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Pregnancy and diabetes: Why lifestyle counts

The action plan

Your diabetes health care team will help you establish your target blood sugar range. Then it's up to you to make healthy lifestyle choices and follow your diabetes treatment plan.

Remember the basics:

  • Check your blood sugar level often. Frequent blood sugar monitoring — perhaps up to seven or more times a day — can help you prevent low blood sugar and high blood sugar (hyperglycemia). Remember, controlling your blood sugar level is the best way to promote a healthy pregnancy and prevent diabetes complications.
  • Take insulin or other medications as directed. Although oral diabetes medications are sometimes used during pregnancy, your health care provider might recommend switching to insulin instead. Some medications — including certain drugs to treat high blood pressure or kidney problems — aren't recommended during pregnancy.
  • Be flexible. You'll need to adjust your insulin dosage depending on your blood sugar level, what you eat, whether you're vomiting and various other factors. Your stage of pregnancy matters, too. During the last three months of pregnancy, for example, hormones made by the placenta to help the baby grow can block the effect of insulin in your body. As a result, you might need more insulin than usual.
  • Remember healthy-eating principles. Your diabetes diet probably includes plenty of fruits, vegetables and whole grains. Although you can eat the same foods during pregnancy, your health care provider or registered dietitian might suggest changes to your meal plan to help you avoid problems with low blood sugar or high blood sugar. It's also important to take prenatal vitamins containing folic acid.
  • Include physical activity in your daily routine. Physical activity is another important part of your diabetes treatment plan, even during pregnancy. Get your health care provider's OK to exercise. Then choose activities you enjoy, such as walking, swimming or stationary biking. Aim for at least 150 minutes a week of moderate aerobic activity — based on Department of Health and Human Services guidelines for exercise during pregnancy. If you haven't been active for a while, start slowly and build up gradually. Also, remember that physical activity affects blood sugar. Check your blood sugar level before and after any activity, especially if you take insulin. You might need to eat a snack or adjust your insulin pump's basal rate before exercising to help prevent low blood sugar.
  • Schedule regular prenatal checkups. Your health care provider might recommend regular ultrasounds or other prenatal screening tests to monitor your baby's growth and development.

Remember, your health care team is there to help you manage your blood sugar level and prevent complications. If you have questions or concerns, don't hesitate to ask for help.

Labor and delivery: What to expect

Your health care team will help you determine the best time and safest way to deliver your baby. Sometimes labor is allowed to begin naturally. In other cases, labor is induced early to reduce the risk of complications for mother or baby. During labor, your health care team will closely monitor your blood sugar level and adjust your insulin dosage accordingly. If your baby is too large, an induction isn't successful or you develop complications, you might need to deliver your baby by C-section.

After delivery, your attention will turn to your baby — but it's still important to take good care of yourself. Continue to check your blood sugar level often, especially if you're breast-feeding. Keeping yourself healthy is the best thing you can do for your baby.

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References
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  2. Zabihi S, et al. Understanding diabetic teratogenesis: Where are we now and where are we going? Birth Defects Research. 2010;88:779.
  3. Pollex E, et al. Safety of insulin glargine use in pregnancy: A systematic review and meta-analysis. The Annals of Pharmacotherapy 2011;45:9.
  4. Jovanovic L. Glycemic control in women with type 1 and type 2 diabetes mellitus during pregnancy. http://www.uptodate.com/home/index.html. Accessed Sept. 15, 2011.
  5. Diabetes and pregnancy. American Congress of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp051.cfm. Accessed Sept. 15, 2011.
  6. Ecker JL, et al. Obstetrical management of pregnancy complicated by pregestational diabetes mellitus. http://www.uptodate.com/home/index.html. Accessed Sept. 15, 2011.
  7. Moore TR, et al. Pregnancy risks in women with type 1 and type 2 diabetes mellitus. http://www.uptodate.com/home/index.html. Accessed Sept. 15, 2011.
  8. 2008 Physical Activity Guidelines for Americans. U.S. Department of Health and Human Services. http://www.health.gov/paguidelines/guidelines/default.aspx. Accessed Sept. 15, 2011.
  9. Mersereau P, et al. Barriers to managing diabetes during pregnancy: The perceptions of health care practitioners. Birth. 2011;38:142.
  10. Diabetes basics: Tips. American Diabetes Association. http://www.diabetes.org/diabetes-basics/tips/tips-search-results.html?tip_category=exercise&page=2. Accessed Sept. 16, 2011.
  11. Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 20, 2011.
DA00042 Dec. 16, 2011

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