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Ominous Rise in Pre-Pregnancy Diabetes

Diabetes Is Linked to Miscarriage and Birth Defects
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That daughter, now 4 months old, is perfectly healthy -- which means Kaplan dodged a bullet, says Celia Dominguez, MD, assistant professor of gynecology and obstetrics at Atlanta's Emory University.

"Whether it's type 1 or type 2 diabetes, when it is not well controlled, even if the baby does make it there is a high risk of anomalies, ranging from 'mermaid' babies without bottom limbs to all kinds of other problems," Dominguez tells WebMD. "If mother's diabetes is not diagnosed or in poor control, it can mean significant handicap to the child."

Although Lawrence's study did not distinguish between type 1 and type 2 diabetes, both she and Dominguez believe the increase in prepregnancy diabetes is due to a surge in obesity-linked type 2 diabetes.

Dominguez says several trends are crashing together: growing obesity, a delay in pregnancy, and a tendency for everyone to get heavier as they get older.

"We are literally now changing the face of pregnancy to encompass a little more high risk," she says. "And with that increase in maternal weight unfortunately come other problems like high blood pressure. So do I see more pregnant women with type 2 diabetes than I did two decades ago? Yes."

Diabetes Control Important Even If No Pregnancy Planned

Half of all pregnancies are unplanned, Lawrence says. This means that sexually active women of childbearing age should keep their diabetes under tight control even if they aren't currently planning to have a baby.

Here are some tips from Kaiser Permanente.

Even if you aren't pregnant:

  • Get screened for diabetes with a fasting blood sugar test or the glucose tolerance test.
  • If you have type 1 or type 2 diabetes, work with your health care professional to get your blood sugar under control.
  • If you have prediabetes or type 2 diabetes and are overweight, work on reducing your weight before becoming pregnant.

If you are pregnant:

  • Discuss screening for gestational diabetes with your doctor. Some women might need to be screened at the beginning of their pregnancy and others between 24 and 28 weeks of pregnancy.
  • If you are pregnant with diabetes, work with your provider on reducing your blood sugar to the goal range and establish a routine of exercise like walking. Always talk with your doctor before you start exercising.
  • After giving birth, women with gestational diabetes should have their blood sugar level tested to make sure it returns to normal.
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