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Pregnancy for a diabetic woman is far more complicated than for those women who do not suffer from the disease.
For those women who already have, and are aware that they have, diabetes, it is very important that they seek regular consultations with their medical team. Above all, they should consult with their doctor before they conceive, so a working plan for the pregnancy can be worked out.
However, given that the symptoms of diabetes are not always obvious; some women may be unaware that they have diabetes. In fact, of the estimated 3 million diabetics in the UK, as many as 1.2 million are unaware that they have the disease.
Indeed, 2 to 4% of women develop diabetes in the second half of their pregnancy, which equates to 7,500 - 15,000 pregnancies, so it's not uncommon.
Diabetes that occurs during pregnancy is called "gestational diabetes".
There are therefore three possible types of diabetes that may be present during the pregnancy, and in all cases a doctor should be consulted before conception, as changes to medication and close monitoring will be required.
1. Type 1 Diabetes.
This is obviously a pre existing health condition, and the prospective mother is highly likely to be aware that she has the disease. It is important in this case that the mother continues to take insulin during her pregnancy, but she must also keep a close check on her blood sugar levels, as the amount of insulin she requires will vary during the course of the pregnancy.
2. Type 2 Diabetes (which was diagnosed before becoming pregnant).
If the mother's type 2 diabetes was being controlled with tablets before the pregnancy, these should be stopped as soon as she finds she is pregnant, and her treatment changed to insulin. After the birth and subject to medical checks, the mother would normally return to the oral medication and cease taking insulin.
3. Gestational Diabetes.
If gestational diabetes is diagnosed in the second half of pregnancy, the changes necessary are the same as for the type 2 diabetic when they are first diagnosed. In other words, treatment will be necessary, but will depend on the degree of diabetes. In other words, the first step is to attempt to control the diabetes with diet, and if this fails to stabilize blood glucose levels, oral medication would normally be prescribed, and if that fails to rectify the situation, insulin.
However, oral medications when pregnant should not be taken, so if diet does not work, the patient should be put straight onto insulin. After the birth, the mother can usually stop any form of diabetic treatment.
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