Diabetes During Pregnancy
During pregnancy, the placenta plays a critical role in supplying a growing fetus with nutrients and water. The placenta also makes a variety of hormones to maintain the pregnancy. In early pregnancy, hormones can cause increased insulin secretion and decreased glucose produced by the liver, which can lead to hypoglycemia (low blood glucose levels). As the pregnancy progresses, some of these hormones (estrogen, cortisol, and human placental lactogen) can have a blocking effect on insulin, a condition called insulin resistance.
As the placenta grows, more of these hormones are produced, and the potential for insulin resistance becomes greater. Normally, the pancreas is able to make additional insulin to overcome insulin resistance, but when the production of insulin is not enough to overcome the effect of the placental hormones, gestational diabetes results or there may be worsening of pregestational diabetes.
Women with diabetes before pregnancy have already been diagnosed. Depending on the severity of their disease, they may need continued care by their health care provider along with their obstetrician.
Gestational Diabetes Testing During Pregnancy
Nearly all nondiabetic pregnant women are screened for gestational diabetes between 24 and 28 weeks of pregnancy. In addition to a complete medical history and physical exam, a glucose screening test is given, which involves drinking a special glucose drink followed by measurement of glucose levels after a one-hour interval. If this test shows an increased blood glucose level, a three-hour glucose tolerance test will be done.If results of the second test are in the abnormal range, gestational diabetes is diagnosed.
Treatment for diabetes
Your health care provider will recommend the best treatment for you based on:
- Your Age
- Your overall health and medical history
- The progression of the condition
- Your tolerance for specific medications, procedures or therapies
- How long the condition is expected to last
- Your opinion or preference
Treatment to help keep blood glucose levels in the normal range may include:
- Special diet with controlled amounts of carbohydrate
- Blood glucose monitoring
- Insulin injections
- Certain oral hypoglycemics
Managing diabetes during the pregnancy
Special fetal testing and monitoring may be needed for pregnant diabetics, especially for those who are taking insulin. Tests can include the following:
- Fetal movement counting. Counting the number of movements or kicks in a certain period of time, and watching for a change in activity.
- Ultrasound. A diagnostic imaging technique which uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs as they function, and to assess blood flow through various vessels.
- Nonstress testing. A measurement of the fetal heart rate in response to the fetus' movements.
- Biophysical profile. A test that uses the nonstress test and ultrasound to examine fetal movements, heart rate and amniotic fluid amounts.
- Doppler flow studies. A type of ultrasound which uses sound waves to measure blood flow.
Infants of diabetic mothers may be delivered vaginally or by cesarean, depending on the estimated fetal weight and the mother's health. An amniocentesis may be done in the last few weeks of pregnancy to check the amniotic fluid for fetal lung maturity, as the lungs mature more slowly in babies whose mothers have diabetes. If the lungs are mature, some mothers may have labor induced or, depending on the estimated fetal weight, a cesarean delivery.
For information on birthing class times and price, please contact Julia Profit,
Obstetrics Manager & Childbirth Educator at Bailey Medical Center email@example.com or by phone at 918-376-8241.