Do pregnant women tend to have hypoglycemia (low blood sugar)?

From the Guidelines

Pregnant women do not typically tend to have hypoglycemia, as pregnancy is more commonly associated with insulin resistance and higher blood sugar levels. In fact, the physiological changes of pregnancy, including increased insulin production and placental hormones that promote insulin resistance, generally work to maintain higher rather than lower blood glucose levels to ensure adequate nutrition for the developing fetus 1. However, some pregnant women may experience hypoglycemic episodes, particularly if they have pre-existing diabetes and are taking insulin or other blood-glucose lowering medications, if they have inadequate food intake, or if they experience severe morning sickness (hyperemesis gravidarum) 1.

When hypoglycemia does occur during pregnancy, it's usually managed by consuming small, frequent meals containing complex carbohydrates and protein, avoiding long periods without eating, and carefully monitoring blood glucose levels. For diabetic pregnant women, medication adjustments may be necessary under medical supervision. The American Diabetes Association (ADA) recommends targets for women with type 1 or type 2 diabetes, including fasting glucose 70–95 mg/dL and either one-hour postprandial glucose 110–140 mg/dL or two-hour postprandial glucose 100–120 mg/dL 1.

Key points to consider include:

• Pregnancy is associated with insulin resistance and higher blood sugar levels
• Gestational diabetes is a concern during pregnancy
• Hypoglycemic episodes can occur in pregnant women with pre-existing diabetes or inadequate food intake
• Management of hypoglycemia during pregnancy involves consuming small, frequent meals and monitoring blood glucose levels
• Medication adjustments may be necessary for diabetic pregnant women under medical supervision.

Overall, while hypoglycemia can occur during pregnancy, it is not typically a common issue, and the focus is usually on managing higher blood sugar levels to ensure a healthy pregnancy outcome 1.

From the FDA Drug Label

Insulin requirements may decrease during the first trimester, usually increase during the second and third trimesters, and rapidly decline after delivery. The FDA drug label does not directly answer the question of whether pregnant women tend to have lower than normal blood sugar. However, it mentions that insulin requirements may decrease during the first trimester, which could imply that blood sugar levels may be lower, but this is not a direct answer to the question.

• The label discusses the importance of good glucose control during pregnancy.
• It also mentions that insulin requirements may change during pregnancy, but does not provide information on whether pregnant women tend to have hypoglycemia 2.

From the Research

Blood Sugar Levels in Pregnant Women

• Pregnant women do not tend to have lower than normal blood sugar levels, but rather, their blood sugar levels can fluctuate due to various factors such as insulin resistance and hormonal changes 3, 4, 5.
• Insulin resistance increases during pregnancy, especially in the last half, and can become severe in women with gestational diabetes and type 2 diabetes 4, 5.
• The goal of diabetes management in pregnancy is to maintain near-normal glucose levels, with fasting glucose levels between 60 to 105 mg per dL (3.3 to 5.8 mmol per L) and postprandial levels less than 120 mg per dL (6.7 mmol per L) 6.

Gestational Diabetes and Blood Sugar Levels

• Gestational diabetes mellitus (GDM) is a pathological state of carbohydrate intolerance beginning or first recognized during pregnancy, which leads to increased risk of adverse pregnancy outcome 3, 5, 7.
• Women with GDM have a higher risk of developing non-insulin-dependent diabetes later in life and warrant long-term follow-up 6, 7.
• The diagnosis of GDM is based on the 75 g oral glucose tolerance test (OGTT) and is associated with an increased risk of adverse perinatal outcomes 7.

Management of Blood Sugar Levels in Pregnancy

• A team approach to diabetes management optimizes pregnancy outcomes for mother and baby 6.
• Diet modification and insulin therapy are common treatments for GDM, with the goal of maintaining near-normal glucose levels 3, 6.
• Self-monitoring of blood glucose levels guides insulin and dietary modifications 6.