Question: What are the implications of having diabetes in various stages of pregnancy?
Answer: If you become pregnant and you already have diabetes, you'll be on insulin from the start of your pregnancy. If you have type 2 diabetes, which is, many people call 'adult-onset diabetes,' and are taking pills, you will be changed to insulin at that time. If you have diabetes and are taking other medicines to protect your kidneys or to protect your heart, your doctor will take you off of those medicines, as well, if you're not off them already in anticipation of becoming pregnant.
During the first trimester, blood sugar control is critical. That's the time when your baby's organs are forming, and that's a time when serious birth defects can develop. So having a blood sugar that's normal when you conceive and for that first trimester is probably the most important time to have tight glucose control.
During the second trimester, your baby is growing, and having good glucose is, of course, better for your baby, but it's not as critical as in the first trimester. However, it's not a time to slack off.
During the third trimester is when your baby grows at its most rapid rate, and the problems in the third trimester are usually related to big babies, as opposed to babies with problems, and a big baby is more difficult to deliver both for the baby and for the mom.
If you have diabetes before pregnancy, then there's also a chance of having complications around delivery. For instance, you may have problems with your placenta not working as well, or you may go into pre-eclampsia, which is a state where you become swollen and your blood pressure goes up and you get really bad headaches. Pre-eclampsia can be life-threatening, and during the end of your third trimester, your doctor will be following you very closely for pre-eclampsia.