Diabetes and Pregnancy

Diabetes complicates about 8 percent of pregnancies each year. About 75 percent of these diabetic pregnancies are gestational diabetes—that is, the woman is diag­nosed as having diabetes during the pregnancy. Of the remaining, 23 percent involve preexisting type 2 diabetes and about 1 to 2 percent involves preexisting type 1 diabetes.

The issues surrounding preexisting diabetes are slightly different from those faced by women who first develop diabetes during pregnancy. Women who have diabetes before they become pregnant have to deal with glucose control at concep­tion and early in pregnancy. If there are any diabetes-related complications, these may also have an impact on the pregnancy. Women who have gestational diabetes are faced with learning all about diabetes, including watching their diet and taking insulin, while pregnant. This chapter gives you details on  both situations.

Planning Pregnancy with Preexisting Diabetes
Women with preexisting diabetes face a number of issues, which are discussed in the following sections.

FERTILITY

Recent studies suggest that fertility in women with type 1 diabetes is the same as in women without diabetes. Polycystic ovary syndrome (PCOS) is a risk factor for type 2 diabetes, and women with this condition may have difficulty with ovulation and getting pregnant. Metformin, pioglitazone, and rosiglitazone can make the menstrual cycles regular and cause ovulation in women with polycystic ovary syn­drome. Metformin is frequently used for this purpose, and the medication is stopped when the woman becomes pregnant.

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