As a diabetic, what do I need to worry about during my pregnancy?
Dr. Keith Eddleman:
First of all, for yourself, you want to keep your finger sticks, your blood glucose as normalized as possible because uncontrolled diabetes can lead to an acceleration of your disease,an increase in the risk to your kidneys, to your eyes, and all the organs that are usually affected by diabetes.Nine months is a long time, and if you leave your diabetes uncontrolled for that period of time, then you can certainly do damage to your other organs.And from a fetal standpoint, there are several different risks.First of all, uncontrolled diabetes at the time that you conceive and the first part of the pregnancy when the baby's organs are forming,yields a significantly increased risk for congenital birth defects, for congenital abnormalities. And that risk is correlated with your level of something called hemoglobin A1C.It's a marker in your blood that gives a rough estimate of how high your blood glucoses have averaged over the past 60 days or so prior to the time that you get pregnant.And if you have an elevated hemoglobin A1C, there is as high as a 20 to 25 percent risk that you can have a baby with a congenital abnormality. So, that's the first risk to the fetus.And the second risk to the fetus from uncontrolled diabetes is fetal growth issues.Fetuses can grow either way too big, and not fit through the birth canal, and be at an increased risk for birth injury, or they can not grow well and be growth restricted.