Pregnancy and Diabetes

Maternal health and fetal complications are at a much greater risk in women with diabetes who are pregnant. Even the stress of a pregnancy can bring about gestational diabetes, which is a form of glucose intolerance that begins during the pregnancy and resolves itself after the birth of the baby. Whether there is preexisting diabetes or gestational diabetes there is an increased risk of fetal congenital defects and death from hyperglycemia, or abnormally high blood sugar, which must be controlled. Any woman with diabetes that is pregnant should get some form of nutritional counseling from a registered dietician.

There are many changes that occur during a pregnancy that can have detrimental effects on controlling the diabetes and the use of insulin. The placenta produces some hormones and enzymes that reduce the effectiveness of insulin. Insulin from the mother does not cross the placenta but blood glucose will. If too much blood glucose crosses over to the baby the baby's pancreas will increase insulin production. This increase in insulin leads to a condition that is typical for women with diabetes, macrosomia, or big baby syndrome. Newborns of mother with either form of diabetes can also suffer from respiratory problems, hypocalcemia, hypoglycemia, hypokalemia, or jaundice.