by Ariana Pichardo-Lowden, M.D.

A healthy pregnancy and a healthy baby are the goals of every pregnant woman.  Recognizing the risk for developing diabetes during pregnancy before conception is important and can help women take important measures to preserve their health and the health of their babies.  Prediabetes is very common but also frequently unrecognized. There are many successful strategies to help control prediabetes and prevent its progression to type 2 diabetes.

Woman with prediabetes or at risk for prediabetes have a greater chance of developing diabetes during pregnancy.  High sugar level during pregnancy, also called gestational diabetes (1), may be transient but can also predispose to subsequent type 2 diabetes.  Gestational diabetes occurs when the body cannot make enough insulin during pregnancy, or the insulin does not function well enough to allow blood sugar to enter efficiently in the body cells to produce energy.  This is called insulin resistance.  This is influenced in part by hormones from the placenta that circulate during pregnancy.  Having prediabetes before gestation will increase the risk of insulin resistance during pregnancy.

According to the National Institutes of Health statistics, as many as 10% of pregnant women in the United States develop gestational diabetes.  Diabetes during pregnancy can negatively affect the health of women and their babies.  High sugar levels around the time of conception increase the risk of childbirth defects, preterm birth, and stillbirth.  Having high sugar levels during pregnancy raises the risk of needing a cesarean delivery, and also increases the risk of the baby being born too large, which is called macrosomia.  It also increases the risk of the baby developing type 2 diabetes and obesity in the future.

If you are a woman of childbearing age and think that you may be at risk for diabetes or prediabetes [read also Prediabetes Awareness (1)], don’t wait.  Assess your risk factors (2), talk to your healthcare provider, and take early action to improve your sugar metabolism before getting pregnant.  Preconception care and control of prediabetes can make a difference in the health of mothers and their babies.

Sources: (1) https://www.cdc.gov/diabetes/bahttp://www.cdc.gov/prediabetes/pdf/Prediabetes-Risk-Test-Final.pdfsics/gestational.html; (2) www.cdc.gov/prediabetes/pdf/Prediabetes-Risk-Test-Final.pdf