{"id":13231,"date":"2014-08-12T00:00:00","date_gmt":"2014-08-12T04:00:00","guid":{"rendered":"https:\/\/www.diabete.qc.ca\/simpliquer\/votre-impact\/soutien-de-la-recherche\/pregnancy-in-women-with-type-1-or-type-2-diabetes\/"},"modified":"2023-06-01T14:32:24","modified_gmt":"2023-06-01T18:32:24","slug":"pregnancy-in-women-with-type-1-or-type-2-diabetes","status":"publish","type":"page","link":"https:\/\/www.diabete.qc.ca\/en\/diabetes\/living-with-diabetes\/pregnancy-and-hormonal-changes\/pregnancy-in-women-with-type-1-or-type-2-diabetes\/","title":{"rendered":"Pregnancy in women with type 1 or type 2 diabetes"},"content":{"rendered":"<div class=\"classic-block\">Being well-prepared for pregnancy can help reduce the risk of complications, keep you healthy throughout your pregnancy, and give your baby a good start in life.<\/p>\n<p>Blood\u00a0glucose\u00a0(sugar) control is a daily challenge for people with diabetes. Hormonal changes during pregnancy make diabetes even more challenging.<\/p>\n<p>The majority of women who properly control their diabetes before and during pregnancy have successful pregnancies, and give birth to beautiful, healthy babies.<\/p>\n<h2>Risks and potential complications<\/h2>\n<p>Women with diabetes have a higher risk of miscarriage and of having a baby with birth defects (heart and kidney defects, for example). This risk significantly increases if blood glucose (sugar) control is not optimal, especially at conception and during the first 3 months of pregnancy, when the baby\u2019s organs are forming.<\/p>\n<p>If your blood glucose (sugar) levels are poorly controlled, you should avoid becoming pregnant until your healthcare team has helped you improve your blood sugar control.<\/p>\n<p><strong>Risks for the mother:<\/strong><\/p>\n<ul>\n<li>Miscarriage<\/li>\n<li>Rapidly worsening\u00a0retinopathy\u00a0(damage to the retina caused by diabetes)<\/li>\n<li>Rapidly worsening\u00a0nephropathy\u00a0(kidney damage caused by diabetes) and kidney failure<\/li>\n<li>A more difficult vaginal delivery (because of the baby\u2019s weight) requiring special maneuvers by the obstetrician or the use of forceps or suction<\/li>\n<li>Caesarean delivery<\/li>\n<li>Gestational hypertension and pre-eclampsia (a pregnancy complication characterized by\u00a0high\u00a0blood pressure\u00a0and significant swelling)<\/li>\n<li>Excess amniotic fluid, which can cause premature labour<\/li>\n<\/ul>\n<p><strong>Risks for the baby:<\/strong><\/p>\n<ul>\n<li>Defects (especially if the diabetes is poorly controlled in the first 3 months of pregnancy) of the heart, kidneys, urogenital tract, brain, spinal cord and backbone<\/li>\n<li>Higher-than-average birth weight (more than 4 kg or 9 lbs.) or, conversely, sometimes stunted growth and low birth weight<\/li>\n<li>Premature birth<\/li>\n<li>Difficulty breathing at birth because of delayed lung maturity, among other factors<\/li>\n<li>Hypoglycemia\u00a0at birth, all the more severe if the mother\u2019s diabetes was poorly controlled in the days\/weeks prior to the birth<\/li>\n<li>Jaundice<\/li>\n<li>Calcium deficiency in the blood at birth<\/li>\n<li>Malfunction in the production of red blood\u00a0cells\u00a0(polycythemia or hyperviscosity)<\/li>\n<li>Perinatal death<\/li>\n<\/ul>\n<p>All of these complications occur almost exclusively when the mother\u2019s diabetes has been poorly controlled.<\/p>\n<p>With the intensification of treatment for women with diabetes, the mortality of newborns has decreased significantly, but remains slightly higher in women with poorly controlled diabetes, especially if they have episodes of ketosis, ketoacidosis or hypertension during pregnancy.<\/p>\n<h2>How to reduce the risks<\/h2>\n<p>Strict blood sugar control from preconception to delivery and close monitoring by a multidisciplinary team in a specialized centre can greatly reduce most of these risks.<\/p>\n<p>It is advisable for diabetic women who want a child to keep their\u00a0glycated\u00a0hemoglobin (A1C), below 7.0 % (even below 6.5 % if possible) to reduce the risk of complications and deformities. This may seem a tall order, but it is achievable. If you can\u2019t reach that number, remember that any decrease in A1C whatsoever improves your chances of having a healthy baby.<\/p>\n<p>Note: \u00a0women with A1C above 10.0% should seriously consider delaying pregnancy until they reach their blood glucose (sugar) targets.<\/p>\n<p>To help you succeed, your doctor may suggest increasing or modifying your current treatment. For some women with type 2 diabetes, it is sometimes advisable to start\u00a0insulin\u00a0treatment prior to pregnancy to ensure better blood glucose (sugar) control.<\/p>\n<p>Be aware that stricter control of blood glucose using antidiabetic medication or insulin may increase the risk of hypoglycemia. In short, women with diabetes who are planning a pregnancy and who need antidiabetic medication or insulin should monitor their blood glucose (sugar) levels more frequently to avoid\u00a0hyperglycemia\u00a0and hypoglycemia.<\/p>\n<p>Women with type\u00a01 diabetes are also advised to test for ketones in their urine or blood when their blood glucose (sugar) level stays high for several hours. Ask your healthcare provider to show you how to do this test.<\/p>\n<h2>Attaining a healthy weight<\/h2>\n<p>Overweight women are more at risk for fertility problems and pregnancy complications. Before becoming pregnant, all overweight women should try to reach a\u00a0<a href=\"https:\/\/www.diabete.qc.ca\/en\/diabetes\/the-life-with-diabetes\/weight-management\/weight-management-in-adults\/\" target=\"_blank\" rel=\"noopener noreferrer\">healthy weight<\/a>\u00a0(a BMI between 18.5 and 25), particularly women with type\u00a02 diabetes.<\/p>\n<p>Losing 10% of your body weight at a slow and gradual pace, even if you don\u2019t reach your healthy weight, will still have a positive impact on your fertility and limit birth complications. Overweight women are advised to seek advice from a dietitian or kinesiologist to help them lose weight and increase their\u00a0physical activity.<\/p>\n<h2>Care of the eyes and kidneys<\/h2>\n<p>People with diabetes are at risk of developing eye and kidney complications, and these risks increase during pregnancy. That is why diabetic women wishing to become pregnant should have an eye exam and their kidney function tested prior to conception. It is recommended that you see your\u00a0ophthalmologist\u00a0or optometrist if you have not had an eye exam in the last six months.<\/p>\n<p>If you suffer from eye or kidney complications, they should be treated and controlled before conception so that they do not become worse.<\/p>\n<p>Before becoming pregnant, it is also important that your blood pressure (hypertension) is properly controlled. Hypertension causes a rise in the pressure of the small blood vessels in the eyes and kidneys, which makes them fragile. It can also have a negative impact on the development of the placenta during pregnancy and cause complications.<\/p>\n<h2>Folic acid<\/h2>\n<p>Folic acid (folate) is an important vitamin in the prevention of brain and spinal-cord defects (spina bifida) in babies. Most women get their daily requirement of folic acid by eating a varied diet.<\/p>\n<p>Folic acid is found in leafy green vegetables, fruits, nuts, bread and cereals. In addition to eating a balanced diet, it is recommended that all diabetic women who want a child start taking a supplement of 1 mg per day of folic acid at least three months before conception and continue taking this supplement for at least the first 3 months of pregnancy.<\/p>\n<p>Consult your pharmacist for advice about taking a folic acid supplement.<\/p>\n<p style=\"text-align: center;\">_______________________________________<\/p>\n<p><strong>Research and writing:<\/strong> Diabetes Qu\u00e9bec team of health care professionals<\/p>\n<p><strong>Excerpted from:<\/strong> Diabetes Qu\u00e9bec (2013),\u00a0<em>Diab\u00e8te et grossesse.<\/em><\/p>\n<p><strong>Other reference:\u00a0<\/strong>Feig D, Berger H, Donovan L et al. Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada: Diabetes and Pregnancy. Can J Diabetes 2018; 42 (Suppl 1): S255-S282.<\/p>\n<p>Last update: July 2018<\/p>\n<p>\u00a9All rights reserved Diabetes Quebec<\/p><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Being well-prepared for pregnancy can help reduce the risk of complications, keep you healthy throughout your pregnancy, and give your baby a good start in life. Blood\u00a0glucose\u00a0(sugar) control is a daily challenge for people with diabetes. Hormonal changes during pregnancy make diabetes even more challenging. The majority of women who properly control their diabetes before&hellip;<\/p>\n","protected":false},"author":1,"featured_media":17929,"parent":24321,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"7588,12762,12656,15794,9530,15732","_relevanssi_noindex_reason":"","footnotes":""},"class_list":["post-13231","page","type-page","status-publish","has-post-thumbnail","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.diabete.qc.ca\/en\/wp-json\/wp\/v2\/pages\/13231","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.diabete.qc.ca\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.diabete.qc.ca\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.diabete.qc.ca\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.diabete.qc.ca\/en\/wp-json\/wp\/v2\/comments?post=13231"}],"version-history":[{"count":6,"href":"https:\/\/www.diabete.qc.ca\/en\/wp-json\/wp\/v2\/pages\/13231\/revisions"}],"predecessor-version":[{"id":28691,"href":"https:\/\/www.diabete.qc.ca\/en\/wp-json\/wp\/v2\/pages\/13231\/revisions\/28691"}],"up":[{"embeddable":true,"href":"https:\/\/www.diabete.qc.ca\/en\/wp-json\/wp\/v2\/pages\/24321"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.diabete.qc.ca\/en\/wp-json\/wp\/v2\/media\/17929"}],"wp:attachment":[{"href":"https:\/\/www.diabete.qc.ca\/en\/wp-json\/wp\/v2\/media?parent=13231"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}