Diabetes
and pregnancy
We now
know that the key to a healthy pregnancy for a woman
with diabetes is keeping blood glucose (sugar) in
the target range -- both before she is pregnant and
during her pregnancy. To do this, you need a diabetes
treatment plan that keeps meals, exercise, and insulin
in balance.
This plan
will change as you change with pregnancy. You will
also need to check your blood glucose often and keep
a record of your results. With your blood glucose
in the target range and good medical care, your chances
of a trouble-free pregnancy and a healthy baby are
almost as good as they are for a woman without diabetes.
It is estimated
that between two and three percent of pregnant women
are affected by gestational diabetes.
How
is diabetes in pregnancy caused?
What causes
a pregnant woman to contract gestational diabetes
is still not known. The hormones that are produced
when pregnancy occurs may in some ways prevent the
functioning of insulin. If the mother’s body
cannot produce sufficient insulin to overcome this,
the diabetes in pregnancy can develop.
Who
is most at risk?
Like normal
diabetes, some women are more prone to develop gestational
diabetes than others. The following factors are considered
to put women at risk of developing gestational diabetes:
Are over
35 years old
Are obese
Have previously had a stillbirth in the latter stages
of pregnancy
Have already had a large baby
Also, any
person is more at risk if they have a family history
of type 2 diabetes.
What
precautions are there before pregnancy ?
How
do high blood glucose levels cause problems?
When extra
sugar is in your blood, the baby is "fed" extra sugar,
too. All this excess sugar can make the baby too big
and fat. Delivery of big babies is harder on mom and
baby.
Because
your baby is getting extra sugar, your baby's pancreas
makes extra insulin. After birth, it's hard for the
baby to stop putting out extra insulin. The baby must
be watched, and treated if the blood glucose level
drops too low.
For some
reason, jaundice happens more often in babies of women
with diabetes. Jaundice is a build-up of old red blood
cells that the body can't process fast enough. This
problem goes away rapidly with treatment
What
are the symptoms of gestational diabetes?
One of
the problems of gestational diabetes is that it does
not manifest itself with clear symptoms. The symptoms
common to high blood sugar (thirst, frequent urination,
hunger) sometimes occur, but all of them are common
in the latter stages of pregnancy.
What
could gestational diabetes do to me and my child?
During
pregnancy, the presence of high blood sugar levels
may cause the foetus to grow larger than it usually
would. This can make delivery more complicated and
in some instances may provoke the need for a caesarean
section.
Following
the birth, the baby may be suffering from hypoglycaemia
(low blood sugar) because of the pancreas’ compensation
for the extra blood sugar created by the mother. The
baby, immediately following the birth, may continue
to create extra insulin even though the mother’s
sugar levels are no longer present. This may be corrected
by a glucose solution drip.
Unfortunately, the complications do not end there.
Newborn babies from mothers with gestational diabetes
are at greater risk of developing jaundice which will
usually fade after a few weeks.
The baby also suffers an increased risk of congenital
problems from birth. These include heart defects and
respiratory problems (such as respiratory distress
syndrome.) There is also a slightly increased risk
of stillbirth, or the baby dying newborn. However,
if glucose levels are identified and strictly managed
the risk of death is minimal.
The baby will also be more at risk of developing type
2, and being overweight in later life.
Most women
who encounter gestational diabetes, and keep their
blood sugar levels within a safe range, should be
able to deliver their babies without complications.
However, women who suffer from gestational diabetes
are more at risk of developing it again and also of
developing type 2 diabetes at a later stage of life.
How
can I reduce my chances of contracting gestational
diabetes?
To lessen
the risk of contracting gestational diabetes, women
pre-pregnancy should opt for healthy lifestyle choices.
These include eating a balanced diet, exercising regularly
and appropriately and making certain to maintain a
normal body weight.
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