Type 1 Diabetes and Pregnancy
This article will cover everything you need to know about Type 1 diabetes and pregnancy.
Deciding to have a baby is a big decision for most people, and for women with Type 1 diabetes, it’s one which means a lot of thought and planning. Taking care of your health and that of your baby is important, as it is for all pregnant women, and if you have Type 1 diabetes it’s crucial.
Type 1 diabetes can be difficult to manage on its own, and a pregnancy can complicate it further. Yet many women have successfully met the challenges of diabetes during pregnancy, and have enjoyed healthy pregnancies and healthy babies.
What Is Type 1 Diabetes?
Previously known as insulin-dependent or juvenile diabetes, Type 1 diabetes is an autoimmune disease. The body’s immune system attacks and destroys the cells in the pancreas that produce insulin. Insulin helps the body to process a type of sugar (glucose) to create energy.
In Type 1 diabetes, the body doesn’t produce insulin, and without it the body’s cells can’t convert glucose (sugar) into energy. Science doesn’t know what causes this autoimmune condition, and there is no prevention or cure.
Symptoms of Type 1 diabetes include:
- Excessive thirst
- Passing more urine
- Feeling tired and lethargic
- Constant hunger
- Slow healing of wounds and cuts
- Skin infections
- Blurred vision
- Unexplained weight loss
- Mood swings
- Feeling dizzy
- Leg cramps
These symptoms can occur suddenly, and usually first affect people under the age of 30. People with Type 1 diabetes need to replace the insulin their bodies can’t make every day. To manage the condition, they must test their blood glucose levels several times daily, and maintain a healthy lifestyle.
Getting Pregnant With Type 1 Diabetes
Research has shown those with Type 1 diabetes have fewer children than their siblings who are unaffected. Uncontrolled blood glucose levels are also associated with an increased risk of miscarriage so, where possible, it’s important to plan ahead if you want to get pregnant.
Speak to your care provider about planning for pregnancy with Type 1 diabetes. You will need to keep your blood glucose levels within your specific target range. Maintaining a health body weight and improving diet and exercise are other ways to increase your overall health and reduce your risk of complications during pregnancy.
Your care provider will also assess any other complications of diabetes you might have, such as high blood pressure, damage to kidneys, nerves or eyes, and problems with thyroid function. All medications you are taking will be reviewed as well, to make sure they are safe for use during pregnancy.
Risks Associated With Type 1 Diabetes and Pregnancy
There are several risks associated with Type 1 diabetes during pregnancy. Any existing conditions can worsen, including eye and kidney problems, or high blood pressure. Other risks for the mother include:
- Infections of the urinary bladder and vaginal area
- Preeclampsia (high blood pressure, usually with protein in the urine)
- Difficult labour and birth
High blood glucose levels during early pregnancy can have devastating effects on babies:
- Premature delivery
- Birth defects
- Macrosomia (having a large baby)
- Low blood glucose at birth (hypoglycemia)
- Prolonged jaundice (yellowing of the skin)
- Respiratory distress syndrome (difficulty breathing)
These risks can be reduced by keeping blood sugar levels under control before and during pregnancy.
What Is The Best Tip For Helping Yourself At Home?
Doctor Andrew Orr has a Masters in Reproductive Medicine and Women's Health, and is also a Nutritionist. He regularly sees women with pregnancy complications. When asked what is the very best tip he has for women who have Type 1 diabetes during pregnancy, he says, “Definitely follow a low GI grain-free diet”.
This means aiming for a whole foods diet (paleo is ideal) and getting rid of all breads, cereals, pasta, biscuits, and cake – anything with grains in it. Some diabetics find their blood sugar levels spike higher after eating grains than after eating chocolate! Eliminating grains can reduce the likelihood of further complications and help your pregnancy to be as healthy as possible.
Type 1 Diabetes Management During Pregnancy
Hormones play an important part in pregnancy and they can affect how your metabolism works. You might need to adjust your diabetes management as your pregnancy develops, especially as your insulin requirements can change.
Early in your pregnancy, your body might begin to use glucose more effectively than usual, meaning you will need less insulin. This can result in lower blood sugar (hypoglycaemia) at this time, especially if you have morning sickness and aren’t able to eat properly. Your usual symptoms of hypoglycaemia might also change at this time.
As your pregnancy develops, the placenta will take over providing nutrition to your baby. It also produces hormones which affect the ability of insulin to do its job. This can cause your body to become insulin resistant, and you might need to take more insulin. Your diabetes care provider will work with you to determine the best dose; some mothers-to-be need twice their usual amount of insulin.
In the last month or so of pregnancy, your insulin needs might change again and your dose drop accordingly. After the birth, your insulin requirements will drop dramatically compared with your needs during pregnancy.
All these changes mean you need to be on top of your diabetes management, to avoid any complications. Testing your blood glucose levels regularly and overnight, as needed, can help you monitor your levels and adjust your dosage as required. Your diabetes care provider will work with you to figure out the best routine for your situation.
Type 1 diabetes doesn’t mean you can’t have a healthy and positive pregnancy. You might need to take more care with your pre-conception health, and work closely with your care providers to avoid complications, and keep your diabetes well managed while pregnant. Managing Type 1 diabetes can be quite demanding during pregnancy, so make sure you have plenty of support.
Recommended Reading: Gestational Diabetes | Diet and Symptoms.