St. Luke’s Maternal Fetal Medicine
Diabetes in Pregnancy
Diabetes during pregnancy can occur in three different forms. First, diabetes can occur exclusively during pregnancy. This form of diabetes, called gestational diabetes, can be discovered during the 1-hour glucose testing performed by your obstetrical care provider between the 26th and 30th week of pregnancy. If the initial test results are abnormal, the next step is to do a more prolonged glucose test. When these results are also abnormal, the patient is usually required to undergo dietary restrictions (such as limiting sugar intake) and glucose monitoring for some time to determine risks, or the need for any other therapy. When the monitoring does indicate an increased risk for developing diabetes during pregnancy, your obstetrical care provider will provide you with information regarding any therapy that is necessary. It is important to follow your obstetrical care provider’s recommendations regarding prenatal visits during diabetic care in order to improve the outcome of the pregnancy.
Type II, or adult onset diabetes, is diabetes that develops during adulthood. It is usually associated with a family history of diabetes and/or with obesity. This type of diabetes is usually treated with dietary restriction, exercise, and frequently oral medications (pills) to decrease the blood sugar level. This type of diabetes does increase pregnancy risks. If you have been diagnosed with Type II diabetes, you are strongly encouraged to talk with your obstetrical care provider regarding special care or therapies that may be needed during your pregnancy.
Type I diabetes, otherwise known as juvenile onset diabetes, is diabetes that develops during the juvenile years and occurs for a prolonged period of time. Frequently patients are put on insulin therapy, long dose acting insulin, or an insulin pump. For the best possible pregnancy outcome, it is strongly encouraged that all people with Type I diabetes seek high-level obstetrical care during their pregnancy.
Women who have had a diagnosis of Type I or Type II diabetes are strongly encouraged to seek a doctor or genetic counselor’s advice before attempting to become pregnant. It is important to achieve the highest level of control prior to achieving pregnancy; however, continuing your medical care and caring for your diabetes is usually associated with a good outcome as long as you continue to follow the advice of your obstetrical care provider.
Lack of control in diabetes can cause problems in both the pregnant woman and the fetus; however, the chance of these complications occurring is significantly decreased with proper care. This care consists of regular visits to your diabetic care provider, your obstetrical care provider, and sometimes a high-risk obstetrical care provider (such as a maternal fetal medicine specialist), in addition to any testing or monitoring of the fetus necessary for the treatment and follow-up of the diabetes. Diabetes will not necessarily worsen during pregnancy, however, the hormones of diabetes and those produced by the placenta can increase the need for insulin. If diabetes has been diagnosed, kidney function tests and eye exams are usually required during pregnancy.
St. Luke’s Maternal Fetal Medicine
333 N. 1st Street, Suite 150
Boise, ID 83702
(208) 381-3088
