, of course, but healthy foods may help ensure a healthy baby! Here are a few general tips that can help:

• You may feel hungrier during your pregnancy because your caloric needs are more significant. Eating nutrient-dense foods throughout the day and supplementing with healthy snacks can help you stay satiated.
• Fat, proteins, carbohydrates—what should you avoid? Likely nothing, unless you have a specific reason or your own health concerns. Make sure your meals are balanced and include a good amount of protein, fiber, and healthy fats.
• Adequate protein is essential during pregnancy, so make sure you get quality sources at each meal throughout the day.
• Eat balanced meals as much as possible. It’s important to try and include protein, fiber, and healthy fats in each meal. However, it can be challenging to do this in the morning if you have any symptoms of nausea. Try to start your day with some protein: nuts, legumes, and seeds are high in protein and B6, which might help reduce morning sickness.
• It’s a good idea to limit added sugars and sugar-sweetened beverages. This includes fruit juices, candy, and even some artificial sweeteners.

Continuous Glucose Monitors Can Help in Postpartum

For most healthy people, glucose levels return to normal after giving birth. For others, including those diagnosed with gestational diabetes, blood glucose may continue to stay elevated for some time. This is most likely due to the physiological changes you experience during pregnancy. They can increase insulin resistance, making it harder for your body to use the foods we eat for energy. This may become concerning since gestational diabetes can put you at an increased risk of developing type 2 diabetes later on in life.

So what can you do about it? You already know prenatal care is important throughout your pregnancy. But don’t forget about postpartum care! Things like postpartum preeclampsia, backaches, even urinary incontinence can pop up after you give birth. And while shedding the baby weight (remember getting to a healthy weight is more important than just shedding pounds) may be at the top of your mind, consider thinking about blood glucose levels too. 

Monitoring your glucose levels in postpartum can provide important information on your overall blood glucose trends, making it easier to implement lifestyle changes and address health problems. A continuous glucose monitor (CGM) may be a useful way to monitor these trends. In turn, this can help you reach your postpartum goals—whether these are decreasing your blood glucose levels, body composition changes, or improving energy levels.

After your new baby arrives, you’ll be needed in all kinds of new ways! And you’ll want to feel good, healthy, and full of energy. By focusing on your health, learning about your risk factors, and working toward better diabetes management, you can invest in your future and the future of your family.