Diabetes and Pregnancy: What You Need to Know


Diabetes and Pregnancy: What You Need to Know

Young pregnant woman with doctor in ambulance.

Are you worried about getting gestational diabetes while pregnant? Or are you living with type 1 or 2 diabetes and thinking about starting a family? A Family Medicine OB doctor can offer you essential support and guidance to keep your health on track throughout your pregnancy and beyond.

Managing diabetes while pregnant can be a challenge. Read on to learn how a Family Medicine Obstetrics provider can offer the guidance you need to have a successful pregnancy when coping with diabetes.

The three types of diabetes

There are three types of diabetes:

  • Type 1
  • Type 2
  • Gestational

Type 1 diabetes occurs when a person’s pancreas stops producing insulin. 5-10% of all patients with diabetes have type 1.

Type 2 diabetes is the most common type, and accounts for 90-95% of individuals with diabetes. With type 2, a person’s body makes some insulin, but the body is unable to use it for energy. This is called insulin resistance.

Gestational diabetes begins during pregnancy, despite a person never having diabetes before. According to the CDC, 2-10% of pregnancies in the U.S. are affected by gestational diabetes. For most women, the condition goes away after the baby is born.

Managing diabetes during pregnancy

Diabetes can be a challenge to manage during pregnancy. Poorly controlled blood sugar compromises both the mother and baby’s health and increases the risk of birth defects, miscarriage, stillbirth, preeclampsia, and more.

On the other hand, practicing good blood sugar control, eating healthy, exercising, managing stress, and sometimes taking medication, can positively support a diabetic’s overall health during pregnancy.

Making lifestyle and diet adjustments can be a lot to think about when your body is going through so many changes. No matter what type of diabetes you have, working with an experienced OB doctor can offer you compassionate support and guidance to help make these changes successfully.

In addition, WWMG’s Family Medicine OB providers offer support for mental health issues like anxiety and depression that can intensify during pregnancy due to hormone changes.

Who’s at risk for gestational diabetes?

Some women are at an increased risk of getting gestational diabetes. The following factors can increase one’s chances of developing it:

If you fall into one of the high risk categories above, talk to your Family Medicine Obstetrics provider about getting tested for gestational diabetes.

Testing for gestational diabetes

Dr. Ann Begert, a Family Medicine OB doctor at WWMG’s Whitehorse Family Medicine, explains how gestational diabetes is diagnosed. “A glucose tolerance test given at 28 weeks is usually performed.” This test takes about one hour and measures your body’s response to glucose.

If the initial test results are positive, your provider will ask you to come back for a three-hour test. “If the second test is positive, you may have gestational diabetes,” says Dr. Begert.

Monitoring diabetes with a medical provider can help control your blood sugars during the child-bearing months. And it may be reassuring to know that for many women, gestational diabetes goes away after the baby is delivered.

However, according to the CDC, about half of women with gestational diabetes go on to develop type 2 diabetes. Losing the baby weight after giving birth can help patients avoid this outcome.

In addition, it’s recommended that women who had gestational diabetes work with their Family Medicine provider to test their blood sugar regularly in the year after giving birth, then every year, to prevent type 2 diabetes from developing.

Tips on managing diabetes during pregnancy

If you have type 1 or 2 diabetes, or have been diagnosed with gestational diabetes, you don’t have to manage your condition and pregnancy alone. The OB providers at Whitehorse Family Medicine can advise you on making the best health choices for you and your baby. We value partnership, open communication, patient education, and collaborative goal setting.

A Family Medicine provider can help patients with type 1 diabetes get their blood sugar under control before getting pregnant. But because these patients often have higher risk pregnancies, once pregnant, type 1 diabetics should seek out a specialty OB provider to oversee their care

In addition to working with a skilled OB provider, here are some tips to help you successfully manage type 2 or gestational diabetes while pregnant:

1. Check blood sugar regularly

Patients with type 2 diabetes should check their blood sugar at the frequency recommended by their Family Medicine OB provider.

Dr. Begert says, “If you are diagnosed with gestational diabetes, we usually have you check your blood sugars two to four times a day” to keep the condition managed and your health on track.

2. Follow a healthy diet

To ensure proper nutrition for you and your baby’s health, following a healthy diet while pregnant is essential. Eating three meals a day without sugary foods is ideal.

Dr. Begert suggests “avoiding simple carbohydrates and maintaining a well-balanced diet.”

“Eating white foods such as rice, potatoes, and bread isn’t your friend.” Instead, she recommends making it a goal to eat plenty of protein-rich foods, fruits, and vegetables.

3. Stay active

At least 150 minutes of exercise a week is recommended as a general rule. “Regular exercise can tremendously help with gestational diabetes or any [type of] diabetes.” Begert suggests walking or some form of activity for 30-45 minutes a day at least five to six days a week.

Some types of exercise to consider include walking, swimming, yoga, or dancing. These can help you maintain the “ideal weight gain during pregnancy of 20-30 pounds,” says Dr. Begert. Your Family Medicine OB provider can help you design an exercise regimen that will work for you.

4. Managing diabetes with medication

“When our patients are diagnosed with gestational diabetes, we refer them to a Registered Dietitian to discuss diet counseling” says Begert. The patient may see the dietician for several weeks to make a healthy eating plan and to keep them on track.

However, this method doesn’t work for everyone, and if it doesn’t, the next step is medication. Insulin is still a recommended treatment for gestational diabetes.

Dr. Begert shares that “Most Family Medicine practitioners don’t begin with insulin because patients find it challenging giving themselves injections.” As an alternative, metformin is commonly prescribed, although she says, “there’s not a lot of data about how it affects the baby.” So diet and exercise are usually explored as the primary interventions.

Lowering Prenatal Risks

When managing diabetes while pregnant, consider several key factors to ensure a successful journey to parenthood.

  • Attend regular appointments with your OB provider

Being pregnant and having diabetes can increase the risk of stillbirth, spontaneous abortion, and maternal preeclampsia. Dr. Begert emphasizes the importance of good prenatal care and regular appointments with your OB to reduce the chances of perinatal mortality or other complications.

  • Take a nonstress test

Women who have pre-existing medical conditions such as high blood pressure or advanced maternal age will go through special monitoring such as a nonstress test to check the health of the baby. This test measures the baby’s heart rate and how the mother’s heart responds to stress.

  • Check the baby’s size

For patients with gestational diabetes, Begert recommends getting an ultrasound during the last month of pregnancy to check the baby’s size. Higher blood sugar levels in the mother can make the baby larger, which could lead to a more challenging delivery and may require a cesarian section (C-section).

Once a large baby is born, “It’s essential to monitor the baby’s blood sugar for 24 hours after delivery to check for low blood sugar or hypoglycemia,” so it can be treated, says Begert.

Patient support and education

During pregnancy, patients with type 2 or gestational diabetes can benefit from education and care from a Family Medicine OB provider who will support you and your baby’s health throughout your pregnancy and after.

At Whitehorse Family Medicine, we have providers who care for multiple generations of families, and have delivered multiple generations of babies within that family. This is rewarding for our patients because they know they’re working with an experienced provider they can trust.

In addition, because Whitehorse has multiple OB providers on staff, they can collaborate on patient care to ensure the best outcomes for our pregnant patients and their babies. Dr. Begert shares that “reinforcement within the collaborative group is beneficial during pregnancy to keep patients on the right track.”

Family Medicine OB Care at WWMG

If you are pregnant and have type 2 diabetes, or have been diagnosed with gestational diabetes (or would like to get tested for it), request an appointment with one of our experienced Family Medicine OB providers at Whitehorse Family Medicine.

Our healthcare team is dedicated to offering comprehensive OB care to support and guide you through a successful pregnancy. Whether you have concerns or questions, or need physical and mental health support, contact us to request an appointment. Our caring doctors are here to provide you and your family with the quality healthcare you deserve.