Pregnancy And Diabetes: Pregnancy can significantly elevate blood glucose levels, particularly in the second and third trimesters. This is primarily due to the insulin resistance induced by placental hormones like human placental lactogen (hPL), cortisol, and progesterone, which support fetal development but impair insulin efficacy. Women with pregestational diabetes (Type 1 or Type 2) and those developing gestational diabetes mellitus (GDM) are especially vulnerable. Elevated maternal blood glucose increases the risk of adverse outcomes, including macrosomia, shoulder dystocia, neonatal hypoglycemia and preeclampsia.

In a conversation with Jagran English, Dr. Niti Kautish, Director - Obstetrics & Gynaecology, Fortis Escorts Hospital Faridabad explained how to take care of diabetes during pregnancy. 

How To Manage Diabetes During Pregnancy?

Maintaining tight glycemic control is essential to reduce the risk of maternal and fetal complications. Key management strategies include:

Glycemic Monitoring: Frequent self-monitoring of blood glucose (SMBG) is critical, focusing on fasting and postprandial levels. HbA1c levels are also monitored, though with caution, as they may not fully capture glycemic variability during pregnancy.

Medical Nutritional Therapy (MNT): A carefully designed diet incorporating complex carbohydrates, fibre and lean proteins, while limiting simple sugars, helps to minimize glucose fluctuations.

Physical Activity: Moderate exercise improves insulin sensitivity and supports glycemic control; however, activities should be tailored to individual tolerance and pregnancy risk factors.

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Tips To Manage Diabetes During Pregnancy (Image Credits: Canva)

Pharmacologic Interventions: Insulin remains the gold standard for managing diabetes in pregnancy, as it does not cross the placenta and allows for precise dosing adjustments to meet changing insulin requirements. Commonly used regimens include a combination of basal insulin and prandial insulin to manage both fasting and postprandial hyperglycemia. For some patients with gestational diabetes, oral agents like metformin are considered, though insulin is preferred for those with significant hyperglycemia or inadequate control with lifestyle interventions alone.

Frequent Obstetric Monitoring: Regular fetal growth scans, amniotic fluid assessments, and fetal heart monitoring are critical to detect potential complications early.

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