Key Takeaways
- During pregnancy, blood sugar levels can change due to diabetes or gestational diabetes, exercise, and not eating enough to maintain blood sugar levels.
- Symptoms of hypoglycemia can become severe if not managed correctly and may have serious effects on the pregnant person and developing baby.
- A dietitian can play a pivotal role in helping with hypoglycemia management during pregnancy by offering guidance on which foods help maintain blood sugar levels and how often you should eat.
Many changes take place in the body during pregnancy. Sometimes, these changes include how a person’s body regulates blood sugar.
People with diabetes who become pregnant are at risk of experiencing low blood sugar, a condition medical experts call hypoglycemia.
Having low blood sugar can be dangerous and cause symptoms such as feeling shaky or jittery, confusion, light-headedness, and, in severe cases, loss of consciousness.
However, some people with mild hypoglycemia have no symptoms and don’t realize they are low.
Read on to learn what causes low blood sugar during pregnancy, how to monitor your levels, treatment options, how it may affect your baby, and more.
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What Causes Low Blood Sugar During Pregnancy?
The American Diabetes Association defines low blood sugar as being less than 70 mg/dL.
Low blood sugar, sometimes referred to as low blood glucose, during pregnancy can occur for several reasons.
Diabetes
The most common reason for low blood sugar during pregnancy is having type 1 or type 2 diabetes or gestational diabetes.
People with these conditions often take medications to help regulate their blood sugar. However, this can sometimes result in blood sugar that is too low.
Not Eating Enough
Another reason may be not eating enough for your increased energy needs while pregnant.
If you're struggling with nausea or food aversions, it’s still crucial that you eat regularly to avoid low blood sugar.
Exercise
Being physically active while pregnant is important. However, it’s crucial that you fuel your body appropriately.
It’s also important not to engage in too much exercise if your body is not used to it.
Keep your exercise routine at a familiar level, and if you want to increase your intensity, do it gradually.
Low blood sugar can occur during exercise or up to 24 hours afterward, so monitoring your blood sugar levels closely is important.
Rare Causes
In rare cases, people who have undergone bariatric surgery before pregnancy can experience low blood sugar issues during pregnancy.
And even more infrequent, hypopituitarism can cause low blood sugar in pregnant people.
Diagnosis
Typically, during weeks 24 and 28 of your pregnancy, your doctor will order a glucose challenge test to check for gestational diabetes.
The test involves having your blood sugar level checked one hour after drinking a sugary drink provided by the lab.
Depending on your doctor’s instructions, you may need to fast several hours before the test.
If you don’t have diabetes or gestational diabetes but are experiencing low blood sugar while pregnant, your medical provider will need to order testing to determine the cause.
Risks And Complications
Depending on the degree of hypoglycemia, having low blood sugar can have risks.
Mild to moderate low blood glucose may have mild symptoms and is easily corrected by eating.
However, severe low blood sugar can cause serious complications such as confusion, fainting, coma, or death.
Some people do not notice their low blood sugar symptoms until it has dropped dangerously low, which puts them at risk of severe complications.
Monitoring Blood Sugar Levels While Pregnant
Monitoring your blood glucose levels during pregnancy is important for managing diabetes or gestational diabetes and ensuring the health of you and the baby.
Your doctor may ask you to monitor your blood sugar more frequently throughout the day than you are accustomed to for closer monitoring.
They may also recommend a continuous blood sugar monitoring device.
Below are the general daily target blood glucose numbers. Your target goals may vary slightly depending on your individual circumstances.
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Treatment Options For Low Blood Sugar During Pregnancy
Managing low blood sugar during pregnancy involves various methods.
The 15-15 Rule
The 15-15 rule is a simple but effective method for treating a low blood sugar episode.
Follow this approach rather than eating a lot of food until you feel better, which can cause your blood sugar to rise too high.
- If your blood sugar is less than 70 mg/dL, eat 15 grams of carbohydrates (examples are listed below), set a timer for 15 minutes, and check your blood sugar when the time is up.
- If it’s not at or above 70 mg/dL, eat another 15 grams of carbohydrate and wait 15 minutes before checking again.
- Repeat this process until your blood sugar is above 70 mg/dL.
- Eat a quality meal or protein snack to prevent it from dropping again.
Carbohydrates the American Diabetes Association suggests for these episodes include:
- Glucose tablets.
- Gel tube.
- Four ounces (½ cup) of fruit juice or regular soda (not diet).
- One tablespoon of sugar, honey, or corn syrup.
- Hard candies like jelly beans or gumdrops (check the food label for how many to consume).
Dietary Changes
It’s important to make dietary changes while pregnant, especially if you’re experiencing episodes of low blood sugar.
To help maintain your sugar levels, focus on eating a balanced diet that includes complex carbohydrates, fiber, proteins, and healthy fats.
It’s also important to eat regularly. If you are experiencing nausea, loss of appetite, or food aversions, try breaking your meals into smaller meals throughout the day.
Foods to include in your daily diet include:
- Starchy vegetables, such as potatoes, corn, winter squash, and green peas.
- Non-starchy vegetables, such as broccoli, carrots, leafy greens, peppers, and tomatoes.
- Fruits, such as oranges, berries, apples, bananas, grapes, and melons.
- Whole grains, such as wheat, rice, oats, cornmeal, barley, and quinoa.
- Protein, such as lean meats, low-mercury fish, eggs, nuts and seeds, beans, chickpeas, and soy products.
- Dairy, such as milk, yogurt, cheese.
Medications
If you had diabetes before getting pregnant, you may need to talk with your medical provider about adjusting your medications.
If you’re having low blood sugar episodes, the dose you took prior to conceiving may be too much for pregnancy and could be the cause of the drop in blood sugar.
Your dosing may need to be modified several times throughout your pregnancy as the baby grows and your energy requirements change.
It’s important to keep good records of your blood sugar and medications and stay in contact with your doctor when there are any blood sugar issues.
Will Low Blood Sugar Affect My Baby?
A study from 2020 found several risks and complications for the newborn associated with women diagnosed as having blood sugar equal to or lower than 70 mg/dL during pregnancy. These included:
- Low birth weight.
- Small head circumference.
- Short body length.
Symptoms Of Hypoglycemia
Symptoms of hypoglycemia can come up suddenly or slowly and can range from mild to severe.
Mild symptoms
- Feeling shaky or jittery
- Hunger
- Tired
- Feeling dizzy or lightheaded
- Confusion or irritability
- Fast or irregular heartbeat
- Headache
- Changes in vision or speech.
Severe symptoms
- Loss of consciousness.
- Seizure.
- Coma.
If your blood sugar drops too low while you are sleeping, you may experience other symptoms, such as:
- Sweating enough to make your pj’s and sheets damp.
- Nightmares.
- Crying out in your sleep.
- Feeling tired and irritable the next day.
Importance Of Having A Plan
Having a plan in place for treating low blood sugar is extremely important.
Not only do you need to be vigilant in checking your blood sugar throughout the day and always carry a fast carbohydrate source, but you also need to train your friends and family on how to respond.
Symptoms of low blood sugar, such as confusion, dizziness, slurred speech, and impaired coordination, can sometimes be mistaken for intoxication.
By teaching those closest to you about your symptoms and the potential risks, they can recognize if you need immediate assistance and know how to appropriately help.
It’s also a good idea to wear a medical bracelet that signifies you have diabetes or hypoglycemia, which can alert emergency responders in case of unconsciousness.
Treating Severe Hypoglycemia
In the event of severe hypoglycemia, if you’re unable to treat your low blood sugar, you may need glucagon.
Glucagon is a fast-acting medication that increases blood sugar. It’s available by prescription and comes in injection or nasal spray form.
Talk with your medical provider about the possibility of needing glucagon.
Teach those close to you how to correctly administer glucagon if you ever need it and to call 911 right away.
Instruct them to never put food or liquid into your mouth if you are unable to swallow, as this can cause you to choke.
When To Seek Medical Attention
If you are experiencing low blood sugar and following the 15-15 rule is not helping increase your blood sugar, or your symptoms are worsening, seek immediate medical attention.
Instruct friends and family to call 911 immediately if you ever experience symptoms of severe low blood sugar.
If you do not have a diagnosis of diabetes or gestational diabetes but are having symptoms of low blood sugar, be sure to let your medical provider know so they can evaluate you.
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Takeaway
Low blood sugar during pregnancy can happen due to several reasons, including diabetes, not eating enough, exercise, or other rare causes.
Diagnosing issues with blood sugar during pregnancy typically happens between weeks 24 and 28 and includes observing how your blood sugar responds to a sugary drink.
Risks for the baby may include smaller head circumference, low birth weight, and being shorter in length.
Risks for the pregnant person may happen in severe cases of hypoglycemia and may include loss of consciousness, seizures, and death.
Managing blood sugar while pregnant includes close monitoring and following the 15-15 rule if blood sugar falls below 70 mg/dL.
It’s crucial to know the signs and symptoms of hypoglycemia and to educate those you are with regularly about it and how to help you in an emergency.
How A Dietitian Can Help
A prenatal dietitian can play an important role in helping you learn what to eat, how much to eat, and when to eat to keep your blood sugar in a healthy range.
They can work with you to create a meal plan that takes your preferences, medical conditions, and physical activity level into account while still supplying you with all the necessary nutrients for a healthy pregnancy.
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Frequently Asked Questions
Having low blood sugar while you’re pregnant can cause you to have symptoms such as feeling very hungry, jittery, lightheaded, confused, or, in extreme cases, lose consciousness.
If you have frequent low blood sugar throughout your pregnancy, the baby may be at risk for having a low birth weight, having a smaller head circumference, and being shorter in length.
Having gestational diabetes typically causes blood sugar to be too high, but can also cause blood sugar to drop too low.
Learning how to keep your blood sugar in a healthy range is key in managing gestational diabetes.
Having blood sugar on the lower side of the range is fine during pregnancy, but blood sugar that is dropping below 70 mg/dL or causing you to have symptoms of low blood sugar is not healthy.
Talk with your medical provider if you are experiencing low blood sugar while you are pregnant.
