Hypoglycemia In Pregnancy

During pregnancy, a woman’s body undergoes several metabolic changes that result in hypoglycemia. It is a condition of low blood sugar level that results due to slow metabolism of glucose that enters your cells to give you the energy for keeping your body active.

What Is Hypoglycemia In Pregnancy?

Hypoglycemia generally happens during pregnancy when the blood sugar goes down below 70 mg/dL. During the pregnancy period, the normal blood sugar ranges from 70 mg/dL to 1000 mg/dL (1). In fact, a study shows that women with a history of Type 1 diabetes may experience hypoglycemia during pregnancy particularly during the first or second trimester. Insulin is a glucose regulating hormone that regulates blood glucose level (2). During pregnancy, a woman’s body undergoes metabolic changes and requires more diet to support the growing fetus. In such conditions, their body requires a high amount of insulin to regulate extra glucose produced in the body. With hormonal changes, it can be challenging for the female body to regulate glucose, resulting in gestational diabetes (3).

What Are The Types Of Hypoglycemia During Pregnancy?

Regardless of the type of hypoglycemia you contracted, any of the warning signs of hypoglycemia during pregnancy should be taken to the attention of your doctor. Early diagnosis and prompt treatment are very important. Generally, you will get two symptoms for hypoglycemia during pregnancy which are:

1.Reactive Hypoglycemia

If you have reactive hypoglycemia, then your blood sugar level will decrease within a couple of hours following your meal. Usually, this happens more in people who are suffering from diabetes. However, it can also happen to those who don’t have diabetes (4).

2. Fasting Hypoglycemia

If you have fasting hypoglycemia, then your blood sugar level could fall to an alarming level in between the time of your meals (5). Usually, this type of hypoglycemia is more often found in people who don’t have diabetes.

Who Is More Prone To Hypoglycemia During Pregnancy?

An expecting mother who is heading towards the closing stages of the first trimester. That is, those who are going through 8 to 16th weeks of pregnancy (6).

If a pregnant woman falls sick frequently, then it can cause hypoglycemia.
A pregnant woman experiencing gestational diabetes who take insulin shots
Expecting mothers with terrible morning sickness (7).
A pregnant woman with a record of low blood sugar.

What Causes Low Blood Sugar In Pregnancy?

There are some medical conditions that can cause hypoglycemia. In such cases, taking evasive actions and obtaining the right treatment are important. Other things that can cause low blood sugar in pregnancy are:

1. Morning Sickness Or Nausea

If you are having morning sickness during pregnancy, expecting mothers tend to decline more foods, thereby ending up in significantly low intake of food. This can lead to hypoglycemia.

2. Lifestyle

Your lifestyle could cause hypoglycemia. For example, if you exercise too much, then it can cause the breakdown of glucose at an alarming level, which can cause a low blood sugar level. In case you do not eat an adequate amount of carbohydrates, it can lead to hypoglycemia (8).

3. Diabetes

If you have diabetes or previous history of type 1 diabetes then that could be a reason for hypoglycemia as it happens more to diabetic (9).

4. Gestational Diabetes

This can happen because of hormonal changes, opposition to insulin, and stress during pregnancy. Irrespective of the triggering factor, the blood sugar level will go down, causing hypoglycemia if you have gestational diabetes.

5. Medication

The medications you take for your diabetes could bring down your blood sugar level significantly, thereby triggering hypoglycemia (10). This usually happens when the expecting mother fails to have an adequate intake of food or has a wrong dose (high) of the diabetic drug.

Signs And Symptoms Of Low Blood Sugar During Pregnancy?

Low blood sugar will project itself with different symptoms (11). Some of these symptoms will include:

Problems with clarity in thought
Irregular heart rate
Blurry and unclear vision
Mood fluctuation and anxiety
Your body may sweat often and shake uncontrollably
Some symptoms are related to sleep. If hypoglycemia kicks in during sleep, it can bring about:
Nightmares
Feeling tiredness extremely after waking
Cold night sweats
Tiredness, fatigue, and weakness throughout the day
In extreme cases, seizures and blackouts can happen

How To Diagnose Low Blood Sugar In Pregnant Women?

The tests to evaluate blood sugar levels are usually done once you enter your second trimester. However, if there are warning signs of low blood sugar, then you would have to undergo more tests during the first trimester itself.

Also, if you don’t have diabetes (in spite of the low blood sugar readings), then your doctor will make you undergo different blood tests to figure out the reason for hypoglycemia. Moreover, you have to provide the details of your diet, exercise, medical history, and lifestyle to your doctor.

Side Effects Of Hypoglycemia In Pregnancy?

Hypoglycemia can affect both the baby and the mother during the pregnancy period (12):

Effect on Mother

If you have severe hypoglycemia, then you might have to be hospitalized. Gestational diabetes could cause complications during labor pain, which might cause injuries at the time of birth.

Effect on Baby

Hypoglycemia could hamper fetal development and cause mental and physical abnormalities to the baby. Expecting mothers with gestational diabetes have more odds of delivering a baby with jaundice. If the mother has hypoglycemia, then the baby could have a low level of blood sugar.

Treatment For Reducing The Severity Of Hypoglycemia During Pregnancy

In case of severe hypoglycemia, the patient will have to eat foods that are high in calories. Also, glucose tablets might aid in this cause. So,

You have to eat at least 15 grams of carbs, which will normalize the blood sugar level within 15 minutes.
If the patient is unable to eat or drink, then consult with the doctor as soon as possible.
At the time of the labor or delivery, constant monitoring of the blood sugar is required.
If a tumor is causing the hormonal changes for which the pregnant woman is suffering from hypoglycemia, then that tumor has to be removed before the delivery.

Safety Measures To Take While Suffering From Hypoglycemia During Pregnancy?

Keep a glucometer and check the level of your blood sugar from time to time
Keep a high-calorie snack close to you in most of the time
Eat-in small meals
You have to eat more food on the day you exercise more
Must abstain from alcohol
You have to abstain from carbonated drinks

Hypoglycemia during pregnancy could happen due to various reasons followed by hormonal changes and metabolic changes. If it happens, then you have to consult your doctor as soon as possible. Delay in diagnosis may result in severe consequences and cause complications. Along with diagnosing and taking medicational treatment, be sure to take nutrition and carbohydrate rich diet to manage hypoglycemia.

FAQs

1. Is Hypoglycemia Bad During Pregnancy?

Hypoglycemia refers to the low level of blood sugar level. This condition during pregnancy can affect the mother and growing fetus. If the hypoglycemia is mild, it may not impact the growth of the baby ; however, frequent fluctuation can create a problem for both. For instance, severe hypoglycemia may result in seizures and often leads to death of women due to diabetes. Babies with hypoglycemia may also face several complications after birth.

2. How Do You Treat Hypoglycemia During Pregnancy Quickly At Home?

If you observe symptoms of hypoglycemia during pregnancy or are diagnosed with this condition, you can treat it by eating or consuming 15-20 gm of fast-acting carbohydrates. These sugar rich foods are quickly converted into sugar.

3. What Causes Sugar To Drop During Pregnancy?

There are several factors that lead to drop of blood sugar during pregnancy. Some of the common factors are changes in the hormones that process sugar or glucose into the body, not consuming enough carbohydrates, gestational diabetes during previous pregnancy, prolonged medication of diabetes and other medical conditions often resulting in hypoglycemia.

4. What Blood Sugar Level Is Too Low During Pregnancy?

The blood sugar level below 60-80 mg/dl is considered too low during pregnancy and results in hypoglycemia. The condition is very common during pregnancy because of hormonal changes.

References

U.S Centers For Disease Control And Prevention – https://www.cdc.gov/diabetes/about/low-blood-sugar-hypoglycemia.html
Persson B, Hansson U. Hypoglycaemia in pregnancy. Baillieres Clin Endocrinol Metab. 1993 Jul;7(3):731-9 – https://pubmed.ncbi.nlm.nih.gov/8379913/
NHS, Gestational diabetes Overview – https://www.nhs.uk/conditions/gestational-diabetes/
Altuntaş Y. Postprandial Reactive Hypoglycemia. Sisli Etfal Hastan Tip Bul. 2019 Aug 28;53(3):215-220.- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7192270/
Tommy’s Pregnancy Informations – https://www.tommys.org/pregnancy-information/pregnancy-complications/type-1-or-type-2-diabetes/hypoglycaemia-and-pregnancy
Persson B, Hansson U. Hypoglycaemia in pregnancy. Baillieres Clin Endocrinol Metab. 1993 Jul;7(3):731-9 – https://pubmed.ncbi.nlm.nih.gov/8379913/
Lee NM, Saha S. Nausea and vomiting of pregnancy. Gastroenterol Clin North Am. 2011 Jun;40(2):309-34, vii – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3676933/
The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System – https://www.hopkinsmedicine.org/health/conditions-and-diseases/diabetes/hypoglycemia-low-blood-sugar
Magon N, Chauhan M. Pregnancy in Type 1 Diabetes Mellitus: How Special are Special Issues? N Am J Med Sci. 2012 Jun;4(6):250-6 – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3385360/
American Diabetes Association Professional Practice Committee; 6. Glycemic Targets: Standards of Medical Care in Diabetes—2022. Diabetes Care 1 January 2022; 45 (Supplement_1): S83–S96. – https://diabetesjournals.org/care/article/45/Supplement_1/S83/138927/6-Glycemic-Targets-Standards-of-Medical-Care-in
Health Link British Columbia – https://www.healthlinkbc.ca/health-topics/gestational-diabetes-dealing-low-blood-sugar