Diabetes and Pregnancy: Fluctuating Hormones and Glucose Management

Being pregnant is known to be a roller coaster of hormonal changes. If you have type 1 or type 2 diabetes, the hormonal thrill ride can also affect your glucose levels in unexpected ways.

Not only will your blood sugar readings likely be different from what you are used to, but they can also fluctuate week to week as your body goes through the different stages of pregnancy.

If you know what to expect, you can plan and talk over concerns with your doctors and dietician. Your diabetes-care team, who knows your history and needs, may have different recommendations than the ones offered here.

Unusual Tendencies

Your blood glucose levels may fluctuate in new ways through different stages of the pregnancy. For instance, during the first trimester, some women notice their glucose levels are lower than usual. This is why keeping all medical and obstetrics appointments, and asking relevant questions, are important.

If you have type 1 diabetes, your body’s need for insulin may increase, especially during the last trimester. This is owed to hormones produced by the placenta. The placental hormones help the baby grow but also block the effectiveness of Mom’s insulin, so she may need to take more.

If pregnant with type 2 diabetes, your physician might have already switched you from oral medications to insulin, or may recommend doing that now. The safety of oral diabetes meds during gestation has not been determined, and increased insulin resistance during pregnancy can lower the effectiveness of oral medications.

Insulin does not cross the placental barrier so it is safe to take during pregnancy.

Be Prepared for Blood Sugar Lows

Although keeping close control of blood sugar levels is necessary during pregnancy, some women find this makes them more vulnerable to hypoglycemia, or having dangerously low blood glucose. Pregnancy can also make symptoms of low blood sugar more difficult to detect.

You can maintain peace of mind by knowing how to manage hypoglycemia and being prepared for the possibility. Always carry a source of glucose with you (e.g., glucose tablets or gel, fruit juice), and have a glucagon kit with you at all times.

Glucagon kits provide an injection that will quickly remedy a hypoglycemic event. You, your family and friends, and those with you at work, should know the signs of hypoglycemia, where the glucagon kit is, and how to use it.

Be Prepared for Blood Sugar Highs

In certain stages of pregnancy, frequently the final trimester, some women notice higher than usual glucose readings. To protect yourself and the baby, know how to test for ketones (via blood or urine).

Ketones are acids that the body manufactures when burning its own fat. They indicate your blood sugar is too high and that your glucose management is in need of adjustment. If ketones are present and you feel unwell, contact your doctor or emergency services.

Sources: NHS; American Diabetes Association
Photo credit: Frank de Kleine

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