Diabetes often begins long before pregnancy, and other times, it results from the body reacting to being pregnant (called gestational diabetes mellitus). As Los Angeles’s preeminent high-risk pregnancy specialist, Dr. Steve Rad is an expert on overseeing the potential complications of diabetes during pregnancy.
Poor control of diabetes during pregnancy increases the risk of congenital disabilities and other risk factors for the expectant mother.
What is diabetes?
Diabetes is a condition where the body cannot use the sugars and starches it takes in as food to make energy. The body produces too little or no insulin and cannot use it to change blood glucose into energy. As a result, extra sugar builds up in the blood (hyperglycemia) which can be harmful to the body.
Some ethnicities are at higher risk of developing diabetes. These include African Americans, Hispanic/Latino Americans, Asian Americans, Indigenous peoples, and Pacific Islanders.
Patients with a family history of diabetes are at higher risk of developing gestational diabetes – if they don’t already have diabetes.
There are three types of diabetes: type 1, type 2, and gestational diabetes.
What is type 1 diabetes?
Type 1 diabetes is suspected to be an autoimmune reaction that destroys the cells in the pancreas that make insulin. This dynamic can go on for years before any symptoms appear. Though the disease is not preventable, it can be managed with glucose monitoring and injected insulin.
Women with type 1 diabetes are able to have a normal, healthy pregnancy. However, it is imperative they control their blood sugar levels. Before becoming pregnant, discuss a strategy with your health care provider and be sure to attend all follow-up appointments.
Work with your doctor to keep your A1C levels (the amount of insulin sticking to red blood cells) as low as possible. Though the A1C measurement is most accurately found during bloodwork, it is possible to estimate your A1C at home using an estimated Average Glucose (eAG) level chart. Be aware that your need for insulin may change during pregnancy; consider using a continuous glucose monitor.
Without proper blood sugar control during pregnancy, severe complications may occur.
What is type 2 diabetes?
Type 2 diabetes is when the pancreas makes sufficient insulin, but the cells don’t respond. Also called insulin resistance, the pancreas keeps pushing insulin into the bloodstream, but because cells cannot assimilate insulin, blood sugar still rises. Chronic high blood sugar can cause disastrous side effects such as heart disease, loss of vision, and kidney problems.
What is gestational diabetes mellitus?
Gestational diabetes occurs when the body is overburdened by pregnancy, and the pancreas does not produce an adequate insulin supply. At the same time, cells become insulin resistant, and high blood sugar readings may follow.
There is some degree of insulin resistance in all pregnant people during the third trimester. Women who begin pregnancy with some insulin resistance have an increased risk for gestational diabetes. Patients with gestational diabetes are at a higher risk of developing Type 2 diabetes.
Gestational glucose tolerance occurs in pregnant people who have never experienced problems with their blood sugar. Some women experience this disease with every pregnancy, others only once. Occasionally, patients struggle with beginning breastfeeding after gestational diabetes.
Some studies suggest the higher prevalence of gestational diabetes is related to maternal obesity.
Doctors typically test for gestational diabetes between 24 and 28 weeks of gestation. While sometimes patients will have to take insulin, gestational diabetes can also be controlled with a healthy diet, exercise, and other lifestyle changes.
What are the risks of diabetes in pregnancy?
High blood sugar readings are not good for the mother or baby. Without proper blood sugar control during pregnancy, severe complications may occur. These include:
Fetal macrosomia is a baby born larger than average. These babies’ weight is more than 8 pounds, 13 ounces at birth. Only about 9% of babies worldwide weigh this much. Risks increase if the baby weighs more than 9 pounds, 15 ounces.
This condition may make a vaginal delivery difficult or even impossible. Fetal macrosomia also increases the baby’s risk of health problems after birth.
Cesarean sections are much more prevalent in diabetic mothers. Because the baby is delivered through incisions in the abdomen and uterus, it takes longer for the mother to recover from birth.
Preeclampsia occurs only in pregnant patients. Typical symptoms include hypertension, a trace amount of protein in the urine, and swelling (edema) in the fingers and toes.
High blood pressure may harm the baby, and patients with diabetes are more prone to high blood pressure. Preeclampsia can cause the baby to be born preterm and with low birth weight and cause a seizure or stroke in the mother during delivery.
Low blood sugar can occur in patients who take insulin or diabetes medications. Low blood sugar is an acute disease and can be fatal if not addressed immediately.
This condition can be avoided by keeping blood sugar under control. If the expectant mother does develop hypoglycemia, the baby must be monitored for low blood sugar immediately after delivery.
Ideal “diabetes in pregnancy” diet
Eating a proper diet for diabetic pregnant women can be the key to a healthy delivery.
Dr. Rad will assist you in constructing the proper diet during diabetic pregnancy. However, there are several basic diet rules to follow:
Why choose Dr. Steve Rad and the Los Angeles Fetal and Maternal Care Center?
Did you know that all pregnancies in the United States are at risk of becoming high-risk? Even a pregnancy that begins “low-risk” can become high-risk.
That is no secret to double-board certified Dr. Steve Rad, an Obstetrician-Gynecologist with sub-specialty training in Maternal-Fetal Medicine / Perinatology.
Dr. Rad has been named a top Maternal-Fetal Medicine specialist in Los Angeles by Los Angeles Magazine for six years in a row.
Dr. Rad has undergone rigorous training with high honors at renowned institutions including the Department of Obstetrics and Gynecology at David Geffen School of Medicine at UCLA, USC, Cedars-Sinai Medical Center, and UCSF Medical Center, as well as centers internationally in London, Austria, Israel, and Africa.
Dr. Rad is passionate about neonatal obstetrics and gynecology while using his proficiency to guide high-risk mothers with prenatal testing, special monitoring, and diligent care during their pregnancy up to and including the birth of their baby.
Call us at (844) 473-6100 or schedule your consultation online. We are currently accepting new patients.
We are conveniently located for patients throughout Southern California and the Los Angeles area at locations in or near Beverly Hills, Santa Monica, West Los Angeles, West Hollywood, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, Newport Beach, Irvine, and Downtown Los Angeles. We also offer in-home prenatal care and a fly-in program for out-of-town and international patients. Dr. Rad even travels to patients who need him throughout the U.S. and around the world.
If you can’t make it to Dr. Rad, he also offers virtual consultations worldwide.