For a woman with diabetes the key to successfully delivering ay baby is in meticulous control of her blood sugar levels. This applies not only to the pregnancy itself but also to the months preceding conception. Poor control of has been shown to be related to congenital abnormalities and intra-uterine and neonatal deaths. It may also result in maternal problems such as polyhydramnios and .
Diabetic pregnant women are given special advice on how to achieve good control through diet and insulin administration, and the insulin dose is changed several times to suit the changing needs of pregnancy. Pregnancy affects diabetes because the need for insulin both increases and fluctuates widely, causing instability.
In some cases diabetes may affect pregnancy by making the foetus overweight – sometimes by up to 5 kg. During labour, which is often induced at about 38 weeks, the mother is usually given a glucose and insulin infusion to maintain diabetic control. Although normal delivery is the aim Caesarean section may be necessary, particularly because it is difficult to control diabetes throughout a long labour. With improved antenatal care and treatment, diabetes hardly poses any problem nowadays.
Occasionally, diabetes is diagnosed for the first time during pregnancy which is why urine samples are tested for excess levels of sugar at every antenatal visit.