Why my Insulin dose is changing every time?
This is very important to understand. As pregnancy advances, particularly from after 28 weeks, placental activity increases to keep the baby in good health. To do this placenta produces some hormones which act against Insulin and your dose of Insulin goes up and up during pregnancy, sometimes on daily basis we need to increase Insulin dose.
So, increment of Insulin dose in pregnancy is normal, if the dose does not go up, we get worried whether the placenta is working normally or not.
What exercise is good in Pregnancy?
Standard antenatal exercise should be fine from sugar point as well. Walking would be the best and weight lifting or stranious exercise should be avoided. Swimming is also a very good exercise.
What extra care needed during delivery?
At the time of delivery, a normal or near normal sugar is very important. Most of the time during delivery you will not be eating, particularly if the delivery is by section. So we commonly connect you to a glucose drip (to give you nutrition) with Insulin. At this time for a strict control we check blood sugar by pricking finger frequently, sometimes once in every hour. In case of gestational diabetes we disconnect Insulin soon after delivery of the placenta. If you had diabetes from before your dose of Insulin reduced to that before pregnancy. If you were on tablet before, you should continue Insulin till the time you are breast feeding.
What happens to the sugar of my baby?
The baby"s sugar is usually normal. If at the time of delivery, the mothers sugars are not under control, then there is a chance that the baby"s sugar can be on the lower side. Early initiation of breast feeding after delivery is advised.
What follow up is required?
People with gestational diabetes should get glucose tolerance test 6 weeks after delivery to make sure that diabetes is disappeared. You must remember that you will have a high risk of diabetes in future, so take precaution. Eat healthy food, take some form of regular exercise and do not become fat.
Follow up for people with type 1 or 2 diabetes would be the same as in non-pregnant time. If you are planning to conceive again, make sure your control at the time of conception is very good and you take Folic acid vitamin 5 gm every day.