We are pleased to present the following book excerpt from Pregnany & Diabetes, by Marina Chaparro, RDN, CDCES, MPH.
How Is Type 2 Diabetes Different from Gestational or Type 1 Diabetes in Pregnancy?
Both type 2 diabetes and type 1 diabetes occur independent of pregnancy and are usually diagnosed before pregnancy. For that reason, you’ll often see the term “preexisting diabetes.” Unlike gestational diabetes, which is only diagnosed during pregnancy and goes away once you deliver the baby, type 2 diabetes is a chronic condition that needs to be managed for life. In gestational diabetes, about 70%–85% of cases can be treated with exercise and nutrition, which is not always the case for type 2; it’s certainly not the case for type 1 diabetes, in which taking insulin is essential due to the fact that the body does not produce it.
Pregnancy is considered an insulin-resistant state. Women with preexisting diabetes may have a harder time managing diabetes because of the expected rise in insulin resistance caused by pregnancy hormones. Exercise and nutrition may no longer be enough to keep blood glucose in target or compensate for the body’s increased need for more insulin. Preexisting diabetes will require constant diet and insulin adjustments. Regardless of the type of diabetes (gestational, type 2, type 1), the ultimate goal for all is to keep blood glucose as close to normal as possible. The risks of high blood glucose to the baby are similar in all types of diabetes.
How Does My Diabetes Affect My Baby?
When you live with diabetes, it’s especially important to make sure your numbers are in check before pregnancy, as those first 3 months are critical in your baby’s development. The goal is to keep blood glucose as close to normal as possible without enduring hypoglycemia. Consistently high blood glucose can put you and your baby at risk for serious health complications like preeclampsia, congenital abnormalities (heart defects), fetal macrosomia (large baby), neonatal hypoglycemia (low blood glucose at birth), birth trauma, or even spontaneous abortion.
One of the most critical periods for your baby is the first 14–56 days after conception. During this time, your baby’s organs—the lungs, heart, brain, ear, and so forth—are being formed. The problem is many women don’t realize they are pregnant until midway through their first trimester, meaning perinatal care will not begin until after week 10–12 when the critical formation period has passed. If you are overweight, have high blood pressure, or have any other chronic condition before pregnancy, it will be crucial to plan ahead and obtain the green light from your doctor to reduce any potential risks to your baby. And whether you have gestational, type 2, or type 1 diabetes, it’s essential to keep your blood glucose targets in check before, during, and after pregnancy.
The good news is that planning for conception will undoubtedly have a positive impact on your health and reduce the likelihood of any adverse event. In the next chapter, we’ll review in detail everything you need to know to get ready for pregnancy, including the preconception planning checklist, getting to know the pregnancy team, identifying and treating chronic complications, helping you achieve a healthy weight, and more.
Pregnancy & Diabetes contains information for those with gestational diabetes, type 2 diabetes, and type 1 diabetes. It also includes resources for all, such as recipes, snack ideas, meal plans, myths and realities, and more. You can find the book for purchase on Amazon.
Marina Chaparro, RDN, CDCES, MPH, is a nationally recognized bilingual registered dietitian, diabetes educator, and spokesperson. She is a certified diabetes educator and founder of Nutrichicos, a bilingual nutrition practice specializing in children and family nutrition based in Miami, FL. Her advice is frequently featured in outlets such as Parent’s magazine, Huffington Post, Medscape, Oprah, The New York Times, Miami Herald, Univision and more. She also
contributes to On Track Diabetes and is a frequent speaker at local and national conferences on topics such as infant nutrition, Latino health issues, and diabetes.
Marina lives with type 1 diabetes herself and loves teaching kids and families how to thrive with type 1 diabetes. She is a member of the pediatric endocrinology team at Joe DiMaggio Children’s Hospital, where she provides comprehensive diabetes education to children and families and instructs patients on the latest diabetes-care technology advances. Marina is a graduate of Boston University, earned a master’s degree from Florida International University and holds a specialty certificate in pediatric weight management. Find Marina on Twitter @nutrichicos, on Facebook at Nutrichicos- Nutrition for Children & Families, on Instagram @nutrichicos, and on YouTube.