The Department of Obstetrics & Gynecology and the Diabetes Unit at Massachusetts General Hospital recently launched a new clinic to treat pregnant women with diabetes: the Diabetes in Pregnancy Program (DIPP). DIPP provides integrated

obstetric and endocrine care for pregnant women with all types of diabetes, including type 1, type 2 and gestational diabetes.

DIPP is led by maternal-fetal medicine specialist Sarah Bernstein, MD, and endocrinologist Camille Powe, MD. The team also includes nurses and nutritionists with specialized training to treat pregnant women with diabetes.

Dr. Bernstein and Dr. Powe discuss this new program and their motivation for launching it.

Q: How does diabetes impact pregnancy and does treatment make a difference?

Dr. Bernstein: It used to be considered very dangerous for women with diabetes to get pregnant. But with the latest medical treatments, women with diabetes can now have a healthy pregnancy and a healthy baby.

Dr. Powe: The most important thing for you and your baby is to keep your blood sugars in check. Treating high blood sugars during pregnancy does a number of things to improve your pregnancy:

  • It lowers the risk that you will have a large baby, which can be more difficult to deliver, so the risk of having a c-section or the baby getting stuck in the birth canal goes up.
  • It lowers the risk you will develop preeclampsia, a type of high blood pressure during pregnancy
  • It lowers the risk that your baby will have other problems when he or she is born, such as low blood sugars or breathing problems

Q: What are the challenges of treating diabetes during pregnancy?

Dr. Powe: The hormone changes that happen when you are pregnant can have a big impact on your blood sugar levels. What makes this even more complicated is that these effects change continually over the course of your pregnancy.

If you have diabetes before becoming pregnant, you may notice that your blood sugar is lower early in your pregnancy. Later in your pregnancy, however, your hormones often cause your body to become very resistant to insulin, so your blood sugars typically increase.

Dr. Bernstein: There are many changes to how your diabetes affects your body during pregnancy. Even if your diabetes was well-managed before your pregnancy, you made need to adjust your treatments. This is why it is so important to find a medical team who understands how pregnancy affects blood sugar and has experience with these changes.

Q: Why did you start the Diabetes in Pregnancy Program?

Dr. Bernstein: We started DIPP because we wanted to provide better care for pregnant women with diabetes. It is just so important for pregnant women with diabetes to get proper care!

We wanted to make it easier for women with diabetes to get both endocrine and OB care by combining those services into one program in one place.

Q: What services does DIPP offer to pregnant women?

Dr. Powe: We take a team approach to caring for our patients. Our program facilitates coordination between different specialists, including:

  • Obstetricians who provide specialized prenatal care for women with diabetes
  • Endocrinologists who provide integrated diabetes care
  • Expert nutritionists who counsel you on how to eat best for you and your baby

Q: How can I prepare before getting pregnant if I have diabetes?

Dr. Bernstein: If you have already been diagnosed with diabetes, the most important thing is to get your blood sugars under very good control before getting pregnant.

If you have diabetes and are thinking of getting pregnant, you can also come to DIPP for a pre-conception consultation. We can help you optimize your diabetes control before pregnancy to help set you up for success.

Learn more about the DIPP