What Is Hypoglycemia in Pregnancy?
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Medically reviewed by Layan Alrahmani, MD
Hypoglycemia occurs when your blood glucose levels drop too low to support normal body functions. It is usually defined as a blood glucose level less than 70 milligrams per deciliter (mg/dL).
In pregnant people, it occurs most often among those with chronic diabetes mellitus. It can also result from gestational diabetes, which begins when you're pregnant. Though rare, this problem can arise from other causes.
Low blood sugar can cause fatigue, heart palpitations, and fainting. Severe cases can result in seizures or coma. Without treatment, it can be fatal. Hypoglycemia can also cause harm to the developing fetus or complications after birth.
With proper care, this problem can often be managed with diet and medications. Preventing a sudden drop in your blood sugar is the best way to control this problem.
This article explains how hypoglycemia affects fertility outcomes, gestation, and the postpartum period.
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Hypoglycemia and Fertility
Hypoglycemia can develop as a common complication of diabetes. Even if you've never had hypoglycemia, having type 1 or type 2 diabetes before or during your childbearing years may make it more difficult to get pregnant.
People with diabetes can experience problems with reproductive organs, including the fallopian tubes, ovaries, or uterus. They can also have delayed puberty, irregular menstrual cycles, early menopause, and polycystic ovary syndrome (PCOS), all of which can contribute to infertility.
There is evidence that diabetes can interfere with male fertility. Research shows that people with penises, diagnosed with either type 1 or type 2 diabetes, may be more likely to have the following problems:
Lower than normal sperm concentration
Abnormal sperm movement
Higher incidence of abnormal sperm formation
While it's possible to develop hypoglycemia without diabetes, the occurrence is rare. Having low blood sugar without diabetes may be a sign of one of the following health conditions, which may affect your ability to conceive:
Enzyme deficiencies
Low levels of cortisol, human growth hormone (HGH), or other hormones
Medications
Hypoglycemia usually occurs with diabetes. While diabetes isn't inherited, you can have a genetic disposition that increases your risk of developing it. There is also a rare and severe form of hypoglycemia called congenital hyperinsulinism, which is caused by a genetic defect. It can cause abnormally high levels of insulin, resulting in dangerously low blood sugar levels.
Hypoglycemia and Gestation
Abnormal blood glucose levels may affect you and the developing fetus. Whether it's related to preexisting type 1 or type 2 diabetes, gestational diabetes, or another cause, untreated hypoglycemia can increase the risk of complications for pregnant people and their babies.
Risks
Glucose is the main source of energy for your body and brain. Without enough glucose, you're unable to continue normal physical and mental function.
Normal glucose levels are necessary to meet the changing demands of a pregnant person supporting a growing fetus. Keeping glucose levels within the normal range also helps the pregnant body store energy for labor and lactation (nursing). Untreated low blood sugar can result in seizures and a coma. Without treatment, severe episodes can lead to death.
Sufficient glucose levels in the pregnant body are also necessary to support fetal development until birth. Sustained low levels of blood glucose during pregnancy may prevent normal fetal growth and cause infants to be born small for gestational age. It may also damage fetal beta cells, which produce and regulate insulin.
Hypoglycemia in pregnancy is very common. Having type 1, type 2, or gestational diabetes increases your risk of hypoglycemia during pregnancy. Gestational diabetes occurs in up to 10% of pregnant people in the United States. Up to 71% of women with type 1 diabetes develop hypoglycemia at some time during pregnancy.
Concerning Symptoms
Symptoms of hypoglycemia may vary among different people. The only way to identify low blood glucose levels is to take a test. A reading lower than 70 mg/dL indicates low blood sugar.
Common problems that occur with this condition include the following issues:
Shakiness
Feeling dizzy or light-headed
Sweating or chills
Headache
Fatigue
Blurred or impaired vision
Anger and moodiness
Heart palpitations
Pale skin
Difficulty thinking clearly
Seizures
Tingling or numbness in the lips, tongue, or cheeks
Hunger
You will need emergency treatment for a hypoglycemic episode if you have the following symptoms:
Change in consciousness
Continued confusion after taking glucagon
Continued low blood glucose levels despite consuming carbohydrates or taking glucagon
Treatment
Treatment for pregnant people with hypoglycemia is similar to treatment for the condition at any stage of life. It can often be treated with a regimen that requires you take the following precautions:
Conduct regular blood glucose testing.
Maintain a regular schedule of meals and snacks.
Follow an exercise plan approved by your diabetes health team.
Take insulin and other medications according to the prescribed dosage and schedule.
If you experience symptoms of hypoglycemia, the American Diabetes Association (ADA) advises that you check your blood glucose levels. If your blood glucose levels are low or you have symptoms and are unable to test, take the following steps:
Find a place to sit or lie down to avoid injury in case you feel weak or faint
Consume 15 grams of carbohydrates to raise your blood glucose level. Sources may include:
Glucose tablets per instructions
Glucose gel tube per instructions
4 ounces (1/2 cup) of juice or regular, not diet, soda
1 tablespoon of sugar, honey, or corn syrup
Jellybeans or hard candies, using the food label to determine the number needed
Recheck your blood glucose level after 15 minutes of consuming the carbohydrates.
Consume an additional 15 grams of carbohydrates if your blood glucose level is below 70 mg/dL.
Repeat this cycle of eating 15 grams of carbohydrates every 15 minutes and retesting until your blood glucose level increases to at least 70 mg/dL.
Eat a meal or snack to prevent your blood glucose from falling again.
If you have a severe hypoglycemic event, in which you need help to recover, you should take glucagon. Glucagon is a prescription hormone that promotes the release of stored glucose into your bloodstream. It is available in injectable or inhaled forms. You should instruct close friends, family members and coworkers on how to administer glucagon in case you need it.
Hypoglycemia and Postpartum
During the postpartum phase, your blood glucose levels will change as your body adapts to the birth of your baby. Your experience with hypoglycemia during this time depends on the cause of your hypoglycemia and your overall health.
Impact on Recovery
If you had hypoglycemia as a complication of type 1 or type 2 diabetes, your blood levels should return to the levels you were able to maintain before pregnancy.
Having gestational diabetes gives you a higher risk of identifying unknown type 1 or type 2 diabetes after delivery. About 50% of people who had gestational diabetes during pregnancy later develop type 2 diabetes, but there are steps you can take to prevent it.
Making lifestyle changes as you recover from childbirth may help reduce your risk of developing type 2 diabetes. Initial testing for postpartum diabetes is conducted between four weeks and six months after giving birth. Even if you have a negative initial postpartum diabetes screening, screening may continue every three years for at least 10 years postpartum.
If you have had gestational diabetes, you likely will have it again in future pregnancies. Having gestational diabetes leaves you with a 2 in 3 chance that it will occur in future pregnancies.
Nursing
Nursing is beneficial for both the lactating parent and baby, even if you had diabetes before your pregnancy or developed gestational diabetes.
The process helps the nursing parent's body process glucose and insulin better after pregnancy. It also helps you lose the extra weight gained during pregnancy. This can lower your risk of being overweight, a risk factor for developing type 2 diabetes at any stage of life.
If you had gestational diabetes, nursing may help reduce the risk of developing type 2 diabetes that remains after giving birth. In one study, parents who nursed for longer than two months reduced their risk of developing type 2 diabetes by almost half.
Nursing can help lower the risk of developing type 1 diabetes in babies. It can also reduce their chances of becoming overweight or obese later, both of which are risk factors for type 2 diabetes.
Learn More:What Is Breastfeeding?
Summary
Hypoglycemia occurs when your blood glucose level drops below 70 mg/dL. At this level, it's hard to support normal body functions as well as provide the energy needed to sustain healthy fetal growth.
Most cases of hypoglycemia in pregnancy occur in people with type 1 or type 2 diabetes. It can also develop as a complication of gestational diabetes. Rarely, it occurs from another health problem not linked to diabetes.
Symptoms can include heart palpitations, fatigue and fainting. Severe cases can result in seizures, coma or death. It can also prevent normal fetal growth.
This problem can often be controlled with diet and medications. The best way to manage hypoglycemia is to take steps to maintain normal blood sugar levels.
A Word From Verywell
It's normal to feel anxious and afraid when you learn that anything is wrong during your pregnancy. However, a diagnosis of hypoglycemia doesn't have to interfere with your desire to have a normal pregnancy and healthy birth. Occasional or mild hypoglycemia usually isn't considered harmful to you or the fetus.
While you can't prevent hypoglycemia, you can take precautions to reduce your risk of abnormal blood sugar levels and extreme hypoglycemic events. Eat regularly, exercise daily, and monitor blood sugar levels if you have diabetes when you get pregnant. Take insulin and other medication as advised to maintain normal blood glucose levels.
Making the changes necessary to avoid or reduce the effects of hypoglycemia can help you feel that you're doing all you can to protect the health of yourself and your baby.
Frequently Asked Questions
How do I know if I have hypoglycemia in pregnancy?
A blood test showing glucose levels lower than 70 mg/dL is the only way to confirm a diagnosis of hypoglycemia. Symptoms of dizziness, racing heartbeat, and confusion may indicate lower than normal levels and the need to confirm a diagnosis with a blood test.
What is the leading cause of hypoglycemia in pregnancy?
Most cases of hypoglycemia occur as a complication of type 1, type 2, or gestational diabetes. While it's possible to develop hypoglycemia without diabetes, the occurrence is rare. In these cases, the problem is often related to other health problems like tumors, alcohol abuse or diseases of the liver, heart, or kidneys.
Can I prevent hypoglycemia in pregnancy?
There's no definitive way to prevent hypoglycemia during pregnancy, but you can lower your risk of getting it. If you have type 1 or type 2 diabetes, work to ensure your blood sugar levels are under control before pregnancy. During pregnancy, closely monitor blood sugar levels and report symptoms of hypoglycemia to your healthcare provider for advice.
