Pre-existing Diabetes + Pregnancy = Potential Problems

Experts are concerned that the number of women who already have diabetes before they conceive is rapidly rising. Between 1999 and 2005, Americans with pre-existing diabetes doubled in size across all age ranges and races, including women of childbearing age. Different from gestational diabetes—a temporary type that women develop later in pregnancy—pregnancy diabetes can pose more of a threat to a fetus that is developing. Poorly controlled diabetes during pregnancy can cause major problems, such as stillbirths, miscarriages, or birth defects.

A baby's organs form during the first five to eight weeks of a woman's pregnancy. If the mother has diabetes and does not keep it maintained, she had have up to a 25 percent risk of delivering an infant with a major malformation of the heart, skeleton, or brain. The way for a diabetic woman to reduce the risk of this happening is to get their blood sugar levels checked before they become pregnant and keep them normal throughout their pregnancy. This way they have a much better chance of having a healthy baby.

Although currently there is no known way to prevent type 1 diabetes, characterized by the body not producing sufficient amounts of insulin which converts blood sugar into the energy we need for survival, type 2 diabetes can be warded off or controlled thought a healthy diet, exercise, or weight loss. All of these are especially important as a defense for women who have had gestational diabetes during pregnancies in the past.

Before a woman thinks about conceiving, it is a good idea to get tested for diabetes if she is overweight and has one of the following risk factors: family history of diabetes, inactive lifestyle, previous history with gestational diabetes, or if they are of African-American, American Indian, Hispanic, or Asian/Pacific Islander heritage. For women that have already had gestational diabetes, it is advised to have annual diabetes tests, as well as one at the first prenatal visit of each subsequent pregnancy.

The main message is that women really need to be aware of the risk factors and get tested before they get pregnant so they will have plenty of time to know they have diabetes and get it under control. Unfortunately, it is found that more than half of all pregnancies today are unplanned and many women unknowingly develop diabetes, and symptoms of type 2 aren't always obvious. For women that already have diabetes, the main objective, if possible, is to plan their pregnancies, as the stakes are pretty high for them.

Since gestational diabetes usually develops well into a woman's pregnancy, it doesn't usually cause the birth defects that pre-existing diabetes can. However, this does not go without risks. Gestational diabetes causes a buildup of glucose in the blood stream and can fatten babies that are developing which can make it more difficult to deliver and possibly require a cesarean. There could also be health problems that follow in the future for the baby. Even though gestational diabetes seems to disappear following delivery, the women who have it are more likely to have it again with later pregnancies. They are also more likely to develop type-two diabetes later on in life.

So here are some tips to keep you safe if you are considering having a child if you have diabetes or even if you don't.

If you are not pregnant:

• Consult your physician and get screened for diabetes with a glucose tolerance test or a fasting blood sugar test.
• If you are overweight or already have type 2 diabetes, work on reducing your weight before conceiving.
• If you already have type 1 or 2 diabetes, work with your physician to get your blood sugar at a healthy level.

If you are already pregnant:

• Consult your physician about getting a screening for gestational diabetes. Some women might need to wait until 24 to 28 weeks to be screened, and some may need to be screened at the beginning.
• If you are pregnant and you have diabetes, work with your physician to keep your blood sugar under control. You may need to establish a routine of exercising, but make sure you consult your physician before you start.
• After delivery, women with gestational diabetes should have their blood sugar tested to make sure that it returns to normal.