HEALTHY PREGNANCY for a woman is the one in which she keeps her blood glucose (sugar) levels in target range i.e. both before she is pregnant and during her pregnancy.
In any case, if a woman is planning to get pregnant, it is the best time to control the blood glucose levels before getting pregnant because high blood glucose levels are harmful for the baby during the first weeks of the pregnancy (even before knowing that you are pregnant). Babies born to women with diabetes, especially women with poor diabetes control are at greater risk for birth defects.
REQUIRED BLOOD GLUCOSE TARGET IN PREGNANCY
Before eating: 60-119 mg/dL
1 hour after meal: 100-149 mg/dL
IMPORTANCE OF PLANNING PREGNANCY IN DIABETES
If you have diabetes during pregnancy, you can still manage the situation by proper planning of your pregnancy. You need to pay special attention to your health and you may need to see doctors who specialise in treating diabetes or its complications.
Pregnancy causes a number of changes in the body, so it might be a requirement to change how you manage your diabetes. Even if the woman had diabetes for years, it may still be a requirement for changing the meal plan, physical activity routine and medicines. As the woman gets closer to the delivery date, the requirements might change again. Thus, planning of the pregnancy becomes a critical task in diabetes.
PREGNANCY COMPLICATIONS DURING DIABETES
As given above, there is a risk of birth defects in the babies born under diabetes. Other complications of high blood sugar before and during pregnancy are:
In mother:
Worsening of diabetic eye problem
Worsening of diabetic kidney problem
Infections of the urinary bladder & vaginal area
Preeclampsia (high blood pressure with proteins in the urine)
Difficult delivery or C-section
In baby:
Premature delivery
Birth defects involving weighing too much or too less or having breathing problems
Increased risk of losing baby through miscarriage
Glucose in a pregnant woman’s blood passes to the baby. If your blood glucose level is too high during pregnancy, so is your baby’s glucose level before birth. In some cases, it has also been seen that after delivery, the baby’s glucose level may drop quickly and go too low.
Prolonged jaundice (yellowing of skin)
LABORATORY EXAMINATIONS REQUIRED BEFORE PREGNANCY
(Under risk of diabetes)
Examinations before pregnancy suggested by doctor includes:
HbA1c levels (glycosylated hemoglobin)
High blood pressure
Heart disease
Kidney, eye and nerve damage testing
Thyroid test
HEALTHCARE TEAM
Medical team containing healthcare professionals of diabetes and pregnancy will ensure for the best care. This healthcare team may include:
Medical doctor:
You will need monitoring and advice on glucose control during and after your pregnancy.
Obstetrician-gynecologist:
Has experience treating women with diabetes. You will see your OB/GYN regularly throughout your pregnancy.
Nurse:
Who provides prenatal care and advice on managing diabetes.
Dietitian:
A registered dietitian to help with meal planning. A healthy diet for glucose control and nutrition has never been more important than now.
Psychologist:
To help you cope with stress, worry, and the extra demands of pregnancy.
Pediatrician:
Doctor who will care for children
OTHER CONSIDERATIONS FOR MANAGEMENT OF DIABETIC PREGNANCY
Exercise:
Exercise as much as possible. Take 30 minutes of walk on regular basis. It will help to control your diabetes and will help to have healthy pregnancy as well.
Healthy lifestyle:
Along with getting your blood glucose levels in your target range, it is important to establish healthy lifestyle habits as well that will reduce the risk for complications and improve the health of the baby. For women with diabetes, this lifestyle change means an HbA1c as normal as possible (less than 7%), achieving or maintaining a healthy body weight, improving diet and exercise and having a pre-pregnancy exam.
Folic acid consumption:
Women with diabetes should take a higher dose of folic acid. The normal daily dose for women trying to get pregnant and for pregnant women is 400µg. It will prevent birth defects in the brain and spinal cord.
Simultaneous medications:
If you take drugs for conditions related to your diabetes, such as high blood pressure, these may have to be altered because they may interfere with the development of the baby inside the womb.
Monitoring:
Expect to monitor your blood glucose levels more frequently during pregnancy. Your eyes and kidneys will be screened more often to check they are not deteriorating in pregnancy, as eye and kidney problems can get worse.
Breastfeeding:
It is recommended to feed the baby after birth as soon as possible– within 30 minutes – to help keep the baby’s blood glucose at a safe level.
Risk of gestational diabetes:
About 4% of all pregnant women without preexisting diabetes will develop gestational diabetes sometime around the 28-week. Gestational diabetes occurs when the mother’s body becomes resistant to insulin, causing glucose levels to build up in the blood. As with type 1 and type 2 diabetes, high blood glucose levels can cause problems for both mother and baby. Women with gestational diabetes usually get a special meal plan and are encouraged to exercise; they also have to test their blood glucose and may need to inject insulin. Gestational diabetes usually goes away after pregnancy, but brings an increased risk for the condition in pregnancy.
Smoking:
Smoking is especially harmful for people with diabetes. Smoking can increase diabetes-related health problems such as eye disease, heart disease, kidney disease and amputations. If you smoke, talk with your doctor about how to quit.
Herbal Supplementation:
Fenfuro is a first of its kind patented and clinically evaluated supplement for effective management of blood glucose levels. FENFURO is a group of furostanolic saponins, derived from fenugreek seeds (Trigonella foenum graecum) by innovative process. One of the most important properties of fenugreek seed extract is blood sugar level (BSL) lowering property. Various studies have investigated blood cholesterol-lowering and blood glucose lowering properties of fenugreek seed extract. FENFURO contains a rich variety of saponins and flavonoids. All of these substances are known to lower blood lipid levels and play valuable role in glucose regulation.
Thousands of women each year are able to monitor diabetes in pregnancy. Remember to manage the glucose levels, prioritize proper nutrition and exercise and stay connected to healthcare team. Medically management of diabetes is the key to the success of pregnancy.
REFERENCES
https://medlineplus.gov/diabetesandpregnancy.html
http://www.webmd.com/diabetes/pregnancy-diabetes-and-pregnancy#1
http://americanpregnancy.org/pregnancy-complications/diabetes-during-pregnancy/
http://www.nhs.uk/conditions/pregnancy-and-baby/pages/diabetes-pregnant.aspx
https://www.niddk.nih.gov/health-information/diabetes/diabetes-pregnancy
http://www.diabetesforecast.org/2010/aug/a-guide-to-pregnancy-with-diabetes.html?referrer=https://www.google.co.in/?referrer=http://www.diabetesforecast.org/2010/aug/a-guide-to-pregnancy-with-diabetes.html?referrer=http://www.diabetesforecast.org/2010/aug/a-guide-to-pregnancy-with-diabetes.html?referrer=https://www.google.co.in/?referrer=http://www.diabetesforecast.org/2010/aug/a-guide-to-pregnancy-with-diabetes.html?referrer=https://www.google.co.in/?referrer=http://www.diabetesforecast.org/2010/aug/a-guide-to-pregnancy-with-diabetes.html
