Discussion about diabetes and pregnancy tends to focus on gestational diabetes, a type of diabetes that develops during pregnancy. But what are the implications for women with pre-existing Type 1 or Type 2 diabetes?

Having diabetes doesn’t mean a woman can’t or shouldn’t get pregnant, but it does mean she should take extra precautions, said Dr. Monica Selander, an OB/GYN who practices at the Myrtle Beach and Georgetown locations of Tidelands Health OB/GYN. Diabetes, especially if not properly controlled, can present risks to both mother and baby.

A major risk for a pregnant woman with diabetes is worsening gylcemic control, she says. That’s because the body naturally develops increased insulin resistance during pregnancy.

There’s also an increased risk of developing preeclampsia, of undergoing a cesarean section, of trauma during delivery due to increased newborn size and diabetic ketoacidosis (unusually high levels of ketones).

Uncontrolled diabetes in a mother can also threaten the health of a baby. These risks include an increased likelihood of stillbirth and birth defects; fetal macrosomia (abnormally large birth size); preterm labor; polyhydramnios (excessive accumulation of ambiotic fluid); hypoglycemia (low blood sugar); and hypocalcemia (low calcium) after delivery.

These risk factors are present regardless of whether the mother has Type 1 or Type 2 diabetes, says Dr. Selander.

“Although the pathology behind Type 1 and Type 2 diabetes is different, the risk factors for the mother and baby are very similar as they are the result of persistently elevated blood glucose levels,” she says.

To reduce risks for both herself and her child, a woman with diabetes should focus on proper management of the condition.

“The best action a woman with pre-existing diabetes can take is to have her blood sugar levels well controlled,” says Dr. Selander. “A healthy diet and exercise are key to achieving this, along with medical management, as appropriate. Maintaining a healthy body weight is also important because many cases of Type 2 diabetes are associated with obesity.”

It’s important for all women, but especially those with diabetes, to receive proper prenatal care from an OB/GYN or other qualified health care professional, Dr. Selander says. An OB/GYN can help develop a plan that’s right for each mother and baby.

“All the risks and poor outcomes associated with diabetes during pregnancy are directly related to how controlled the mother’s blood glucose levels are,” she says. “Well-controlled blood sugar kept at normal levels decrease the risks of every possible poor outcome.

“On the other hand, persistently elevated blood glucose levels that are poorly controlled increase the chances for adverse outcomes significantly. This is why it’s essential that patients with diabetes follow the dietary and medical regimens set by the woman’s care team.”