There is a diabetes epidemic. Many more people are at risk for diabetes everyday. Many women have not had prepregnancy care or have not had recent screening for diabetes, despite having an increased risk for diabetes. About 5-10% of women have diabetes when they get pregnant and just don’t know it. Uncontrolled diabetes during pregnancy can lead to many health problems for mother and baby.
The earlier in pregnancy an issue of abnormal glucose is diagnosed, the easier it will be to manage. Insulin needs increase by 2-3 times during the course of a pregnancy and diabetes will cause glucose levels will to dramatically increase if noticed. Diet, exercise, and other methods of managing glucose during pregnancy work more effectively when we start them prior to much higher glucose control.
Diabetes screening for people who are not pregnant and early pregnancy can be done with a fasting glucose, a glucose challenge test or a lab called an A1c which tells us an estimated average glucose. Many area programs caring for women during pregnancy have adopted some method using these tests.
What happens next?
If a woman is diagnosed with any elevation in glucose prior to or during pregnancy there is help. Registered Dietitians can help you to plan how eat in manner that helps meet nutritional needs and helps to control glucose. In most cases a referral to a CDE (Certified Diabetes Educator) to learn more about the diagnosis of diabetes, exercise, self-blood glucose monitoring, and other aspects as well. Many times a specialist will be needed during pregnancy to help with medication or insulin management. There will likely be more monitoring during the pregnancy to screen for risks to the baby. When glucose levels are controlled in the normal range we can greatly reduce the risk of problems to mother and baby.
April Eddy, RN, CNS, CDE (APNP)
Diabetes Clinical Nurse Specialist for Perinatal Services