Women with Type 1 diabetes can have a great pregnancy and a healthy baby. It takes work and planning but if the sugar is controlled prior to conception and kept regulated during the pregnancy for most women with Type 1 diabetes the chance that all will be fine is the same as if she did not have diabetes!
Someone with Type 1 diabetes who is planning a pregnancy needs to think of the impact of the pregnancy on their diabetes situation, the effect of the diabetes on the baby and then what happens blood sugars during pregnancy.
A woman with diabetes can have damage to the eyes, kidneys, nerves and circulation. Diabetic changes in the eyes and kidneys can in a small percentage of patients become worse during pregnancy, more so if there is already a lot of damage present. Nerve damage and circulation problems tend to hold steady. Some blood pressure medicines (ACE or ARB drugs) and cholesterol lowering statin drugs should not be used during pregnancy.
For the baby the critical period is the first six to eight weeks when all the vital organs are being formed. If the sugars are not well controlled there is an increased risk of a congenital malformation. If the sugars stay high for the rest of the pregnancy its as if the baby uses the sugar to make fat, the baby may be large and more difficult to deliver for both mother and baby. The baby that has got used to having lots of sugar may have a low blood sugar after birth. Assuming the father does not have diabetes the baby’s risk of Type 1 diabetes in the long term is about 3%.
During pregnancy the amount of insulin needed often decreases over the first 14 -17 weeks but then over the rest of the pregnancy it increases to usually one and a half times what was being taken prepregnancy. After delivery the amount of insulin required drops right back down to prepregnancy needs immediately.
Having a baby is exciting, having diabetes and being pregnant adds a worry but if the sugars are controlled especially during the first eight weeks and then for the rest of the pregnancy the chances are that the mom will get through it just fine and the baby will be healthy.