Diabetes and Pregnancy: Analyzing the Realities & Myths

Pregnancy is a critical period in a woman's life that considerably heightens their risk of contracting several health complications. It's no news that gestation provokes changes in the general female physiology.

Stefan Hartmann

2022 Oct 07

15 min read

Pregnancy is a critical period in a woman's life that considerably heightens their risk of contracting several health complications. It's no news that gestation provokes changes in the general female physiology.

Pregnant women are prone to developing abnormal blood sugar levels, high blood pressure, weight gain, and other hormonal and psychological changes.

Since glucose is the major fuel in the human body, significant changes in its concentration may result in problematic consequences for an expectant mother. Diabetes and low blood glucose levels are equally life-threatening to pregnant women.

In this light, we’ll discuss the relationship between diabetes and pregnancy, several crucial risk factors, ways to prevent or manage diabetes during pregnancy, and other relevant pieces of information.

After digesting this composition, you’ll realize the potential dangers of diabetes during pregnancy, how to avoid its occurrence or downplay its effects, and go on to have a healthy baby regardless of your blood glucose levels.

What to Expect

  • A Brief Recap of Diabetes
  • Types of Diabetes and Their Effects on Pregnancy
  • Factors Triggering Diabetes During Pregnancy
  • Dangers and Effects of Diabetes on Pregnancy
  • Treating and Managing Diabetes During Pregnancy
  • Popular Misconceptions About Pregnancy and Diabetes Resolved

A Brief Recap of Diabetes

diabetes and pregnancy

When people use the term “diabetes” loosely, they typically refer to diabetes mellitus. Diabetes mellitus is a chronic metabolic disease characterized by elevated blood glucose levels. It shouldn’t be confused with diabetes insipidus — a less common metabolic disorder related to salt and water balance.

The normal fasting blood glucose level—concentration of glucose in blood measured before a meal—ranges from 70 mg/dL (3.9 mmol/L) to 100 mg/dL (5.6 mmol/L). On two different tests, an individual is said to have diabetes if their blood sugar level is up to 126 mg/dL (7mmol/L).

Women with diabetes are likely to suffer several pregnancy complications, and some women without prior history of diabetes may experience prediabetic or diabetic symptoms during pregnancy.

Types of Diabetes and Their Effects on Pregnancy

diabetes and pregnancy

The American Diabetes Association classifies diabetes mellitus into three major categories depending on the cause of the disorder. They include:

These diabetes variants negatively affect pregnancy in different ways. In the subsequent paragraphs, we’ll adequately shed light on the role each of these complications plays in pregnancy.

Type 1 Diabetes and Pregnancy

Insulin deficiency is responsible for the high blood sugar levels in type 1 (insulin-dependent) diabetes. Normally, insulin—a peptide hormone—stimulates the conversion of blood glucose to glycogen and its storage in the liver and muscle cells. Hence, the hormone reduces blood sugar concentration.

Women with insulin-dependent diabetes can have a healthy pregnancy. However, it increases the odds of suffering diabetic complications, such as high blood pressure, digestive and kidney diseases, and vision loss. Women with diabetes may also have excessively large babies (macrosomia) and children with birth defects.

Expectant mothers with type 1 diabetes usually require insulin more often than those without complications. If your insulin needs aren’t properly met when pregnant, you and the unborn child may suffer severe consequences. As other sections unfold, you’ll recognize the dangers of untreated or mishandled diabetes.

Type 2 Diabetes and Pregnancy

In type 2 diabetes, although insulin production may be normal, the cells can’t effectively utilize the hormone. This disorder may be either due to reduced sensitivity of insulin receptors to the required hormone or an insufficient number of insulin receptors. Consequently, this insulin resistance results in high blood glucose levels.

According to the American Diabetes Association, type 2 diabetes is the most common form of the disease. As such, it’s a frequent occurrence in women of childbearing age.

Type 2 diabetes is linked to several complications, including obesity and polycystic ovarian syndrome (PCOS). Obesity and PCOS make conception more complex and are associated with infertility.

Similarly, uncontrolled insulin-resistant diabetes amplifies the risks of pregnancy challenges, such as preeclampsia (pregnancy-induced hypertension), macrosomia, and abnormally increased amounts of amniotic fluid. It may also lead to pregnancy loss, birth defects, and preterm delivery.

Considering these realities, diabetic mothers must watch their blood sugar levels before and during pregnancy.

Gestational Diabetes

Gestational diabetes occurs when women without a prior individual history of diabetes develop high blood sugar levels during pregnancy. Typically, the placenta produces hormones causing blood glucose to accumulate. However, this occurrence is usually counteracted by insulin.

In the case of gestational diabetes, the body can’t make sufficient amounts of insulin or stops using the hormone effectively, causing high blood sugar levels. Pregnancy-influenced elevated blood sugar may negatively affect the health of the expectant mother and the unborn child.

Although overweight and obesity often contribute to the disease, its exact cause is unknown. Gestational diabetes usually occurs without noticeable symptoms other than polydipsia (increased thirst), polyphagia (excessive hunger), and polyuria (frequent urination).

This type of diabetes poses serious dangers to the baby’s health, such as excessive birth weight, breathing problems, stillbirth, and early pregnancy. More concerning is that the mother with diabetes and the developing baby have a higher risk of acquiring type 2 diabetes later in life. Quite ironically, children whose mothers suffered gestational diabetes during their development may eventually contract hypoglycemia (low blood sugar).

Controlling the mother’s blood glucose levels during pregnancy can sustain maternal and fetal health and prevent the complications associated with pregnancy-associated diabetes.

Factors Triggering Diabetes During Pregnancy

diabetes and pregnancy

Several elements increase the chances of developing gestational diabetes and aggravate the effects of diabetes in pregnancy.

Some risk factors of diabetes to monitor before and during pregnancy include:

  • Overweight and obesity
  • Certain ethnic groups
  • Prediabetes
  • Maternal age
  • Family history of diabetes
  • History of gestational diabetes
  • PCOS and other conditions associated with insulin problems
  • Hypertension, high cholesterol, and heart diseases
  • History of having large babies
  • History of miscarriage, stillbirth, and birth defects

Let’s have a more in-depth view of how these factors make you likely to experience diabetes during pregnancy.

Overweight and Obesity

Overweight and obesity are often associated with diabetes and its related complications during pregnancy, especially gestational diabetes. Women that were overweight or obese before pregnancy may become insulin resistant when they get pregnant. Hence, they tend to come down with pregnancy-related diabetes.

Similarly, gaining excessive weight during pregnancy may also force you to develop diabetes.

Certain Ethnic Groups

Your likelihood of developing pregnancy-induced diabetes hinges partly on your ethnic group. Several studies have shown African-Americans, Asians, Hispanics, Pacific Islanders, Alaska Natives, and Native Americans have higher risks of diabetes during pregnancy. Still, you can’t categorically tell if you’re safe or not through your ethnic group.


Individuals with diabetes have a fasting blood glucose concentration of at least 126 mg/dL (7mmol/L). However, women with elevated fasting blood sugar levels (100 to 125 mg/dL or 5.6 to 6.9 mmol/L) but not high enough to be called diabetes—a condition known as prediabetes—have an increased risk of slipping into diabetes during pregnancy.

Maternal Age

Like most pregnancy-related complications, the risk of developing diabetes during gestation increases with the expectant mother’s age. Women older than 25 years are more prone to pregnancy-linked diabetes. Also, the effects of diabetes on pregnancy worsen as the woman ages.

Family History of Diabetes

Genes play a significant role in pregnancy-related diabetes. Thus, if some of your close relatives have experienced diabetes mellitus, you’re more likely to show diabetes symptoms when pregnant than those without a family history of the disease.

History of Gestational Diabetes

If you experienced diabetes in a previous pregnancy, you have a high chance of enduring a similar complication in a subsequent pregnancy.

Polycystic Ovary Syndrome (PCOS) and Other Conditions Associated With Insulin Problems

Polycystic ovary syndrome (PCOS) is a hormonal disorder causing the ovaries to be enlarged, with small cysts on their outer edges. The condition often makes the affected pregnant women more likely to experience critical complications. More significantly, pregnancy-related diabetes lies among its potential dangers to expectant mothers.

Most women with PCOS require treatment for insulin resistance, as the disorder often prevents the body from using insulin effectively. Other conditions affecting insulin production or activities in the body may also trigger diabetes during gestation.

Hypertension, High Cholesterol, and Heart Diseases

Pregnant women with abnormally elevated blood pressure (preeclampsia), high cholesterol levels, or heart diseases have an increased risk of high blood glucose concentrations.

History of Having Large Babies

If you previously had a baby weighing more than 9 pounds at birth (macrosomia), you’re more prone to experiencing diabetes during the next pregnancy.

History of Miscarriage, Stillbirth, and Birth Defects

You’re vulnerable to pregnancy-associated diabetes if you’ve lost a pregnancy, had a stillbirth, or delivered a child with a birth defect.

Dangers and Effects of Diabetes on Pregnancy

diabetes and pregnancy

Expectant mothers with diabetes are prone to various health issues. Sadly, diabetes doesn’t only put you at risk; the condition also threatens the unborn baby’s health.

Abnormally high blood glucose can harm the developing fetus during the first weeks of pregnancy, even before you realize you’re pregnant.

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Here are some dangers and negative effects of diabetes on pregnancy:

  • Preeclampsia
  • Digestive and kidney diseases
  • Respiratory issues
  • Miscarriage and stillbirth
  • Birth defects
  • Worsened diabetes symptoms
  • Excessively large babies (macrosomia)
  • Shoulder dystocia
  • Cesarean delivery

Let’s extensively go over these possible outcomes of diabetes during pregnancy.


According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), diabetes increases your risk of developing preeclampsia. Preeclampsia is a pregnancy-associated disorder causing hypertension and excess protein in one’s urine (proteinuria) during the second half of gestation. It’s a severe and life-threatening condition for the mother and baby.

Giving birth is the only practical cure for preeclampsia. If you have preeclampsia, your healthcare practitioner may induce delivery once your pregnancy is up to 37 weeks.

However, suppose you show signs of the condition before 37 weeks. In that case, you and your physician may attempt other alternatives to help your unborn child develop until it’s old enough to survive outside the uterus.

Digestive and Kidney Diseases

Pregnancy-linked diabetes can cause and aggravate digestive and kidney diseases. Gastroparesis—a digestive problem involving delayed stomach emptying—is a common diabetes complication. Similarly, kidney diseases, like diabetic nephropathy, are worsened in pregnancy.

Respiratory Issues

Gestational diabetes can cause babies to suffer breathing problems, such as respiratory distress syndrome (RDS) and transient tachypnea of the newborn when it’s born. These conditions occur due to diabetes-influenced preterm delivery preventing the respiratory organs from developing completely.

Miscarriage and Stillbirth

The National Institute of Health (NIH) reveals that diabetes increases the chances of losing pregnancy during the first trimester. High blood sugar can cause the baby to die in the mother’s womb in the last weeks of pregnancy (stillbirth).

Birth Defects

A baby’s vital organs, such as the brain, lungs, kidneys, and heart, begin forming during the first trimester of pregnancy. Elevated blood glucose at this early stage can trigger the birth of a child with birth defects affecting its brain, spine, or heart.

Worsened Diabetes Symptoms

Pregnancy deepens diabetes symptoms, such as diabetes-influenced kidney disease and vision problems.

Excessively Large Babies (Macrosomia)

Having diabetes during pregnancy can cause your baby to be born abnormally large — a condition known as macrosomia. Typically, affected newborns weigh more than 9 pounds.

Shoulder Dystocia

Shoulder dystocia occurs when diabetes-incited macrosomia forces a baby’s shoulder to get caught in the birth canal during delivery.

Cesarean Delivery

Diabetic macrosomia and shoulder dystocia often complicate the delivery process, pushing the health care practitioner to perform a cesarean section to save the mother and baby’s lives.

Preventing Gestational Diabetes

diabetes and pregnancy

You can reduce your likelihood of developing pregnancy-associated diabetes through various practices.

The National Institute of Health (NIH) cites some major means of preventing elevated blood glucose during gestation. They include:

Maintaining a Healthy Weight

Losing extra weight before conceiving can significantly decrease your possibility of acquiring diabetes during gestation if you’re overweight or leaning towards excessive weight. You may achieve a safe weight through healthy meals, routine exercises, and constantly watching your weight.

Being Physically Active

Constantly engaging in physical activities before pregnancy warms up your baby-accommodating infrastructure, preparing your body for a successful pregnancy.

Furthermore, being physically active during pregnancy can prevent the accumulation of toxic cholesterol in your body and help you maintain hormonal balance. This enables you to sustain a safe pregnancy.

General Body Checkup

Regularly performing a thorough checkup before pregnancy can help you assess your total body state and its readiness to support an unborn child. During pregnancy, routine checkups will enable you to determine your best next line of action at each point.

Your healthcare provider should examine you for the following before and during pregnancy:

  • Hypertension
  • Eye disease
  • Nerve damage
  • Heart disease
  • Blood vessel disease
  • Kidney disease
  • Thyroid disease

Treating and Managing Diabetes During Pregnancy

diabetes and pregnancy

Employing several measures from your last menstrual period until delivery can keep you and your baby healthy during diabetes-plagued pregnancy.

These treatment and management strategies for a heightened blood glucose concentration during pregnancy include lifestyle, dietary, and medical procedures.

Lifestyle Processes

The lifestyle approach to treating and managing elevated blood sugar during pregnancy involves:

Sustaining Target Blood Sugar Levels Before and During Pregnancy

Regular blood glucose monitoring and keeping your daily blood glucose level in a target range before and after conceiving can considerably tone down the effects of diabetes on your pregnancy. You should consult your healthcare team to know what targets are ideal for you.

The NIDDK recommends these blood glucose targets for most expectant mothers:

  • 95 mg/dL or less — before breakfast, at bedtime, and overnight
  • 140 mg/dL or less — 1 hour after meals
  • 120 mg/dL or less — 2 hours after meals

If you’re suffering from type 1 diabetes mellitus, your physician may suggest higher targets to avoid hypoglycemia (low blood glucose).

Alternatively, you can confirm if you’re meeting your targets through an A1C blood test. The test reveals your mean blood sugar concentration within the last 3 months. It’ll help if you strive for an A1C close enough to normal — preferably less than 6.5%.

Routine Exercises and Physical Activities

Frequent exercises and physical activities normalize blood flow and cholesterol levels, relieve stress, strengthen organs and tissues, and keep the developing fetus active. Being physically active also keeps your blood sugar concentration in a healthy range.

If you have diabetes, devote about 30 minutes, 5 days a week, to physical activities before pregnancy. Even simple brisk walking should suffice.

Quit Alcohol Intake and Smoking

Alcohol worsens the effect of diabetes on pregnancy and can lead to fetal alcohol syndrome. Meanwhile, smoking increases your chances of experiencing a stillbirth or preterm delivery. As a result, the National Institute for Diabetes and Digestive and Kidney Diseases (NIDDK) advises women with diabetes to abstain from alcohol and smoking during pregnancy.

Dietary Approach

Healthy meals and nutritional supplements validated by clinical trials may enable you to manage elevated blood glucose levels during pregnancy. Vitamin-rich diets and supplements are beneficial to expectant mothers with diabetes. If you have diabetes, you must start taking diets and supplements rich in folic acid (vitamin B9) at least a month before pregnancy.

Health professionals direct women with diabetes to consume a minimum of 400 micrograms (mcg) of folic acid before pregnancy and at least 600 mcg daily during gestation. Other minerals, such as iron, calcium, and multivitamins, can keep you and your unborn baby healthy.

Medical Procedures

Various medical procedures are available for effectively monitoring and managing diabetes during pregnancy. They range from simple medical care by a health care team to diabetes medications certified by a series of clinical trials.

Some beneficial medical strategies for pregnant women with diabetes, according to the National Institute of Health (NIH), include:

  • Taking low-dose aspirin in the form of oral medication to thwart or delay the onset of preeclampsia
  • Insulin injections for offsetting decreased natural insulin levels
  • Fetal echocardiogram for examining your unborn baby’s heart
  • Regular ultrasounds to monitor fetal development
  • Working with a complete health care team — an endocrinologist or diabetologist for effective diabetes care; an obstetrician well-versed in diabetes; a diabetes educator to enlighten you properly on the disease; a nurse practitioner for prenatal care; a licensed nutritionist to assist your meal planning; a trained psychologist to enable you to cope with stress and anxiety
  • Conducting blood tests to check your blood sugar concentration, cholesterol levels, and ketones

Popular Misconceptions About Pregnancy and Diabetes Resolved

diabetes and pregnancy

Several myths about pregnancy-linked diabetes have been conceived and circulated since the 19th century. Here are some disproved misconceptions and unraveled truths about pregnancy and diabetes:

Misconception 1: It isn’t right for women with diabetes to get pregnant.

Reality: This myth was popular in the late 19th century. Although diabetes significantly complicates pregnancy, women with well-controlled diabetes can conceive and deliver safely.

Misconception 2: Gestational diabetes is lifelong.

Reality: A History of pregnancy-influenced diabetes makes you more likely to experience a similar condition in your next pregnancy. Yet, it isn’t a permanent disease and soon resolves after delivery and with appropriate disease control approaches.


diabetes and pregnancy

Even though diabetes makes pregnancy more difficult and vice versa, such conditions aren’t a death sentence if adequately treated and managed.

Babies born from a diabetes-associated pregnancy are more susceptible to obesity and type 2 diabetes later in life. So, adopt a healthy lifestyle, eat a balanced diet, routinely engage in physical activities, and regularly consult health care providers to lessen your and your child’s odds of developing these disorders.

Are you bothered about keeping up with your diabetes management routine during pregnancy? Our diabetes management app, Klinio, is one of your best bets for effectively managing diabetes when pregnant. It assists your meal planning processes, keeps you committed to your exercise routine, helps with your weight management plans, and provides other blood sugar management features.

Written by

Stefan Hartmann

Stefan Hartmann attended the University of Central Florida while working as an Emergency Department Scribe with the goal of practicing medicine one day. He graduated Magna Cum Laude with a Bachelors's in Sports & Exercise Science in 2015. He continued working full time and immediately began work as a Master Trainer at LA Fitness. There he helped clients of all ages and abilities achieve their fitness goals through one-on-one personal training. He then moved to Massachusetts and completed the Physician Assistant Program at Bay Path University from 2016-2018. He has been working as a PA in Urgent Care and Primary Care. Stefan is a firm believer that chronic disease is 100% reversible through Nutrition, Exercise, and the right supplements and alternative modalities.

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