Diabetes and Pregnancy


If I am taking oral medications to control my diabetes, will I have to switch to insulin injections during pregnancy?
Since insulin is thought to control glucose levels better than most oral medications, your physician may want you to switch to insulin injections. There have been studies comparing birth defect rates of babies from women who control their diabetes with insulin injections with those who take oral medications to lower glucose in their blood.

In general,  taking oral medications does not increase the risk that a baby will be born with birth defects. It is important to recognize that there may be more specific information available   for   different   medications.  Consult   with   your physician regarding which medication may be appropriate
for you. 
I am 26 weeks pregnant and was told I have gestational diabetes. Is this the same as Type 1 or Type 2 diabetes and will this affect my baby?
Of all the women who have diabetes during pregnancy,  90%  have   gestational   diabetes.  Gestational diabetes is diabetes that is diagnosed during pregnancy, generally between 24-28 weeks. Most pregnant women are screened for gestational diabetes by drinking 50 grams of a glucose solution and measuring their blood glucose level one hour later.

If this test is abnormal,  additional testing may   be   done   to   verify   whether   a   woman   really   has gestational diabetes. Most women with gestational diabetes do not have symptoms,  but some may experience extreme thirst,  hunger or fatigue. 

For most women with gestational diabetes,  blood   glucose   levels   return   to   normal   after pregnancy,  although 40%  of women with a history of gestational diabetes develop diabetes at some point in the future.  Most women with gestational diabetes can control blood glucose levels with dietary changes,  while 10-15% may require insulin injections. 
Because gestational diabetes typically occurs late in the second trimester when the baby’s body is already formed, it does not usually increase the risk of birth defects, but is associated with a chance for delivering a large baby.

You should discuss with your doctor whether vaginal delivery or cesarean section is most appropriate given the baby’s size.  If gestational diabetes is not well controlled, there   is   an   increased   chance   for   the   baby   to   have hypoglycemia and breathing problems at birth. 

In rare cases where gestational diabetes is present in the first trimester, there may be a small increased risk for birth defects similar to that seen with other forms of diabetes.  It is not clear whether gestational diabetes truly increases these risks, or whether the women in these studies simply had Type 1 diabetes that had not previously been
identified. 
If I have diabetes will I be able to breastfeed my baby?

Diabetes can slow down the production of milk.

Insulin is necessary for milk production, so this may partly explain why women with diabetes are slow to produce milk.

You can stimulate milk production in a number of ways, including skin to skin contact with your baby within one hour after birth and frequent nursing sessions in the first two days. A lactation consultant can help you learn feeding cues from your baby and maximize your milk production.

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