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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