Can a woman with type 1 diabetes get pregnant
By Amelia Dmowska. In addition to the excitement that goes along with the prospect of having a child, any woman considering pregnancy may be flooded with questions, fears, and worries. Ginger and co-author Jennifer Smith wanted to create a guide specifically designed to help women with type 1 diabetes meet those challenges. Ginger has lived with type 1 diabetes and celiac disease since , has written several books about diabetes, and is part of the editorial team at DiabetesDaily. Jenny, a Certified Diabetes Educator and Registered Dietitian, has lived with type 1 diabetes since and works as a diabetes coach for people across the globe.SEE VIDEO BY TOPIC: How Diabetics Should Prepare Prior to Pregnancy
SEE VIDEO BY TOPIC: High Risk Pregnancy: DiabetesContent:
Diabetes and getting pregnant
Diabetes Diabetes and getting pregnant. Having a chronic condition such as diabetes diabetes mellitus takes careful monitoring of your health at the best of times, and this becomes even more crucial during pregnancy, a time when your body changes dramatically. Most women who have pre-existing diabetes who become pregnant have type 1 diabetes once called insulin-dependent or juvenile diabetes , although some may have type 2 once called non-insulin dependent or maturity-onset diabetes.
Another type of diabetes called gestational diabetes is a temporary type of diabetes that occurs in pregnant women who have never had diabetes before and it usually goes away after the baby is born. What it does mean is that you will probably have to work closely with your doctor and other healthcare professionals to ensure you manage your diabetes well during your pregnancy.
Seeing your doctor for pre-pregnancy planning is an important step in ensuring the best outcome for you and your baby. You have a pre-existing condition, so you can plan ahead and discuss with your doctor what you need to do before you become pregnant, and what you can do to manage your diabetes during pregnancy. For example, if you have diabetes, you have a slightly higher risk than other women of your baby:. You yourself have an increased risk of having a miscarriage or of developing high blood pressure during the pregnancy.
However, you can minimise these risks by planning ahead and gaining the best possible control of your blood sugar at the time of conception and throughout the first 2 months of pregnancy. If you have type 2 diabetes and are taking tablets to help control your blood sugar oral hypoglycaemic medication , you can plan ahead and, if appropriate, switch to taking insulin instead, before you become pregnant. Doctors usually recommend taking insulin instead of oral hypoglycaemic medication during pregnancy, as the oral medications are not known to be safe for the unborn baby.
If you have high blood pressure hypertension now is the time to get your blood pressure under control using medications that are safe to continue once you are pregnant. You may need to stop taking some medications, such as certain cholesterol-lowering medicines, while you are pregnant — check with your doctor.
Now is also the time to start taking a folate supplement. This is important for all women planning a pregnancy, as the fetus needs adequate levels of folate during the first few weeks when you may not even know you are pregnant for normal development of the nervous system. Your doctor can advise you about supplements. Like any woman who becomes pregnant, your hormones behave differently during pregnancy than at other times. What this means for you is that you have to be aware of the impact of these possible changes to your hormones and your metabolism so that you can adjust your diabetes management accordingly.
Your insulin requirements are likely to change throughout the period of your pregnancy and shortly after delivery. For example, early in your pregnancy, your body might start using glucose more effectively than usual, which means you need less insulin. You may be more at risk of hypoglycaemia low blood sugar during this time, particularly if morning sickness or nausea affect your intake of carbohydrates.
You might also find that your usual symptoms of hypoglycaemia change during this period so be aware of any signs that you are experiencing a hypo. Common signs of hypoglycaemia include shaking, sweating, headache, confusion, paleness, and changes in mood or behaviour. Later in your pregnancy, your placenta will have grown in order to provide your baby with the nutrition needed to develop.
Unfortunately, it also starts producing hormones that adversely affect the ability of insulin to do its job properly, which can result in a state of insulin resistance from about the fifth or sixth month of your pregnancy. This means that you might need to take more insulin: some mums-to-be need as much as twice their usual insulin dose at this time. In the final 4 to 6 weeks of pregnancy, your need for insulin might change again and you might need slightly less insulin at this time.
Once the baby is born, your insulin needs will fall dramatically, compared with what they were while you were still pregnant. This can make controlling your blood sugar levels challenging. What all these changes mean is that you will have to be extra-vigilant in monitoring your diabetes, and work closely with your doctor and other healthcare professionals to ensure you keep your diabetes under tight control.
Testing your blood glucose at least 4 times a day, and overnight, on occasions, will help you to monitor your condition and help you and your doctors adjust your insulin dosage, if necessary. Some mums-to-be can keep tight control of their blood glucose levels on their usual twice-daily insulin, while others might have to change their routine to include multiple doses of insulin. If you have kidney problems as a result of diabetes a condition known as diabetic nephropathy , you are most likely to have no major problems during pregnancy, although your doctor will be best placed to advise you about your particular circumstances.
Severe kidney disease, for example, is a cause for concern, while mild nephropathy usually causes few problems. Unfortunately, any diabetes-induced renal disease can deteriorate during a pregnancy, but fortunately, things usually return to normal after the delivery unless the kidney disease is severe.
You might find that you are susceptible to urinary infections during pregnancy so ensure you tell your doctor if you have any symptoms or feel feverish for any reason. Any urinary tract infection in a pregnant woman must be treated because there is a risk of the bacteria ascending from the bladder to the kidneys. Most pregnant woman are at risk of conditions such as high blood pressure and swollen ankles as a result of fluid build-up, especially in the later stages of pregnancy, so your doctor will be monitoring you carefully for any signs such as these.
If you have preeclampsia during pregnancy, your doctor may recommend medications, bed rest, early admission to hospital or early delivery of your baby, depending on the severity of the condition. Eye problems diabetic retinopathy frequently get worse during pregnancy although this may reverse after the baby is born.
However, if your eye problems need treatment during pregnancy, you should be able to have laser treatment without damaging your baby. One common concern is carpal tunnel syndrome a condition in which the nerve that travels through the wrist becomes compressed, resulting in numbness, tingling and pain but this often resolves after delivery.
If you have another illness during pregnancy you should see your doctor as soon as possible. This is because illness might make you more susceptible to losing control of your blood glucose. Uncontrolled blood sugar during pregnancy can also place you at risk of high blood pressure, and can worsen the diabetic complications you may already have, such as eye disease diabetic retinopathy. Any woman who is pregnant is usually concerned about keeping her growing baby healthy and if you have diabetes you are likely to have to be even more vigilant.
Also, you have a higher-than-usual chance of having a miscarriage if you have a high blood acid level ketoacidosis as a result of poorly controlled diabetes. Later in your pregnancy, poorly controlled blood glucose levels could result in premature birth, stillbirth, or death shortly after birth. However, you will increase your chances of having a normal pregnancy and birth if you keep tight control of your blood glucose both before and during your pregnancy.
Excess blood glucose as a result of diabetes can increase your chances of having a baby with macrosomia an overly large body , which can cause complications during delivery. But by keeping good control of your blood sugar in the second half of your pregnancy, you can minimise your chances of having a large baby. In the past it was traditional, if you had diabetes, to deliver the baby about 2 weeks before full-term at about 37 or 38 weeks. Also, your baby will need close monitoring after birth for problems such as excessively low blood sugar levels.
After the birth of your baby, the metabolic changes that affected your insulin levels go into reverse. The need for insulin is likely to plummet for 2 or 3 days and, afterwards, your insulin requirements will gradually adjust again and will go back to about the same level as you had before becoming pregnant. The process of readjusting your insulin dose and stabilising your diabetes could take several weeks, so follow the instructions of your doctor closely at this time.
Your baby is likely to be carefully assessed for any signs of hypoglycaemia and jaundice, as well as breathing problems, especially if your baby is born prematurely. However, your baby can be treated, for example, if your baby has hypoglycaemia, hospital staff can give your baby glucose intravenously, if necessary. However, if you have type 2 diabetes, be aware that tablets oral hypoglycaemic agents are passed on through your breast milk so you should keep taking insulin, rather than tablets, while you are breast feeding.
Gestational diabetes is a form of diabetes that develops during pregnancy. It is different from having known diabetes before pregnancy and then getting pregnant. Blood glucose testing measures the amount of glucose sugar in your blood, and is one of the most common screening tests used for diabetes. Type 2 diabetes usually begins with insulin resistance and often goes hand in hand with obesity, high blood pressure and high cholesterol.
Diabetes During Pregnancy
If you have type 1 or type 2 diabetes and are planning a family, you should plan your pregnancy as much as possible. Controlling your blood sugars before conception and throughout pregnancy gives you the best chance of having a trouble-free pregnancy and birth and a healthy baby. Women with diabetes will need to closely monitor their blood sugar levels during their pregnancy. If you develop diabetes during pregnancy, it is called gestational diabetes. If you can, visit your doctor or diabetes educator at least 6 months before you start trying to fall pregnant.
Being well-prepared for pregnancy can help reduce the risk of complications, keep you healthy throughout your pregnancy, and give your baby a good start in life. Hormonal changes during pregnancy make diabetes even more challenging. The majority of women who properly control their diabetes before and during pregnancy have successful pregnancies, and give birth to beautiful, healthy babies. Women with diabetes have a higher risk of miscarriage and of having a baby with birth defects heart and kidney defects, for example. If your blood glucose sugar levels are poorly controlled, you should avoid becoming pregnant until your healthcare team has helped you improve your blood sugar control.
Type 1 or Type 2 Diabetes and Pregnancy
A healthy pregnancy for women with type 1 diabetes starts before conception. Find out how to prepare your body for the challenges ahead. Kerri Sparling was 7 years old when she was diagnosed with type 1 diabetes. She grew up believing that she'd never be able to have children of her own. But by the time she became an adult, significant technological advances in managing the illness gave her hope. With two decades of blood sugar control under her belt, Sparling eventually looked around for models of a healthy pregnancy with type 1 diabetes. Undaunted by the Hollywood dramatization, Sparling did her own research and, in preparation for pregnancy and with the help of her endocrinologist, worked for more than a year to get her A1C — a standard test to find out average blood sugar levels over several months — below seven. Sparling, now 34, has a 3-year-old daughter and confirms that while type 1 diabetes and pregnancy might be a challenging mix, a healthy pregnancy and a healthy baby are both possible. That said, pregnancy demanded a lot more insulin than she was used to taking, and she had to spend the last month of her pregnancy in the hospital with pre-eclampsia high blood pressure in pregnancy before her 6-pound, ounce baby girl was delivered by Caesarean section. But diabetes goes on and on.
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Blood sugar that is not well controlled in a pregnant woman with Type 1 or Type 2 diabetes could lead to problems for the woman and the baby:. The organs of the baby form during the first two months of pregnancy, often before a woman knows that she is pregnant. Blood sugar that is not in control can affect those organs while they are being formed and cause serious birth defects in the developing baby, such as those of the brain, spine, and heart. Besides causing discomfort to the woman during the last few months of pregnancy, an extra large baby can lead to problems during delivery for both the mother and the baby.
All pregnancies have the chance for complications, but having Type 1 makes you more susceptible to specific ones. Here are the most important things to do in order to lower those risks:. Check your number and check often.
Having a Healthy Pregnancy With Type 1 Diabetes
If you have type 1 or 2 diabetes, it is very important to talk to your healthcare team if you are thinking about having a baby. There are some things that are best done before you get pregnant that will reduce your risk of pregnancy complications and baby loss. If you have type 1 or 2 diabetes, you need to be as healthy as possible before you conceive, and while you are pregnant. The first thing to do is talk to your GP or diabetes team.
Diabetes is a condition in which the body can't make enough insulin, or can't use insulin normally. Insulin is a hormone. This leads to high blood sugar hyperglycemia. High blood sugar can cause problems all over the body. It can damage blood vessels and nerves.
Pregnancy with Type 1 or Type 2 Diabetes
Today, thankfully that advice is no longer given. And while a woman with Type 1 diabetes needs to take precautions, she can absolutely, and safely, have a healthy baby. As much information as you possibly need to understand why your blood sugars fluctuate during pregnancy and how to adjust your insulin management to keep your blood sugars as close to non-diabetic levels as possible. Also the book covers preparing for pregnancy, months one through nine of your pregnancy, delivery, and postpartum, including the challenges of breastfeeding for a woman with type 1 diabetes. My co-author Jenny is also my diabetes pregnancy coach. As a certified diabetes educator, woman with type 1 diabetes and mother, she knows this journey inside and out. Plus those hormones impact your insulin needs in ways that are constantly changing and evolving. Also, there is never a break.
Diabetes is a condition where the body is unable to keep blood sugar levels in the normal range. There are three types: type 1 diabetes, type 2 diabetes and gestational diabetes. Insulin is the hormone that controls blood sugar levels, keeping them in the healthy range. In type 1 diabetes, the pancreas is unable to make enough insulin.
Once upon a time, women with type 1 diabetes were told they could never have children. Still, there are a lot of open questions and misconceptions. Here are nine important facts about pregnancy and T1D, clarified:.
This next section is for women who wish to become pregnant, or are already pregnant, and are living with type 1 or type 2 diabetes. You can have a healthy baby if you have type 1 or type 2 diabetes. The key is to obtain optimal blood glucose levels before and during pregnancy. This will require more work on your part but every new mother we've talked to says it's worth it!
Back to Type 1 diabetes. You can have a healthy pregnancy with type 1 diabetes, although managing your diabetes might be harder. Constant high blood glucose levels can harm your baby, especially in the first 8 weeks of pregnancy. Speak to your diabetes team If you're planning to get pregnant.