Hypoglycemia in Pregnancy

Glucose is the main source of energy for your body. Hypoglycemia is characterized by abnormal low levels of blood sugar or blood glucose. Hypoglycemia often occurs with diabetes treatment. However, nondiabetics can suffer from it due to a variety of medical ailments. Hypoglycemia is not a disease in itself, but an indicator of some underlying disease. Hypoglycemia in pregnancy is quite common, but should not be ignored.

Hypoglycemia During Pregnancy: How Low Is too Low?

Normally, the blood sugar level should range between 70 and 110 mg/dl. Traditionally hypoglycemia refers to blood sugar level below 70 mg/dl. However, since during pregnancy the blood sugar levels remain low, according to a report published in the May issue of "diabetes care" by the American Diabetes Association and the Endocrine Society, during pregnancy a blood sugar level lower than 60 mg/dl can be referred to as hypoglycemia.

Possible Cause of Hypoglycemia During Pregnancy

1. With Diabetes

Type 1 or type 2 diabetics may take insulin to lower high blood sugar levels which could lead to hypoglycemia. Besides, taking too much insulin, consuming less glucose or exercising excessively may lead to hypoglycemia in pregnancy.

2. Without Diabetes

Hypoglycemia is very often during early months of pregnancy. This occurs due to metabolic changes occurring as a result of loss of gluconeogenic substances (byproducts of digestion of protein) and glucose to the growing fetus, which leads to low glucose levels in the mother.

  • Medicines: Accidentally taking someone else’s drugs for diabetes is a possible cause. Medications like quinine used to treat malaria may cause hypoglycemia in children or in patients suffering from kidney failure
  • Drinking alcohol excessively without eating
  • Critical illnesses such as severe hepatitis
  • A rare tumor of pancreas leading to insulin overproduction
  • Hormonal deficiencies due to disorders of the pituitary or the adrenal glands
  • Hypoglycemia may sometimes occur after having a meal due to overproduction of insulin, referred to as postprandial or reactive hypoglycemia

How Harmful Is Hypoglycemia in Pregnancy?

Your brain and body need constant supply of glucose for its proper functioning. Various signs and symptoms develop due to hypoglycemia during pregnancy.

1. General Harmful Effects

  • Common symptoms: palpitations, pale skin, fatigue, anxiety, shakiness, hunger, sweating, irritability, crying during sleep, and tingling around mouth.
  • More severe symptoms: confusion or abnormal behavior, such as the female may be unable to complete even routine tasks; disturbances of vision, such as blurred vision; seizures and loss of consciousness. Severe hypoglycemia may make one appear intoxicated.

There are many other medical conditions that may produce these signs and symptoms. Hence, a blood test to determine the blood glucose level when these signs and symptoms appear is the sure shot way to know whether the cause is hypoglycemia or not.

2. Specific Harmful Effects for Pregnancy

Low blood sugar can have specific harmful effects on the pregnant female and her developing baby.

  • Developmental abnormalities: According to a research published in the “Journal of the Anatomical Society of India” in the year 2002, developmental abnormalities may develop due to maternal hypoglycemia. The study conducted on rats found out that hypoglycemia can cause the baby to have smaller size, optic nerve malformation, heart abnormalities, and abnormalities in the development of retina.
  • Low birth weight: According to the Oklahoma research published in “the Journal of the American Osteopathic Association” in the year 2011, hypoglycemia in pregnancy is often associated with low birth weight. In another study published in the journal “Psychiatry Research” in the year 2001, it was found that all developmental milestones such as teething, bladder control, independent walking and sitting, and speech development were delayed in low birth weight infants. Such infants also developed more behavioral and emotional issues during childhood and adolescence.
  • Long-term effects: According to the research published in “The Journal of Maternal-Fetal and Neonatal Medicine” in the year 2000, hypoglycemia in pregnant women puts the unborn child at increased risk of having cognitive deficits, hypertension, coronary artery disease and diabetes. It may also lead to failure of pancreas during adulthood. According to a research done by Swiss scientists and published in the “Journal of Pediatrics” in the year 1999, recurrent episodes of hypoglycemia in infants (caused due to hypoglycemia in mother) may lead to issues with physical growth such as decreased head circumference.
  • Hypoglycemic unawareness: However, sometimes, persons with low blood glucose levels don’t experience or notice the warning symptoms of hypoglycemia. In these causes, a dangerous condition referred to as hypoglycemic unawareness develops. According to the ADA, this condition is more common in those with type 1 and 2 diabetes for a long time or in pregnant women. In its worst form, it can lead to loss of consciousness, coma or even death (rare).

How to Deal With Hypoglycemia in Pregnancy

1. Dietary Method

Recommended treatment for hypoglycemia during pregnancy includes eating 15 g of carbohydrates or sugar, such as a piece of hard candy, ½ a cup of sugary drink (juice or regular soda), or 3 tables or gels of glucose. This treatment should be repeated till the blood glucose level becomes normal.

2. Hormonal Injection

Alternatively, a female may be prescribed a glucagon kit to use at home as the injection of this hormone can increase the level of blood sugar, which stimulates the liver to produce more sugar and send it into the blood.

3. Emergency Treatment

You can self-treat most of the episodes of hypoglycemia. However, in severe cases where one is unable to drink or eat, it may become necessary to seek emergency treatment. If a female becomes unconscious due to hypoglycemia, do not put anything into her mouth and call 911. In case you or someone else in the family is trained to inject glucagon and if it’s available you can inject it.

How to Prevent Hypoglycemia in Pregnancy

  1. With Diabetes: The management plan of diabetes should be followed carefully. It is important to always carry a fast-acting carbohydrate with you, including juice or glucose tablets. Individuals suffering from hypoglycemia unawareness should monitor glucose continuously.
  2. Without Diabetes: Nondiabetics who develop recurring episodes of low blood sugar should eat small meals frequently throughout the day. However, you should work with your physician to identify and treat the cause of hypoglycemia as a long term measure.
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