Diabetes and Pregnancy

Diabetes is a disease in which your blood glucose, or blood sugar, is too high. It occurs when your body doesn’t make enough insulin or is resistant to insulin, a hormone that helps move glucose from your blood into your body’s cells, where the glucose is used as energy. High blood sugar can lead to serious health problems, including heart disease, vision problems and kidney disease.

Untreated, diabetes can also increase the risk of serious complications during pregnancy, threatening the health of mother and baby.

Gestational Diabetes

Some women develop high blood sugar for the first time during pregnancy. This is known as gestational diabetes. The prevalence of gestational diabetes in the United States is estimated to be as high as 9.2% according to a 2014 report from the Centers for Disease Control and Prevention.

All pregnant women without a known history of diabetes are screened for gestational diabetes between 24 and 28 weeks of pregnancy.

Gestational diabetes typically goes away after childbirth. However, you will be at higher risk of developing diabetes later in life.

Understanding Your Risks

Women with diabetes during pregnancy are at increased risk of complications that include:

• Birth defects
• High blood pressure and preeclampsia
• Miscarriage or stillbirth
• Excessive growth of the baby (macrosomia)
• Need for a cesarean delivery (c-section)
• Preterm labor caused by excessive amniotic fluid
• Breathing problems in the baby at birth
• Low glucose levels in the baby at birth
• Jaundice in the baby after delivery

Plan Ahead to Protect Your Baby

If you have diabetes and are planning a pregnancy, consult with your healthcare provider well before conception. High glucose levels before pregnancy and in the very early weeks of pregnancy – when the baby’s organs are developing – can increase the risk of birth defects, especially defects of the heart and spine. Preconception planning and treatment can help ensure you give your baby the healthiest possible start to life.

Treatment during Pregnancy

Controlling your blood glucose level during pregnancy is critical to reducing the risks to you and your baby. 

Treatment should include:

• A healthy diet and regular exercise, as directed by your healthcare providers
• Insulin or oral medications to control your blood glucose level
• A multidisciplinary healthcare team, including an OB/GYN experienced in managing high-risk pregnancies with diabetes, an endocrinologist, a registered dietitian, specialists to treat diabetes-related health issues such as vision problems, kidney disease, and heart disease, and a neonatologist experienced in treating babies born to mothers with diabetes
• Frequent blood glucose monitoring
• Frequent prenatal visits
• Fetal imaging to closely monitor your baby’s growth and development
• Eye exams, as needed, to monitor the impact of pregnancy on diabetic retinopathy
• A carefully planned delivery

After Your Pregnancy

Your blood glucose levels will be monitored closely following delivery, as insulin requirements can decrease quickly in the first 48 hours after childbirth.

If you have gestational diabetes you will need regular screening for diabetes after pregnancy.

The Benefits of Specialized Care

Texas Children’s Pavilion for Women offers specialized care for pregnant women with diabetes, for the best possible maternal and fetal outcomes.

Our patients benefit from: 

• Preconception counseling and care to assess and reduce maternal and fetal risks prior to pregnancy
• Consultation with maternal-fetal medicine physicians, specialists with proven experience managing pregnancies with diabetes, for early detection and treatment of complications
• Close collaboration with your OB/GYN
• Advanced imaging technologies and expertise to monitor your baby’s growth and development
• Delivery at a state-of-the-art facility with access to critical support resources
• A multidisciplinary medical and surgical team experienced in these complex pregnancies and deliveries
• Immediate access to neonatologists and critical care services at Texas Children’s Hospital for babies who need extra care and monitoring, including the Texas Children’s Fetal Center™ and the Texas Children’s Newborn Center, home to Texas Children’s level IV neonatal intensive care unit (NICU)
• Proven fetal outcomes