Diabetes in Pregnancy
A diagnosis of Diabetes can be made prior to or during pregnancy and can result in complications for both the pregnant individual and the baby. Management of Diabetes in pregnancy can be challenging because of the need to make frequent medication and monitoring adjustments.
To better serve our patients, UR Medicine has created a robust Diabetes in Pregnancy Program (DiPP) to support education, management, delivery planning, and long-term care transition for pregnant individuals with diabetes.
This multidisciplinary team of physicians and care providers caring for patients in this program include those from the following Divisions and Departments:
- High-Risk Obstetrics
- Endocrinology
- Nutrition
What to Expect from this
By working together to develop coordinated plans both before and after pregnancy, the team helps ensure that individuals have an integrative, multidisciplinary care team for their pregnancy. Patients are usually co-managed with this program during pregnancy. This means that the DiPP team provides ongoing recommendations (often via zoom) regarding blood sugar monitoring, medication management, and delivery timing; however, patients can receive routine prenatal care with their local OB providers. If complications arise, patients are welcome to have full care through UR Medicine Strong Perinatal Associates.
Multidisciplinary Planning
Every week, DiPP team members (including extended members such as care coordinators) review every pregnant patient with Diabetes. We make sure that everyone on the obstetrics and endocrine teams are ready to manage overall pregnancy care and delivery care.
Special Services
In addition to providing complex Diabetes care, UR Medicine offers additional referrals and care coordination for all aspects of a patient’s reproductive and endocrine care. Moreover, UR Medicine also offers easy access to a Behavioral Health Specialist to ensure that all our patients mental health needs –which can be strained during a complicated pregnancy – are supported.
Continuous Glucose Monitoring
Pregnant individuals often find it challenging to take blood sugars several times a day. The DiPP team can provide continuous glucose monitoring for eligible patients to obtain a better understanding of blood sugar trends throughout the day and night without the need for multiple pokes.
Level II OB/GYN Ultrasound and Fetal Echocardiogram
Those individuals with Diabetes diagnosed prior to pregnancy are at higher risk for having offspring with structural anatomic differences. We offer AIUM certified Level II OB/GYN ultrasound including fetal echocardiography, assuring fetal assessment and fetal monitoring is available on-site. This allows the team to have all of the information available to help guide pregnancy management. We also work collaboratively with our NICU to provide comprehensive care for our patients.
Care Coordination
For those that are followed in ongoing care, our fetal and maternal care coordinators help families with maternal or fetal cardiac disease navigate all of the care that may be needed, including help with coordinating appointments, answering questions, and assuring they are aware of planned services and any test results.
Pregnancy Planning
Planned pregnancies are healthy pregnancies. Our team is happy to see individuals considering their reproductive options and to discuss pregnancy risks and benefits. For those individuals who wish to become pregnant, our team works together to ensure that individuals with pre-existing Diabetes enter pregnancy as healthy as possible with medications and care optimized.
Contraceptive Services
When a patient is not interested in pregnancy, Diabetes (especially Diabetes with kidney failure or other severe complications) can make the options for contraception more limited. Our team works closely with the UR Medicine Complex Contraception Clinic to be certain that individuals have a full range of counseling and options to assure that all of their pregnancies are planned.