The Big Three... ok, maybe Four.

First, we should really get the basics down. How does diabetes, and most specifically high blood glucose levels, affect the baby?

Well, we've got three definite relationships between mom's sugar and the baby and a less defined fourth relationship that's currently the focus of a TON of research.

1. Early, and I mean very. During the first trimester and more specifically the first ten weeks of pregnancy, your body is helping that baby develop all his or her organ systems. When mom has high sugar levels, so does the baby, and this can mess up organ formation.

Diabetic women have twice the risk of having a baby with a congenital heart defect (a problem with the heart's structure that forms because the heart doesn't develop correctly), neural tube defects (similar to congenital heart defects, but these involve the spine and brain and are often more serious) and some leg malformations.

But, the elevated risk goes right on down to that of a non-diabetic woman if blood sugar levels are kept in check! This is why doctors are keen to get every lady's Hb A1c test (a 3-month measure of glucose levels) to 7.0 or lower before conception.


2. Grow, Baby Grow, but Slow! After trimester one, a diabetic lady's main concern is keeping those sugars in control so she doesn't end up with a 16-pound baby that she can't possibly deliver naturally.

What's the connection between big babies and mom's glucose levels? The kid's insulin. That's right, despite you not making any (Type 1s) or not making enough (Type 2s) the kid is pumping it out and refusing to share as early as 10 weeks along. So, when you give him or her blood with high glucose levels, that proto-pancreas uses baby insulin to bring it right down for the fetus.

But lots of insulin makes things big... so much so that there are reports that athletes us it in performance enhancing drug cocktails. So, babies can get too big, too.


3. Delivery. Piggy-backing on #2, if a baby was just born to a mom with high blood sugar, he or she is likely to have a lot of insulin floating around that little body. But, when the kid is out of that sugary womb, there's no glucose to burn. This means the baby can have his or her very first low blood sugar.

Infants already have super low blood sugar readings (40 mg/dL is considered normal) but if it falls below that, your child might be taken to the neonatal intensive care unit so nurses can raise blood sugar levels with formula, and if necessary an I.V. This is WAY less fun than hanging out with your baby, and so maintaining good glucose control up to the very last second of pregnancy is important. And, I would be remiss if I didn't also include after pregnancy so you heal quickly and have the energy to take care of the new little one.

4. Fetal Programming... it gets heavy So far, we've talked about the direct relationships between maternal diabetes, blood sugar control and the baby. But, science is pointing to a whole new set of more subtle relationships between a mom, her womb and her baby. This is called fetal programming.

This process happens in every woman, diabetic or not. Aspects such as mom's body weight, cholesterol levels and glucose levels have subtle effects on the fetus that increase a child's later risk of developing obesity, diabetes or other metabolic conditions. Even things like working out while you're pregnant can affect your baby later in life.


I'll write a lot about fetal programing later on, but first a practical word of caution and encouragement: DON'T FREAK OUT.

As a diabetic woman hoping for a healthy and happy pregnancy, there is one thing you can do to definitively make a positive impact on your pregnancy. That is keeping those blood sugars under control. Now that you're pregnant, you can't become un-diabetic (Type 1s or Type 2s), so don't give it a moment's thought. Just focus on those glucometer numbers and press on.