If you have diabetes, it’s important to talk with your doctor before you get pregnant. You should have a thorough check-up, and your doctor will want to switch you from antihyperglycemic drugs to insulin [1].
If I learn that I am diabetic while pregnant, is it gestational diabetes?
To precisely diagnose your condition, you will likely be referred to an endocrinologist for additional testing. All pregnant women will have their blood glucose level determined during their first visit to the doctor. And the sooner that happens, the better. Your doctor needs to know if you have diabetes mellitus (type 2) before conceiving, and they will likely want you to postpone pregnancy if your glycated hemoglobin level is above 7% [2].
What is glycated hemoglobin?
Analysis for glucose levels reflects the current levels in your blood, while glycated hemoglobin (hemoglobin A1C test) allows you to assess the situation over the past three months. It shows what percentage of hemoglobin has combined with glucose. When planning to conceive, you should strive for an indicator below 6.0% [3].
What if I got pregnant when my levels were high?
If blood sugar levels are not under control from the first days of conception, then the risk of miscarriage and birth defects increases [1, 3, 4]. The recommendation is to consult an endocrinologist or specialist as soon as you find out you have diabetes.
Will there be different treatment strategies for gestational and other forms of diabetes?
Gestational (pregnancy-related) diabetes can be controlled through diet and lifestyle. If you have type 2 diabetes, then insulin doses must be checked and adjusted regularly, and you will have to learn how to monitor your blood sugar levels on your own [3].
What does the management of diabetes look like during pregnancy?
Diabetes requires diligent monitoring before and during pregnancy. You will visit your ob-gyn regularly, as well as your endocrinologist, and may need to see your doctor every two weeks (especially during the first and last trimester). In addition, they may recommend you visit your ophthalmologist once every trimester [1].
Why switch from pills to insulin?
Insulin is considered safe for your developing baby, which cannot be said about antihyperglycemic drugs.
If I switch to insulin injections during pregnancy, can I return to pills later?
After giving birth, your doctor will likely switch you back to hypoglycemic pills if they were effective before pregnancy.
Will I be able to give birth naturally and breastfeed with diabetes?
Yes, both natural childbirth and breastfeeding are possible and encouraged [3].
