While motherhood is painted as the crowning glory and privilege of being a woman, it comes with its own inherent problems which can make a new mother feel upset, like a failure and insecure about her abilities and choices. The journey of development of the kid in the womb is by far the most precious feeling that any woman can ever experience, but at times it leaves behind the care taker and her offspring with lifelong diseases.
Diabetes in pregnant women is of two types:
Gestational diabetes that is diagnosed during pregnancy
Pre-gestational or pre- existing diabetes (type 1 or type 2 diabetes) diagnosed before pregnancy.
Diabetes in pregnant women occurs in about 1 in 20 pregnancies. It usually begins between weeks 13 to 28 of pregnancy and goes away with the pregnancy. Hormonal changes and weight gain are part of a healthy pregnancy, but these changes can sometimes take toll on the body.
Gestational diabetes is a condition where your blood sugar levels are high. This occurs only when you are pregnant. It is one of the most common health problems faced by pregnant women. It usually develops in the middle of the pregnancy, between the 24th and 28th weeks, when hormones interfere with the mother’s ability to use insulin” says Dr. Ajay Aggarwal, Consultant Endocrinologist, Fortis Hospital, Shalimarbagh, Delhi.
Whereas, if you have diabetes before you get pregnant, it is called Pre-gestational diabetes. The two types of pre-gestational diabetes are:
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When body requires more energy than usual and the normal amount of glucose from the food intake is not sufficient. To compensate this, the pancreas makes more and more insulin. But if insulin is not produced in the right amount, i.e. or due to malfunction of the pancreas insulin is not produced, the glucose can't get into the cells, and thus stays and keeps accumulating in the blood making your blood glucose level higher than required causing diabetes. Diabetes, if not taken seriously can lead to blindness, chronic heart diseases, stroke, kidney failure and also sometimes to amputations.
Many people are unaware of the fact that diabetes can be dangerous for pregnant woman. Diabetes, if not controlled can affect your baby. It can cause your baby to grow large (macrosomia) and have a higher birth weight (nearly 4 kg). This can make normal delivery (vaginal delivery) difficult. Uncontrolled diabetes can also put your baby at an increased risk for breathing, low blood sugar levels after delivery and jaundice (yellowing of the skin and eyes) tells Dr. Aggarwal.
If a mother bearing a child is diabetic or develops diabetes due to hormonal changes, there are chances that the baby can acquire diabetes too. The baby also stands chances to be born with defects!
Diabetes in pregnant women can lead to a number of complications for both mother and the child.
Some of the complications which can affect the mother are:
· High blood pressure resulting in fits, in medical terminology; Pre-eclampsia
· Increase in the amount of amniotic fluid; the fluid around baby in the womb.
· Pre-mature birth of baby up-to almost 37 weeks before the actual due date.
· Have to under-go a caesarean birth because of complications
· Chances of developing Gestational diabetes in future pregnancies.
· Risks of developing type II diabetes in later stages of life.
Possible effects on the baby:
· Probability of the baby acquiring low blood sugar (hypoglycaemia) for a few days after birth.
· A more than higher risk of the baby getting jaundice, which is otherwise common in all newborns.
· If the baby is born prematurely, there is a higher chance of his or herfound with the condition of respiratory distress syndrome as the lungs do not get a chance to get developed fully as a result of the high sugar levels during pregnancy.
· The child stands a higher chance of being obese in later life.
· Also face a clear risk of developing diabetes when the child grows older.
So, the big question is, “How to take care of yourself during pregnancy so that you do not get diagnosed with this type of diabetes, and if you have nonetheless acquired it, how do you make sure that the baby is least effected?”
Though diabetes in pregnant women should be considered a big threat to the baby’s health, it is also a fact that there are numerous cases when women with gestational diabetes have delivered healthy babies. So, it is all about taking few precautions during pregnancy. Here are a few things which one should keep in mind and follow:
· Follow the diet plan suggested by your dietician very strictly.
· Try to be active for at least 2 hours and 30 minutes each week. This will help in keeping your blood glucose level on track.
· Use a blood glucose meter to check your blood glucose levels periodically.
It is very important to keep track of your blood sugar level so that you know exactly when it is dropping below the required level and you take the necessary precautions and prescribed medicines.
Dr. Aggarwal “Treatment of choice for Diabetes in Pregnancy is Only Insulin. OHA’s are contraindicated. Insulin therapy helps to maintain your blood sugar levels in the normal range. Maintaining your blood sugar levels in the normal range will help your baby have the right weight. It will also prevent preterm labor, miscarriages and help you to have a good pregnancy outcome.
Insulin pumps help you manage diabetes by delivering insulin 24 hours. Pump is more beneficial as it is more accurate, precise and flexible as insulin delivery systems and provides tight blood glucose control therefore preventing both the mother and the baby from complications.
Insulin Pump is superior over Insulin Injections as it:-
· Delivers insulin more accurately than injections
· Eliminates individual insulin injections ( 12-16 Injections Vs one prick/ every 4th day)
· Improves HBA1c
· Results in fewer large swings in your blood glucose levels (reduces episodes of hypoglycemia and hyperglycemia)
· Allows you to be flexible about when and what you eat
· Can improve your quality of life
· Reduces complications related to diabetes to mother as well as the baby
· Better predictability for insulin absorption
· Allows you to exercise without having to eat large amounts of carbohydrate
The number of people using this new insulin pump therapy to manage their diabetes is growing rapidly. Today, over 250,000 people around the world are using an insulin pump to get a control on their unpredictable fluctuations of sugar level.
All you would-be moms, do not worry, just be careful. You only need to keep a close check on your blood glucose level and enjoy the phase.