Diabetes is the most prevalent complication in pregnancy. The goal of all pregnancies is a healthy outcome for mom and baby. Diabetes adds a unique set of challenges to pregnancy.
Pregnancy complicated with diabetes incudes two groups. The first is women with pre-existing diabetes. This group includes both type 1 diabetes and type 2 diabetes. The second group is women with gestational diabetes. Gestational diabetes is diabetes diagnosed during the second or third trimester of pregnancy, and not clearly type 1 or type 2 diabetes.
Greater attention to diabetes self-management and intensive insulin therapy in both groups of women have resulted in improved maternal blood glucose control. This means better outcomes for both mother and child. In the United States, it is estimated that some form of diabetes complicates 6% to 7% of all pregnancies. Gestational diabetes makes up 90% of these cases and rates are increasing. These increasing rates are likely due to the prevalence of overweight or obesity in women of childbearing age.
Pre-conception counseling is a very important part of diabetes care for women of childbearing age with existing diabetes. This counseling helps identify and manage risk that can affect the pregnancy outcome. Complications decrease when a pregnant woman enters pregnancy with optimal glucose levels. Women of childbearing age with diabetes should maintain an effective method of contraception until a hemoglobin A1C level less than 6.5% is achieved. This assures the least risk of fetal abnormalities.