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What is diabetes?
Diabetes is a condition in which the body produces insufficient insulin which is essential for regulating sugar conversion and for the metabolism of fats and proteins. As a result, blood sugar levels go up.
Pre-existing diabetes
Although diabetes may not necessarily get worse with pregnancy, it needs to be monitored closely as there is a tendency for you to develop high blood pressure (associated with pre-eclampsia) or go into premature labour. You will be more closely monitored by your doctor as compared to your non-diabetic counterparts.
Planning to get pregnant?
Women with diabetes who are considering pregnancy are strongly urged to achieve excellent blood glucose control before conception. That's because hyperglycemia can increase the risk of a miscarriage or of birth defects in the baby. When women have maintained strict blood glucose control prior to conceiving and during the first trimester, the incidence of malformations is much lower than in women with diabetes who did not.
If you are planning to start your family, it is critically important that you discuss your decision with your healthcare provider and members of your diabetes care team right away. You will also want to choose an obstetrician who is familiar with the special challenges of a diabetic pregnancy.
Diabetes in pregnancy
If you develop diabetes during pregnancy, it is called gestational diabetes and is less serious than pre-existing diabetes. It can be controlled through diet and insulin injections (if required). It tends to improve after pregnancy.
What is gestational diabetes?
Gestational diabetes develops in women during pregnancy because the mother's body is not able to produce enough insulin. Insulin is a hormone that enables the body to break down sugar (glucose) to be used as energy. Without sufficient insulin the amount of sugar in the blood rises.
High blood sugar levels in the mother's body are passed through the placenta to the developing baby. This can cause health problems.
Gestational diabetes usually begins in the second half of pregnancy, and goes away after the baby is born. This makes it different to the more common forms of diabetes which, once they occur, are permanent.
What causes gestational diabetes?
The cause of gestational diabetes is unknown. It is thought that the hormones produced during pregnancy may block the action of insulin. Gestational diabetes can happen if the mother's body can't produce enough extra insulin to counteract this blocking effect.
Risk factors
Although there is no clear reason why some women get gestational diabetes, women are more at risk if they:
- have a family history of type II (adult-onset) diabetes
- are over the age of 35
- are obese
- have previously given birth to a large baby
- have previously given birth to a baby born with an abnormality
- have previously had a stillbirth late in pregnancy
Symptoms of gestational diabetes
- Feeling very thirsty
- Frequent urination
- Loss of weight
- General weakness
Gestational diabetes is diagnosed through routine blood and urine tests which are carried out in all pregnancies.
Treatment
Gestational diabetes can be controlled through proper diet:
- More carbohydrates
- More fibre
- Less fat and sugar
If the diabetes cannot be controlled by diet alone, you may be given insulin injections to maintain the blood sugar levels.
Risks
If blood sugar is not maintained in the first few weeks of pregnancy, it can cause your baby to have abnormalities like cleft palate. This is why, the routine blood and urine tests are important.
If you can control your blood sugar and follow the doctor's instructions, you will have perfectly normal and healthy babies. Babies of diabetic mothers may be monitored closely after birth for first few days. This is because in the womb, the baby's pancreas would have produced more insulin to deal with the high blood sugar coming from the mother's blood. Once out of the womb, the pancreas need some time to adjust to start producing normal amounts of insulin.
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