Your Diabetes and Pregnancy Professional Care Team by Elizabeth "Bjay" Woolley (09-13-2001) Your most important resource during a diabetic pregnancy.

The most important resource during a diabetic pregnancy is the professional care team. Your care team should include a diabetes specialist (such as an endocrinologist or diabetologist) who specializes in diabetes care and can help you manage your diabetes during pregnancy, an obstetrician who specializes in high-risk pregnancies and knows how to care for pregnant diabetics, a pediatrician who will be ready to handle any problems that may occur in a baby as a result of a diabetic pregnancy, a diabetes educator, and a dietitian. In addition, it may be a good idea to have visits with an eye doctor, a social worker or psychologist, a podiatrist, and a dentist. Below are brief descriptions of what to expect from your diabetes specialist (such as an endocrinologist or diabetologist), obstetrician, pediatrician, diabetes educator, and dietician:

Diabetes Specialist

The doctor who specializes in diabetes care (such as an endocrinologist or diabetologist) is usually the head of your health care team. You will meet with him/her regularly. Your blood glucose levels will be reviewed, your treatment will be planned, and you can expect to be sent for lab tests to give the doctor an idea of what your average glucose levels have been over a specified period of time. Expect to have a bright light shined into your eyes, feet inspected, and blood pressure checked.

Don't be afraid to be honest with your doctor. Many times patients are tempted to report blood glucose levels that are better than reality. Remember you are both working for the welfare of your baby. Most likely your doctor has "seen it all." During my pregnancy I became appalled at the amount of insulin I had to take. When my doctor saw the look on my face when I was instructed to take over 100 units of insulin a day, he explained that he had another patient who was taking over 300 units and it didn't necessarily mean I was a little piggie or doing anything wrong.

High-risk Obstetrician

Your obstetrician should specialize in high-risk pregnancies and have experience managing pregnant diabetics. Initially, the obstetrician or midwife will evaluate your situation and probably perform a pelvic exam with a PAP smear and group B strep test. You will be sent for lab tests. He/she will also keep tabs on your blood glucose levels, check your urine for ketones, and take your blood pressure and weight frequently. It is a good idea to write down any questions or concerns before your appointment because you may blank out and then kick yourself later for forgetting what you wanted to ask.

The obstetrician may send you for sonograms more frequently than for non-diabetics. The sonogram process may become familiar and you will sometimes leave the office with cold gel in your belly button (the gel is used to slide the sonogram tool around your belly). The sonographer will check the baby's growth, development, and amniotic fluid levels. This is a painless and interesting procedure.

There is a good chance you will visit the office frequently and regularly towards the end of your pregnancy for fetal monitoring (to check baby's movement and heart rate). Other tests you may be offered during your pregnancy include a biophysical profile (using ultrasound), serum alpha fetoprotein (AFP) test, genetic counseling, and amniocentesis.

Pediatrician

The pediatrician should know how to care for babies from a diabetic pregnancy. The baby's blood glucose should be checked soon after birth and if it is abnormal, the pediatrician will be the one to treat it as well as any other complications. Make sure you advise the pediatrician of your situation and let your obstetrician and delivering hospital know who the pediatrician is. It is never too soon to start shopping around and interviewing pediatricians.

Diabetes Educator

The diabetes educator is a great source of information. They instruct you on blood glucose monitoring, diet, types of insulin, insulin injections, exercise, and how to gain tight control. Sometimes the diabetes educator will provide you with a free blood glucose monitor and some supplies. If not, they will tell you what to get and where to get it. Some diabetes educators make themselves available during and after office hours and may even call you at home to check up on you. Don't be afraid to ask questions or to stop and rephrase what you've learned to make sure you understand correctly.

Dietician

The dietician will help you plan your diet. Everyone is different so you may need a special diet tailored to your particular needs and calorie requirements. You may be instructed in carbohydrate counting, an exchange diet, a mixture of the two or something different. They will make sure your plan ensures you are getting good nutrition through the proper amounts from each food group.

If you don't have a health-care team, ask your doctor about establishing one or for referrals. Check with your local American Diabetes Association (ADA) or hospital for listings of health-care providers.

Diabetes and
Pregnancy:
What to
Expect
Recommended books

This is not a health care site. The editor is not a health care professional, is not qualified, and does not give medical or mental health advice.

Please consult with qualified professionals in order to find the right regimen and treatment for you. Do not make changes without consulting your health care team. .

Because this site is for all diabetics at all stages of life, some information may not be appropriate for you - remember information may be different for type 1, type 2, type 1.5, and gestational diabetics.

Articles submitted by other authors represent their own views, not necessarily the editor's.

The editor and contributing writers cannot be held responsible in any shape or form for your physical or mental health or that of your child or children. They cannot be held responsible for how any of the information on this site or associated sites affects your life.

The community associated with this site is a sort of self-help support group. Advice or information shared is personal and possibly not optimal for you. It is up to you to use this information as you see fit in conjunction with your medical care team. The results are your own responsibility. Other members or the editor or contributors cannot be held responsible.