Pregnancy & Diabetes

If you have type 1 or type 2 diabetes, chances are, you learned about your condition before getting pregnant.

Even though you have diabetes, you can still stay healthy throughout your pregnancy and have a healthy baby. That said, it’s important to lay the groundwork for a safe pregnancy, even before you get pregnant. To support a healthy pregnancy, try to:

• Have your blood glucose levels as close to normal as possible before conceiving.
• Lose weight if you’re overweight or obese. This can help improve your baby’s health.
• Tell your doctor right away if you’re pregnant or trying to get pregnant. This way your doctor can prescribe you medicine, if it’s needed.

Sometimes diabetes is diagnosed during pregnancy, usually around the 24th week. This is called gestational diabetes.

If you’ve been diagnosed with gestational diabetes, it doesn’t mean that you had diabetes before getting pregnant or that you’ll necessarily have it after you deliver your baby. In fact, most women’s blood glucose levels return to normal after they have their babies.

During your 24th and 28th weeks of pregnancy, your doctor will give you a routine screening, called the oral glucose tolerance test (OGTT) to check for gestational diabetes. The OGTT checks your blood glucose levels before and two hours after you drink a special liquid. With this test, your doctor can learn how your body processes glucose.

If your blood sugar level is high, your doctor will give you a glucose tolerance test to find out if you have gestational diabetes.

Our treatment approach is different for every patient — and varies depending on whether a patient is diagnosed with type 1, type 2, or gestational diabetes.

That’s because every one of our patients has unique healthcare needs. In general, we we’ve found these techniques help our patients, and their babies, thrive:

• Monitoring blood sugar: We ask our patients to monitor and record their blood sugar throughout the day. This makes sure their blood sugar levels stay in check. We also make sure your healthcare team monitors your blood sugar during labor and delivery.
• Nutrition counseling: Our team includes a registered dietitian who can prepare a specialized nutrition plan for you. You can work together to understand the types of foods you should eat, how much, and how often. A healthy diet can make a big difference in the health of you and your baby.
• Exercise plans: Regular exercise can help regulate your blood sugar levels, whether you had diabetes before pregnancy or not. Plus, exercise can give you more energy, help relieve physical pain during pregnancy, and support your mental wellbeing. An exercise physiologist will prescribe a doable exercise plan that includes activities you enjoy.
• Medication: Sometimes we prescribe oral or injected medications to support the pancreas and release insulin, or prevent the release of glucose from the liver. Your doctor will talk with you about available medication options and if they’re right for you.
• Closing watching you and your baby: If you’ve been diagnosed with diabetes, we’ll make sure to closely monitor your baby’s growth and development throughout pregnancy. Rest assured, we’ll do everything possible to help you have a healthy delivery and baby.

After delivery, your healthcare team will closely monitor you and your baby. You’ll be encouraged to feed your baby frequently in the hours after birth to help stabilize blood glucose levels. And, your team will check your baby’s blood glucose levels too.

Your doctors will also test your blood glucose levels before you leave the hospital. For many mothers with gestational diabetes, their blood glucose levels return to normal right away. But, whether they’ve returned to normal or not, your doctors will inform you about the risk of developing type 2 diabetes, as well as ways to prevent this condition.

In the months after you have your baby, your care team will continue to monitor you. Together, we'll watch for type 2 diabetes, and if you develop it, begin treatment and care. Our team understands this unique season of life — caring for a newborn. It’s exciting but can be stressful too. That’s why, when you visit Joslin, you’ll experience a unique support system who will not only care for you, but will encourage you as a mother.