Managing Pre-Existing Diabetes During Pregnancy

Our Obstetrics Clinic has a team dedicated to caring for women who have diabetes during pregnancy. On Friday mornings, we see patients who have diabetes prior to becoming pregnant, including those with: 

• Type I diabetes who take multiple daily insulin injections or are on insulin pumps
• Type II diabetes

Our goal is to manage your diabetes properly to minimize its effects on you or your baby. If diabetes is not managed properly, it can affect your baby in several ways:

• Macrosomia - a baby that is considerably larger than normal. The baby may be injured during birth due to the baby's large size and difficulty being born.
• Hypoglycemia - Low blood sugar in the baby immediately after delivery. If the level is too low, it may be necessary to give the baby glucose intravenously.
• Respiratory distress - Too much insulin or glucose in a baby's system may delay lung maturation and cause breathing difficulties in babies. This is more likely if they are born before 37 weeks of pregnancy.

Helping Diabetic Women Plan a Pregnancy

We help diabetic women who are not yet pregnant achieve optimum blood glucose control for conception. Our evaluation and monitoring may include:

• 24 hr urine protein test
• Thyroid function testing
• Consultation with Dr. Jeffrey Faig, including a:
  • Review of your entire diabetes history and treatment
  • Discussion of management options, including an insulin pump

Treatment of Diabetes During Pregnancy

Our diabetes team will work with you to create an individualized care plan, specific to your needs. Some common treatments include:

• Dietary changes, focusing on the amount of carbohydrates you eat
• Mild exercise, such as walking after meals
• Monitoring your blood glucose at home
• Insulin injections
• Insulin pump

We may also recommend:

• Fetal echocardiogram 
• Third trimester testing
• Growth scans – ultrasounds to make sure your baby is growing normally
• Counseling regarding mode and timing of delivery, etc.

Visits

All patients will see Dr. Jeffrey Faig, an obstetrician/gynecologist and endocrinologist, who also has expertise in treating patients with diabetes and other hormonal disorders. You will see Dr. Faig at least every two weeks during your pregnancy. Type 1 diabetes patients on insulin pumps or Type 2 patients that require additional care may be seen every week, if necessary. You will also meet with other members of the Diabetes team to review blood glucose levels as necessary.
 
In addition, the Diabetes Nurse and/or Health Educator see patients who:

• Have to go on a special diet
• Have a home glucose monitor
• Need insulin injections