Diabetes during pregnancy: Risks, management, and long-term health

Diabetes during pregnancy is a growing concern, affecting both maternal and fetal health. Proper management of diabetes before, during, and after pregnancy is essential for ensuring the well-being of both mother and child. With rising cases of type 1, type 2, and gestational diabetes among pregnant women, medical experts emphasize the importance of regular monitoring and lifestyle modifications to mitigate potential risks.

Diabetes is a condition that affects how the body processes food into energy. The three primary types include type 1, where the body fails to produce insulin; type 2, which is characterized by high blood sugar levels; and gestational diabetes, which develops during pregnancy in women who previously did not have diabetes. Statistics indicate a concerning rise in diabetes among pregnant women. In 2016, approximately 1% of women who had a live birth in the U.S. had pre-existing type 1 or type 2 diabetes. By 2021, around 8% of women developed gestational diabetes during pregnancy. The prevalence of diabetes varies among different ethnic groups, with Asian women being the most affected by gestational diabetes, while American Indian, Alaska Native, Native Hawaiian, and Pacific Islander women have the highest rates of preexisting diabetes.

Uncontrolled diabetes during pregnancy can pose severe health risks. High blood sugar levels at the time of conception can increase the likelihood of birth defects, stillbirth, and preterm birth. Additionally, women with any form of diabetes during pregnancy face a higher probability of requiring a cesarean section. Infants born to mothers with diabetes are at a greater risk of being excessively large at birth, developing obesity, and eventually being diagnosed with type 2 diabetes later in life.

Doctors recommend that women with pre-existing diabetes consult a healthcare provider before conception. Pre-pregnancy consultations allow for better management of blood sugar levels, necessary adjustments in medications, and early detection of potential complications. Throughout pregnancy, maintaining a healthy lifestyle is crucial. This includes regular blood sugar monitoring, adhering to a nutritious diet planned with a doctor or dietitian, engaging in physical activity, and taking prescribed insulin if required. Women diagnosed with gestational diabetes must closely follow these guidelines to prevent complications.

Following childbirth, women who had gestational diabetes are at an increased risk of developing type 2 diabetes later in life. Medical professionals advise getting tested for diabetes between four to twelve weeks after delivery. Even if blood sugar levels return to normal, ongoing monitoring every one to three years is recommended. Women with preexisting diabetes should continue working closely with healthcare providers to regulate blood sugar levels and address any related health concerns.

Testing for gestational diabetes is a crucial step in early intervention and treatment. It is typically conducted between the 24th and 28th week of pregnancy, but for women at higher risk, testing may be done earlier. If high blood sugar levels are detected in the early stages of pregnancy, it may indicate preexisting type 1 or type 2 diabetes rather than gestational diabetes.

To minimize the risk of developing type 2 diabetes after gestational diabetes, healthcare professionals suggest lifestyle modifications. Achieving a weight loss goal of at least 5% of the initial body weight can significantly lower risks. A balanced nutrition plan, regular physical activity of at least 150 minutes per week, and emotional support from family, friends, or medical professionals can aid in maintaining a healthy lifestyle. Women who have had gestational diabetes or have been diagnosed with prediabetes may also benefit from a structured diabetes prevention program.