Pregnancy and Diabetes

From Intermountain Healthcare

Diabetes in pregnancy can have serious consequences for the mother and the growing fetus. The severity of problems often depends on the degree of the mother’s diabetic disease, especially if she has vascular (blood vessel) complications and poor blood glucose control. Diabetes that occurs in pregnancy is often listed according to White’s classification:

  • Gestational diabetes. When a mother who does not have diabetes develops a resistance to insulin because of the hormones of pregnancy.
    • Noninsulin dependent – Class A1, which can be controlled by changes in diet
    • Insulin dependent – Class A2
  • Pre-gestational diabetes. Women who already have insulin-dependent diabetes and become pregnant.
    • Class B – diabetes developed after age 20, have had the disease less than 10 years, no vascular complications.
    • Class C – diabetes developed between age 10 and 19 or have had the disease for 10-19 years, no vascular complications.
    • Class D – diabetes developed before age 10, have had the disease more than 20 years, vascular complications are present.
    • Class F – diabetic women with kidney disease called nephropathy.
    • Class R – diabetic women with retinopathy (retinal damage).
    • Class T – diabetic women who have undergone kidney transplant.
    • Class H – diabetic women with coronary artery or other heart disease.

It is very important for a mother to closely manage her diabetes during pregnancy. Generally, the poorer the control of blood glucose and the more severe the disease and complications, the greater the risks for the pregnancy.

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