Pregnant Women with Diabetes
There are two types of diabetes when one is concerned about pregnant women with diabetes.
- A woman with pre-existing diabetes who wants to conceive and carry a healthy baby to full term.
A diabetic, who either wants to conceive or finds herself to be pregnant, needs to control her glucose levels strictly – particularly in the early months of pregnancy.
Serious birth defects, or the risks of, is thought to be increased by poor control of pre-existing diabetes and it is also thought to be the cause of an increased risk of miscarriage. - And gestational diabetes , which involves the development of diabetes in a mother to be who showed no sign of the disease prior to her pregnancy.
For those women who develop gestational diabetes there is no increased risk of birth defects although it is important that glucose levels are strictly monitored and controlled to reduce the risk of stillbirth.
Why does gestational diabetes occur? The placenta produces a hormone that goes against the affect of insulin on blood sugar. Mothers who have experienced gestational diabetes should research and be aware of what the symptoms of Type 1 or Type 2 diabetes are and be aware of the steps to take to avoid or delay this disease.
Studies show that it is possible to reduce the risks by watching their diet and experience. In fact, women who went on to control their weight, exercise, and their diet had than a 55% decrease in their risk for developing diabetes.
Studies also show that women who are already overweight when becoming pregnant, or had gestational diabetes during a previous pregnancy, have a increased risk of developing gestational diabetes.
Approximately 1 in 20 pregnant women develop gestational diabetes. If it is present, then this is discovered during the routine screening tests which are usually performed between 24 and 28 weeks.
Gestational Diabetes is more common in pregnant women who have a family history of diabetes, are older than 30 years of age, or come from certain ethnic groups.
Woman who do develope gestational diabetes is at a higher risk of developing type 2 diabetes later in life, unless steps are taking to reduce the risks.
Those with the gestational form or pre-existing diabetes – often deliver bigger babies. The babies grow larger because some of the additional sugar from the mother passes through the umbilical cord into the blood stream of the baby where insulin then converts it into fat stores.
Provided diabetes is properly controlled there is no reason why diabetic women should not have an uncomplicated pregnancy and deliver a healthy child. It is when the diabetes is not controlled that problems occur and complications arise. These complications can lead to miscarriage, high blood pressure, premature delivery and stillbirth.
The current recommendation is for all women to take folic acid before conceiving to avoid the baby developing with neural tube defects. This important for diabetic women as diabetes can increase the risk of this type of birth defect.
Management for Pregnant Women with Diabetes
• Currently, oral medications used to control type 2 diabetes are not approved for use during pregnancy so any woman who is using these drugs will need to switch to insulin before conceiving and during her pregnancy.
• Diet is important. Drinking plenty of water, with a diet high in fiber and low fats are necessary for a healthy diet. Refined sugar should be cut out if possible, if not, cut out as much as possible. Watch your fat intake also. Eat plenty of fresh vegetables and low fat proteins.
• Exercise is important, if you are already exercising when you become pregnant, it is important you remain active to the limits of your body. Low impact exercising, yoga, or water aerobics are choices for those women who are not on a regular exercise program.
It is important that blood glucose levels are monitored closely during pregnancy as insulin requirements can vary significantly from those required before conception. Urine can also be checked for ketones as the presence of these can be an indication that the diabetes is not being adequately controlled. If ignored a condition called ketoacidosis can develop and this can jeopardise the life of the baby.