Diabetes is referred to as a health condition, wherein, the blood glucose level in your body is too high. 'Pre-existing diabetes' or 'pre-gestational diabetes', implies that you have diabetes before you get pregnant. Pre-existing diabetes is different from 'gestational diabetes' (a kind of diabetes that some women develop during pregnancy).
When you have diabetes, your body does not make enough insulin or is unable to utilize insulin properly, and hence you end up with too much sugar in the blood. This can lead to several serious health problems like heart and kidney diseases, and other health problems.
Diabetes during pregnancy can have serious consequences for the mother and the developing baby, particularly, if left untreated. Therefore, it is really important to check and treat diabetes before and during pregnancy, and get appropriate treatment to prevent complications.
Precautionary Steps To Be Taken By A Diabetic If Planning A Pregnancy
Starting a family requires some planning, especially if you are a mother-to-be with diabetes. However, taking some precautionary steps can ensure that your pregnancy and baby are healthy and safe.
• Get your diabetes under control at least three to six months before you plan your pregnancy. If left untreated, diabetes may cause problems during pregnancy such as birth defects, premature birth and miscarriage.
• If you have pre-existing diabetes, may have to visit your doctor more often for prenatal care to ensure that you and your baby are healthy.
• Eat only healthy foods and remain active. Speak to your doctor, a diabetes educator, or dietician, to create a healthy meal plan for you to keep your sugar levels under control before and during pregnancy.
• You can also meet a ‘Perinatologist' if required, a doctor who treats women with high-risk pregnancies, and an ‘endocrinologist', who treats women with diabetes and other health conditions.
• Tell your doctor about any medicine that you take, even if it is not related to diabetes.
• Test your blood and urine to check for any diabetes-related complications. Also get your blood pressure, thyroid and cholesterol checked.
• Pre-conception counselling, an important step for women with diabetes, is highly recommended. It can get you physically and emotionally prepared for a healthy pregnancy.
How Does Diabetes Affect The Baby?
Majority of the women, who are diabetic during pregnancy, go on to have healthy babies, provided they keep their blood sugar levels under control. But, untreated gestational diabetes can cause serious problems. If the mother's blood sugar levels are elevated, too much glucose can enter in the baby's blood, resulting in the baby being overweight or very large.
Also, high blood sugar levels during pregnancy may increase the risk of baby developing hypoglycaemia post-delivery.
The baby may also be at higher risk for breathing problems if blood sugar levels are not under control. Risk of premature delivery and jaundice also cannot be ruled out in the baby. It can also result in other health problems like poor heart functioning in the baby. Miscarriage or stillbirth is also a possibility.
Can Diabetes Cause Birth Defects?
Studies have proven that most women diagnosed with diabetes before pregnancy have a higher risk of giving birth to a baby with birth defects or multiple defects, in comparison to those who do not have diabetes during or before pregnancy.
Birth defects such as heart defects and defects of brain and spine called ‘neural tube defects' and other health conditions may be present at birth. These defects may also change the shape or function of one or more parts of the body, and can impact the overall health of the baby.
What Are The Foods To Avoid?
It is essential to follow a gestational diabetes diet and avoid foods that may raise blood sugar levels during pregnancy. Therefore, avoiding foods that may raise blood sugar levels is essential.
Avoid sugary foods, especially refined and processed foods, as much as possible. These include cakes, sweets, puddings, biscuits, soda, and fruit juice with added sugar.
Avoid starchy foods too that are high in carbohydrates, as they can have a bigger impact on blood sugar. Some starchy foods should be avoided, while some are best limited. White potatoes, white rice, white bread and white pasta belong to this category.
Highly processed foods, condiments, fast foods and alcohol should be avoided too.
Measures To Be Taken During The Course Of Pregnancy
Special monitoring and foetal testing may be required for pregnant diabetics, particularly if you are already on insulin. The following measures need to be taken during pregnancy:
- Some tests such as foetal movement counting, ultrasound, non-stress testing, biophysical profile, Doppler flow studies are particularly recommended during pregnancy.
- Amniocentesis may be performed during the last few weeks of pregnancy to check the amniotic fluid for foetal lung maturity, as the lungs mature more slowly in babies whose mothers are diabetic. The type of delivery is decided based on whether the lungs are mature enough.
- During pregnancy, women should measure their blood glucose during the day and in the night time if there is a concern about hypoglycaemia. The pre-meal glucose measurements should be in the range of 80 to 110 mg/dL and post-meal measurements should be below 155mg/dL. If pregnant women with diabetes have higher levels of blood glucose they should get their urine checked for ketones to rule out ‘ketoacidosis', as it may sometimes lead to miscarriage.
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