Creating a life is a beautiful experience, but pregnancy is also a time of intense change. A woman’s body adapts constantly—hormones fluctuate, metabolism shifts, and everyday routines are reshaped to
support a growing life. Even in the healthiest pregnancies, these changes can feel demanding.
When a woman is living with a chronic condition that can affect the body’s balance, the journey can feel even more uncertain. Questions multiply, and concerns feel heavier. For women with diabetes, pregnancy often comes with a quiet, persistent worry: Will my body be able to handle this?
The concern is understandable. Pregnancy naturally alters how the body processes sugar, increasing insulin resistance as the months progress. Add diabetes to the mix, and managing blood sugar can feel overwhelming—raising fears about both the mother’s health and the baby’s well-being.
But doctors today tell a far more reassuring story than they did a decade ago. With planning, close monitoring, and the right medical support, most women with diabetes go on to have healthy pregnancies and healthy babies.
So what actually happens inside the body? Why does pregnancy make blood sugar harder to manage? And what do doctors now recommend? To find the answers to these questions and understand the impact of diabetes on pregnancy, we spoke to Dr Mannan Gupta, HOD & Chairman- Obstetrics & Gynaecology at Elantis Healthcare in New Delhi.
Is Pregnancy Difficult For Women with diabetes?
Pregnancy is not automatically unsafe for women with diabetes. The difference lies in preparation and management. Diabetes doesn’t stop pregnancy, but it does demand more careful monitoring before, during, and after.
In fact, more than 95% of women with diabetes deliver healthy babies, according to a review article published in ‘The Lancet Diabetes & Endocrinology’
Dr Gupta says, “While pregnancy may be more dangerous for a woman with diabetes, the risk of complications largely depends upon the woman’s blood glucose levels. With appropriate medical care and diligent self-monitoring, many women experience healthy pregnancies regardless of their diabetes diagnosis.”
If diabetes is not properly managed, it can affect the mother’s health during pregnancy and may also cause problems for the baby, he adds.
Dr Gupta recommends that a woman with diabetes plan for her pregnancy at least 6 months before conception and maintain regular medical appointments with her healthcare provider, as well as manage her blood glucose levels diligently throughout her entire pregnancy.
Most Common Risks During Pregnancy Due To Diabetes
During pregnancy, doctors closely watch for possible diabetes-related problems. These include high blood pressure, preeclampsia, babies growing too large, early delivery, and low blood sugar levels in newborns.
Dr Gupta points out that “Women with diabetes also have a higher likelihood of developing an infection during pregnancy, along with having an increased risk of requiring a cesarean section delivery.”
Is Getting Pregnant More Difficult For Diabetic Women?
Having diabetes does not directly reduce a woman’s ability to get pregnant. However, if blood sugar levels are not well controlled, diabetes can affect ovulation or disrupt the menstrual cycle, which may make conception harder.
That said, most women with diabetes can manage their condition well and go on to have healthy pregnancies, often focusing more on blood sugar control than on fertility concerns.
Dr Gupta says, Women with diabetes should start preparing for pregnancy three to six months ahead. This gives doctors time to stabilise blood sugar levels and adjust medications safely.
“The reason for early preconception care is that if a woman has very high blood sugar levels in the first few weeks of her pregnancy, she is putting her unborn child at greater risk for developing birth defects before she may even realize that she is pregnant.”
For women with diabetes who are planning a pregnancy, Dr Gupta stresses the importance of getting blood sugar levels under good control. He also recommends scheduling a preconception visit with a doctor to review current medications and discuss key aspects of health, including diet and insulin management.
“In addition, women should start taking folic acid and focus on healthy habits such as balanced nutrition, regular exercise, and stress management,” Dr Gupta says. “These steps can improve the chances of a smooth and healthy pregnancy.”
What Happens To Blood Sugar In Pregnancy
Pregnancy is a hormonally intense process. As the placenta develops, it releases hormones that help the baby grow, but these same hormones reduce the body’s sensitivity to insulin. This phenomenon, known as insulin resistance, Generally the 2nd and 3rd Trimesters tend to present greater challenges in controlling glucose levels
For women without diabetes, the pancreas compensates by producing more insulin. For women with diabetes, especially those who already rely on insulin, this balance is harder to maintain.
The result? Blood sugar levels can rise more easily and fluctuate more unpredictably. This is also why gestational diabetes (diabetes that appears during pregnancy) can develop even in women with no prior history of the condition.
Monitoring Blood Glucose Levels In Pregnancy
Monitoring blood sugar is important not just during pregnancy, but even before conception and after the baby is born. Good glucose control before pregnancy can help lower the risk of birth defects.
Keeping blood sugar levels in check during pregnancy reduces health risks for both the mother and the baby. After delivery, blood sugar levels can change suddenly, so continued monitoring is important to prevent low blood sugar and protect the mother’s long-term health.
Dr Gupta advises that women planning a pregnancy should start monitoring their blood sugar levels at least a few months before conception and continue daily monitoring throughout pregnancy.
He also points out that insulin needs often drop sharply after delivery, making close blood sugar monitoring especially important in the immediate postpartum period. “Women should continue to track their glucose levels for at least six to twelve months after childbirth to support recovery and long-term health,” he says.
What Doctors Advise For Managing Diabetes During Pregnancy
Dr Gupta advise pregnant women with diabetes to follow a structured meal plan, check their blood sugar levels regularly, and attend all scheduled prenatal appointments.
Staying physically active, managing stress, and learning to recognise the signs of low or high blood sugar are also important steps to prevent complications.
Clear and regular communication with healthcare providers helps ensure timely changes in treatment when needed.
Dr Gupta emphasises that consistency is the most important part of managing diabetes during pregnancy. He advises women to monitor their blood sugar as directed, take medications or insulin on time, eat balanced meals, and avoid skipping snacks.
Keeping a glucose log and reporting unusual readings to the doctor can help address problems early. He also cautions against ignoring symptoms of low or high blood sugar.
Regular ultrasounds, blood tests, and ongoing glucose monitoring allow doctors to spot potential risks early and manage them well before delivery, helping ensure safer outcomes for both mother and baby.
