Diabetes in Pregnancy: What Every Indian Woman Should Know

Diabetes in Pregnancy: What Every Indian Woman Should Know

In India, where diabetes is rising steadily—especially among women of childbearing age—understanding how diabetes impacts pregnancy is crucial. Whether you're planning a pregnancy or are already expecting, managing diabetes carefully can ensure a healthy future for both mother and child.

This blog explains what diabetes during pregnancy means, why it matters, and how to manage it from an Indian perspective—based on the latest global recommendations by the American Diabetes Association (2025 guidelines).

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Why Is Diabetes During Pregnancy a Concern?

Diabetes in pregnancy can be of three types:

1. Type 1 Diabetes – insulin-dependent diabetes present before pregnancy.
2. Type 2 Diabetes – often linked to obesity or lifestyle factors, also present before pregnancy.
3. Gestational Diabetes Mellitus (GDM) – diabetes first diagnosed during pregnancy.

In India, GDM is especially common, affecting 10–14% of pregnant women, and is often missed unless actively screened.

Poorly controlled blood sugar levels during pregnancy can increase risks such as:

• Miscarriage
• Birth defects
• Premature delivery
• High birth weight (macrosomia)
• Preeclampsia (high blood pressure in pregnancy)
• Stillbirth
• Long-term risk of diabetes in the child

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Planning Ahead: Preconception Care

For women with existing diabetes, planning the pregnancy is absolutely essential.

✅ Start preconception counseling early—ideally from puberty if you have diabetes.
✅ Aim for HbA1c <6.5% before getting pregnant.
✅ Use effective contraception until your sugar levels, weight, and overall health are well-managed.
✅ Get screened for diabetic complications—especially retinopathy, kidney health, and thyroid function.

Note: Women with a history of gestational diabetes should get screened for type 2 diabetes before planning their next pregnancy.

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Healthy Diet and Exercise: The First Line of Defense

For all Indian women, whether diabetic or at risk of GDM:

🥗 Eat a balanced diet rich in whole grains, legumes, vegetables, fruits, seeds, and lean proteins.
⛔ Avoid crash diets, keto diets, or excess fat intake—especially in pregnancy.
🚶‍♀️ 150 minutes of moderate activity per week (e.g., brisk walking) is recommended—even during pregnancy.
⚖️ Manage weight wisely. Even 5% weight loss before pregnancy can reduce GDM recurrence risk in overweight women.

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Monitoring Sugar Levels: What Are the Targets?

Blood sugar goals during pregnancy differ from the non-pregnant state:

Time of Measurement	Target Range (mg/dL)
Fasting	< 95
1-hour post-meal	< 140
2-hour post-meal	< 120

Regular self-monitoring with a glucometer is essential. In many cases, your doctor may recommend a continuous glucose monitor (CGM), especially if you have type 1 diabetes.

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Medication During Pregnancy: What’s Safe?

• Insulin is the preferred and safest treatment for type 1, type 2, and GDM.
• Oral medicines like metformin and glyburide are not recommended as first-line during pregnancy due to potential risks to the baby.
• If you're on medications like statins or ACE inhibitors, speak with your doctor well before planning pregnancy—they may need to be stopped.

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Delivery and Postpartum Care

After delivery:

• Insulin requirements often drop suddenly—especially for those with type 1 diabetes.
• Breastfeeding is encouraged as it helps reduce long-term risk of diabetes in both mother and baby.
• Women with GDM should be retested 4–12 weeks postpartum using an oral glucose tolerance test (OGTT)—not just HbA1c.
• Even if sugars are normal, continue getting tested every 1–3 years lifelong, as 50–60% of GDM mothers develop type 2 diabetes later.

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Key Takeaways for Indian Women

• Don’t wait till pregnancy to start diabetes care. Start planning early.
• Work with an expert team—your endocrinologist, obstetrician, dietitian, and diabetes educator.
• Regular screening and prevention of GDM can improve lifelong health outcomes.
• Lifestyle changes—diet, exercise, weight management, and avoiding unplanned pregnancies—are powerful tools in diabetes care.
• Know your rights—demand postpartum diabetes screening and continued education.

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Final Words

Pregnancy is a time of joy and hope. But with diabetes, it also becomes a time of vigilance and preparation. The good news? With the right guidance and timely care, most women with diabetes have healthy pregnancies and healthy babies.

Dr Aravinda J

MD,MRCP(London),Triple FRCP(Edinburgh, London, Glasgow) National RSSDI Executive Committee Member President RSSDI Karnataka chapter ( 2018-19 ) Chairman and Chief Diabetologist Dr Aravind's Diabetes Centre Basaveshwara Nagar, Bengaluru.