Diabetes and Pregnancy

Also called: Gestational diabetes

Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. When you are pregnant, high blood sugar levels are not good for your baby.

About seven out of every 100 pregnant women in the United States get gestational diabetes. Gestational diabetes is diabetes that happens for the first time when a woman is pregnant. Most of the time, it goes away after you have your baby. But it does increase your risk of developing type 2 diabetes later on. Your child is also at risk for obesity and types 2 diabetes.

Most women get a test to check for diabetes during their second trimester of pregnancy. Women at higher risk may get a test earlier.

If you already have diabetes, the best time to control your blood sugar is before you get pregnant. High blood sugar levels can be harmful to your baby during the first weeks of pregnancy - even before you know you are pregnant. To keep you and your baby healthy, it is important to keep your blood sugar as close to normal as possible before and during pregnancy.

Either type of diabetes during pregnancy increases the chances of problems for you and your baby. To help lower the chances talk to your healthcare team about the:

• A meal plan for your pregnancy 
• A safe exercise plan 
• How often to test your blood sugar 
• Taking your medicine as prescribed. Your medicine plan may need to change during pregnancy 

Diabetes Complications

Also called: Diabetic complications

What health problems can diabetes cause?

Over time, having too much glucose in your blood can cause complications, including:

• Eye disease, due to changes in fluid levels, swelling in the tissues, and damage to the blood vessels in the eyes 
• Foot problems, caused by damage to the nerves and reduced blood flow to your feet 
• Gum disease and other dental problems, because a high amount of blood sugar in your saliva helps harmful bacteria grow in your mouth. The bacteria combine with food to form a soft, sticky film called plaque. Plaque also comes from eating foods that contain sugars or starches. Some types of plaque cause gum disease and bad breath. Other types cause tooth decay and cavities. 
• Heart disease and stroke, are caused by damage to your blood vessels and the nerves that control your heart and blood vessels 
• Kidney disease, is due to damage to the blood vessels in your kidneys. Many people with diabetes develop high blood pressure. That can also damage your kidneys. 
• Nerve problems (diabetic neuropathy), are caused by damage to the nerves and the small blood vessels that nourish your nerves with oxygen and nutrients  
• Skin conditions, some of which are caused by changes in the small blood vessels and reduced circulation. People with diabetes are also more likely to have infections, including skin infections. 

What other problems can people with diabetes have?

If you have diabetes, you need to watch out for blood sugar levels that are very high (hyperglycemia) or very low (hypoglycemia). These can happen quickly and can become dangerous. Some of the causes include having another illness or infection and certain medicines. They can also happen if you don't get the right amount of diabetes medicines. To try to prevent these problems, make sure to take your diabetes medicines correctly, follow your diabetic diet, and check your blood sugar regularly.

Diabetes in Children and Teens

Until recently, the common type of diabetes in children and teens was type 1. It was called juvenile diabetes. With Type 1 diabetes, the pancreas does not make insulin. Insulin is a hormone that helps glucose, or sugar, get into your cells to give them energy. Without insulin, too much sugar stays in the blood.

Now younger people are also getting type 2 diabetes. Type 2 diabetes used to be called adult-onset diabetes. But now it is becoming more common in children and teens, due to more obesity. With Type 2 diabetes, the body does not make or use insulin well.

Children have a higher risk of type 2 diabetes if they are overweight or have obesity, have a family history of diabetes, or are not active. Children who are African American, Hispanic, Native American/Alaska Native, Asian American, or Pacific Islander also have a higher risk. To lower the risk of type 2 diabetes in children:

• Have them maintain a healthy weight 
• Be sure they are physically active 
• Have them eat smaller portions of healthy foods 
• Limit time with the TV, computer, and video 

Children and teens with type 1 diabetes may need to take insulin. Type 2 diabetes may be controlled with diet and exercise. If not, patients will need to take oral diabetes medicines or insulin. A blood test called the A1C can check how you are managing your diabetes.

Diabetes Medicines

What are the treatments for diabetes?

Treatments for diabetes can depend on the type. Common treatments include a diabetic meal plan, regular physical activity, and medicines. Some less common treatments are weight loss surgery for either type and an artificial pancreas or pancreatic islet transplantation for some people with type 1 diabetes.

What are the types of medicines for type 1 diabetes?

If you have type 1 diabetes, you must take insulin because your body no longer makes it. Different types of insulin start to work at different speeds, and the effects of each last a different length of time. Your healthcare provider will measure your blood glucose to decide on the type of insulin. You may need to use more than one type.

You will also need to check your blood sugar at home. Your provider will tell you how often. The results of your blood sugar testing can help you make decisions about food, physical activity, and medicines.

What are the types of medicines for type 2 diabetes?

There are several different medicines for type 2 diabetes. Each works differently. Many of them are pills. There are also medicines that you inject under your skin, such as insulin.

Over time, you may need more than one diabetes medicine to manage your blood sugar. You might add another diabetes medicine or switch to a combination medicine. A combination medicine contains more than one type of diabetes medicine in the same pill. Some people with type 2 diabetes take both pills and injections.

Even if you don't usually take insulin, you may need it at special times, such as during pregnancy or if you are in the hospital.

What else should I know about taking medicines for diabetes?

It is important to make sure that you understand your diabetes treatment plan. Talk to your provider about:

• What is your target blood sugar level is 
• What to do if your blood sugar gets too low or too high 
• Whether your diabetes medicines will affect other medicines you take 
• If you will have any side effects from the diabetes medicines 

You should not change or stop your diabetes medicines on your own. Talk to your provider first.