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Navigating Pregnancy

by Quinn Phillips

Diabetes and pregnancy have never had an easy relationship in the public eye. Many people may remember the 1989 movie Steel Magnolias, in which Julia Roberts’s character dies from complications related to pregnancy and Type 1 diabetes — a storyline based on what happened to the author’s sister. But while having diabetes makes pregnancy and childbirth more complicated, it does not rule out the possibility of having a healthy baby.

Women who already have Type 1 or Type 2 diabetes are not the only ones who have to think about diabetes during pregnancy, however. Gestational diabetes is diabetes that first occurs during pregnancy and usually ends soon after a woman gives birth; it, too, demands a high level of attention and blood glucose control. For women with any type of diabetes, recommendations for blood glucose control are generally tighter during pregnancy than at other times due to the potentially harmful effects of high blood glucose on fetal development. But with sufficient planning and commitment, most women who want to have a baby can control their diabetes well enough to safely go ahead with pregnancy.

The following resources offer diabetes-focused as well as general information on pregnancy, and some provide opportunities to discuss challenges and concerns with other people.

Books
DIABETES & PREGNANCY: WHAT TO EXPECT
American Diabetes Association
Alexandria, Virginia, 2001
This book serves as an introductory guide for women with diabetes. Topics covered include stages of development of the fetus, insulin therapy, nutrition, exercise, and how to safely monitor a pregnancy.

BALANCING PREGNANCY WITH PRE-EXISTING DIABETES: HEALTHY MOM, HEALTHY BABY
Cheryl Alkon
Demos Health
New York, 2010
Scheduled to be published in March, this book features numerous accounts by women with diabetes of their experiences during pregnancy. Topics covered include successfully conceiving, finding the right doctor, what to expect during each trimester, and potential problems and complications. The author is a writer-researcher with Type 1 diabetes who writes the blog Managing the Sweetness Within (www.thesweetnesswithin.blogspot.com).

101 TIPS FOR A HEALTHY PREGNANCY WITH DIABETES
Patti B. Geil, MS, RD, FADA, CDE, and Laura B. Hieronymous, RN, MSEd, CPT, CDE
American Diabetes Association
Alexandria, Virginia, 2003
This book, part of the American Diabetes Association’s 101 Tips series, uses a question-and-answer format to cover such topics as pregnancy preparation, nutrition, and managing drugs during pregnancy.

GESTATIONAL DIABETES: WHAT TO EXPECT
American Diabetes Association
Alexandria, Virginia, 2005
This book serves as a general reference guide for women with gestational diabetes. It covers insulin and oral medication, monitoring blood glucose levels, and dietary considerations — including meal plans with various calorie levels, depending on individual needs.

MAYO CLINIC GUIDE TO A HEALTHY PREGNANCY
Harper Paperbacks
New York, 2004
This general guide to pregnancy includes a section on considerations for women with diabetes. It covers nearly every imaginable pregnancy-related topic and includes self-care tips, charts that explain how to handle symptoms, and a series of “decision guides” for choices that commonly arise during and after pregnancy.

Government agencies
NATIONAL DIABETES INFORMATION CLEARINGHOUSE (NDIC)
1 Information Way
Bethesda, MD 20892-3560
(800) 860-8747
TTY: (866) 569-1162
Fax: (703) 738-4929
ndic@info.niddk.nih.gov
www.diabetes.niddk.nih.gov
The NDIC, part of the National Institutes of Health, publishes both “For Women with Diabetes: Your Guide to Pregnancy” (http://diabetes.niddk.nih.gov/dm/pubs/pregnancy) — a comprehensive overview of concerns related to pregnancy and preexisting diabetes — and “What I need to know about Gestational Diabetes” (http://diabetes.niddk.nih.gov/dm/pubs/gestational) — describing what gestational diabetes is and how to manage it effectively; it also includes several links to other online resources. Both publications are available in Spanish. You can contact the NDIC to order paper copies of these brochures.

NICHD INFORMATION RESOURCE CENTER
PO Box 3006
Rockville, MD 20847
(800) 370-2943
TTY: (888) 320-6942
Fax: (866) 760-5947
NICHDInformationResourceCenter@mail.nih.gov
www.nichd.nih.gov/publications/pubs.cfm
The NICHD Information Resource Center, part of the National Institute of Child Health and Human Development, has two especially useful publications on gestational diabetes. One, “Am I at Risk for Gestational Diabetes?” (www.nichd.nih.gov/publications/pubs_details.cfm?from=&pubs_id=113) is a short brochure that explains the condition and its risk factors. The other, “Managing Gestational Diabetes: A Patient’s Guide to a Healthy Pregnancy” (www.nichd.nih.gov/publications/pubs_details.cfm?from=&pubs_id=297) is a 48-page booklet aimed at women already diagnosed with gestational diabetes; it outlines a general treatment plan that can be customized and implemented by a woman together with her health-care team. Both publications can be ordered in paper form by contacting the NICHD Resource Center.

Online information
JDRF: DIABETES (TYPES 1 & 2) AND PREGNANCY
www.jdrf.org/index.cfm?page_id=103524
This Web page is an overview of considerations and risks for women with diabetes who are or may become pregnant. Topics covered include prepregnancy health, insulin requirements, and other changes in medical care during and after pregnancy.

PREGNANCY WITH DIABETES: A DOABLE CHALLENGE
www.diabetesselfmanagement.com/Articles/Womens-Health/pregnancy_with_diabetes
This article on DiabetesSelfManagement.com describes the challenges and decisions that women with diabetes face as they consider pregnancy. The author combines an account of her own pregnancy with general information on the topic.

ACOG: DIABETES AND PREGNANCY
www.acog.org/publications/patient_education/bp051.cfm
This page from the American Congress of Obstetricians and Gynecologists describes how Type 1, Type 2, and gestational diabetes can affect pregnancy. It outlines precautions that can be taken at each step from before getting pregnant to after childbirth.

MANAGING PREEXISTING DIABETES DURING PREGNANCY
www.marchofdimes.com/pnhec/188_1064.asp
This page on the March of Dimes Web site features a checklist of considerations for women with diabetes who are planning to get pregnant. It also offers tips for during and after pregnancy to ensure the health of both mother and baby.

ABOUT.COM: PREGNANCY & CHILDBIRTH
http://pregnancy.about.com
This branch of About.com has articles, lists, diagrams, and videos on numerous pregnancy-related topics. Its section on pregnancy complications has some information and tips on preexisting and gestational diabetes.

KIDSHEALTH: PREGNANCY & NEWBORNS
http://kidshealth.org/parent/pregnancy_newborn/index.html
This section of the KidsHealth Web site has brief articles on a wide variety of topics, from the strictly medical to relationship and parenting concerns. It includes short articles on gestational diabetes and high-risk pregnancies (under “Pregnancy & Childbirth”).

Online discussion
DIABETESDAILY FORUMS: PREGNANCY
www.diabetesdaily.com/forum/pregnancy
This lively discussion forum has threads on topics ranging from insulin doses to morning sickness to sharing the news of a pregnancy or birth. Anyone can read the discussions; posting a message requires logging in as a member of the site, which is free to join.

DIABETES FORUMS: DIABETES AND PREGNANCY
www.diabetesforums.com/forum/diabetes-and-pregnancy
This forum covers a range of topics and has subforums for Type 1, Type 2, and gestational diabetes. It also requires (free) site membership to post a message.

DIABETIC MOMMY
www.diabeticmommy.com
This site features a discussion forum as well as reader-submitted “birth stories” and tips on diet, exercise, and parenting from a variety of sources.

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Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information provided on this Web site should not be construed as medical instruction. Consult appropriate health-care professionals before taking action based on this information.

 

 

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