Pregnancy is a transformative journey filled with joy and anticipation. However, for some women, it also comes with medical challenges—one of which is diabetes in pregnancy. Whether it’s gestational diabetes or pre-existing type 1 or type 2 diabetes, managing blood sugar levels becomes crucial for the health of both mother and baby.

In this blog, we’ll explore what diabetes in pregnancy means, the risks involved, and how it can be effectively managed to ensure a healthy pregnancy and delivery.

What Is Diabetes in Pregnancy?

Diabetes in pregnancy falls into two main categories:
1. Gestational Diabetes Mellitus (GDM)
This is diabetes diagnosed for the first time during pregnancy. It typically develops in the second or third trimester and usually resolves after delivery. However, it increases the mother’s risk of developing type 2 diabetes later in life.
2. Pre-gestational Diabetes
This refers to women who already have type 1 or type 2 diabetes before becoming pregnant. Managing blood sugar levels before and during pregnancy is crucial to avoid complications.

Why Does Diabetes in Pregnancy Matter?

Uncontrolled diabetes during pregnancy can lead to several complications, including:
• Macrosomia (large birth weight), which can complicate delivery
• Birth defects (especially if blood sugar is high in early pregnancy)
• Hypoglycemia after birth
• Increased risk of developing obesity or type 2 diabetes later in life
• For the mother:
• Preeclampsia (high blood pressure and signs of damage to organ systems)
• Increased likelihood of cesarean delivery
• Risk of developing type 2 diabetes in the future (especially after GDM)

Diagnosis and Screening

Gestational diabetes is typically screened for between 24 and 28 weeks of pregnancy using an oral glucose tolerance test (OGTT). Women with risk factors—such as obesity, a history of GDM, or a family history of diabetes—may be screened earlier.

For women with pre-existing diabetes, it’s important to have their condition well-controlled before conception and throughout the pregnancy.

Managing Diabetes During Pregnancy

The cornerstone of managing diabetes in pregnancy includes:
1. Healthy Eating
• A well-balanced diet rich in fiber, vegetables, lean proteins, and whole grains helps maintain stable blood sugar levels.
• Regular meals and snacks are important to avoid highs and lows in blood glucose.
2. Physical Activity
• Moderate exercise, like walking or prenatal yoga, can improve insulin sensitivity and help control blood sugar levels.
3. Blood Sugar Monitoring
• Frequent monitoring is essential to ensure levels stay within the target range recommended by healthcare providers.
4. Medication
• Some women may need insulin or other medications to manage their blood glucose effectively. These treatments are safe under medical supervision during pregnancy.
5. Regular Prenatal Care
• More frequent prenatal visits help monitor the baby’s growth and detect any complications early.

After the Baby Is Born

• Women with gestational diabetes should have their blood sugar re-checked 6–12 weeks postpartum to ensure it has returned to normal.
• Long-term follow-up is important, as up to 50% of women with GDM may develop type 2 diabetes later in life.
• Babies born to mothers with diabetes should also be monitored after birth and as they grow.

Final Thoughts

Diabetes during pregnancy can be daunting, but with early diagnosis, proper management, and a supportive healthcare team, most women go on to have healthy pregnancies and babies. Lifestyle changes made during this period can also lead to lasting health benefits for both mother and child.

If you’re pregnant or planning to become pregnant and have concerns about diabetes, talk to your doctor. Proactive care makes all the difference.

Dr. Minakshi Sharma
MBBS, MS, Fellowship – Laparoscopic Surgery, Fellowship – Infertility