Pregnancy if You Have Diabetes TOP 10 FAQs | Diabetes and Pregnancy

Why should pregnant women with diabetes take folic acid?

There is a link between the presence of diabetes in the mother and the development of neural tube defects (‘spina bifida’) in the baby. Much research has shown that taking folic acid significantly reduces the risk of the baby developing spina bifida.

Does the birth have to be initiated in the case of diabetes?

Diabetes increases the risk of the baby dying before delivery, especially in children who are too big. Especially after 35 weeks of pregnancy, with a peak around the 37th to 39th week. The risk of macrosomy (growing too tall) has also increased. Especially with diabetes, the latter is a problem because the baby’s shoulders grow more than the head, which increases the risk of shoulder dystocia. Introduction at 38 weeks seems to reduce the risk of macrosomy and shoulder dystocia.

In the case of diabetes, should the delivery take place by caesarean section?

No, that’s not necessary. However, if the birth weight is estimated by ultrasound at 4250-4500 grams in women with type 1 diabetes, the risk of developing shoulder dystocia in the baby is 25%, and thus strongly increased compared to women without diabetes. For this reason, it is advised that in the case of a high estimated birth weight of babies of women with type 1 diabetes, birth should take place by means of a planned Caesarean section.

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Is the baby ‘mature’ in the event of an early initiation or an early Caesarean section?

There is a chance that the lungs in particular are not ‘mature’. As a result, the baby may have difficulty breathing in particular. For this reason, if a Caesarean section is planned for a pregnancy of < 39 weeks, or in the event of an early initiation, the lung’s ‘maturity’ must be determined. If the lungs are insufficiently mature, corticosteroids must be administered beforehand, and careful thought must be given to whether premature birth is really desirable. Treatment with corticosteroids reduces the risk of developing respiratory distress syndrome.

What is considered too low a blood sugar level in the newborn baby?

Opinions differ about the exact borderline of what can be called hypoglycaemia and what not. In general, a blood sugar level of < 2.6 mmol/l is considered too low. Others say that 2.0 mmol/l is the lower limit, especially if there are no symptoms. It can therefore be said that an occasional blood sugar level between 2.0 and 2.6 can be considered not dangerous. Nevertheless, it is advised to aim for normal blood sugar, for example by administering extra food.

Does hypoglycaemia often occur in newborn babies?

Yes, hypoglycaemia is remarkably common. It is estimated that more than 60% of mothers with type 1 diabetes experience a hypo of < 2.6 mmol/l and more than 40% a hypo of < 2.0 mmol/l. In mothers with type 2 diabetes, the risk of hypoglycaemia of the newborn baby is more than 50%. Perhaps it is somewhat reassuring that hypoglycaemia is also common in children of mothers without diabetes.

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Does hypoglycaemia in the newborn have consequences for later?

In principle, it does not. Under normal circumstances, in addition to glucose, the body also has other substances in the blood, such as lactate and ketone bodies that can serve as fuel for the brain. In exceptional cases of severe and prolonged hypoglycaemia, however, damage may occur in the form of mental retardation and/or epilepsy. Often there is more to it than just hypoglycaemia.

I inject insulin 4 times a day. Can I inject the insulin into my abdomen now?

Yes, insulin can be injected into the abdomen as usual. It’s not harmful to the baby.

I have a doctor’s appointment with my husband because I want to get pregnant. What needs to be discussed?

The doctor is going to talk to you about the importance of good blood sugar regulation before you get pregnant. In particular, the possible consequences of insufficient regulation such as the baby becoming too big, premature birth and congenital abnormalities will be discussed. The importance of good blood pressure and the role of prenatal diagnostics will also be discussed. Furthermore, the doctor will talk to you about the influence of pregnancy on complications such as retinopathy and nephro patie. Finally, it is important to talk about medication: what is allowed, what is not, and how the medication should be changed.

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I am pregnant and have type 1 diabetes, my husband has it too. Will my child get it now?

If only you would have diabetes, the chance of your child getting type 1 diabetes would be about 3%. If only your husband had type 1 diabetes and you didn’t, the chance would be about 6%. In the case like yours that both the father and the mother have type 1 diabetes, the chance that the child will get diabetes is about 30%.

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Pregnancy if You Have Diabetes