Diabetes and Pregnancy

Diabetes occurs when the level of sugar (glucose) in the blood becomes higher than normal.

There are two main types of diabetes. These are called:

Type 1 Diabetes, and

Type 2 Diabetes.

Sometimes pregnancy causes the blood sugar to rise in women who do not have diabetes. This is called gestational diabetes.

How does pregnancy affect diabetes?

The body requires extra insulin during pregnancy in order to regulate its glucose (sugar) levels. Consequently, pregnant women with diabetes typically require more therapies to manage their blood sugar.

If the diabetes is not well managed while you are pregnant, it could be harmful to both you and the unborn child. As a result, you will need to visit the doctor more frequently and consult a specialist while you are pregnant. By doing this, you'll be able to lower the dangers, maintain your health, and have a healthy kid.

What is gestational diabetes?

Diabetes that develops for the first time during pregnancy is known as Gestational Diabetes Mellitus (GDM). Normally, it goes away shortly after the lady has birth. According to research, GDM affects anywhere from 20 to 50 percent of pregnancies. Typically, GDM begins in the second trimester of pregnancy.

Similar to moms who have known diabetes, having GDM carries hazards for both you and your unborn child, including challenges giving birth and a higher likelihood of needing a caesarean section (see below). The majority of GDM sufferers experience postpartum recovery, however there is a significant chance that it will return (recur) during a subsequent pregnancy. Diabetes is more likely to strike women who have had GDM in the future.

Risk factors:

GDM is more common in pregnant women who are older, overweight (BMI greater than 30), and women who smokes. There is also an increased risk for:

● Women who have had GDM in previous pregnancies.

● Where there has been a short time interval between pregnancies.

● Women who have had a previous unexplained stillbirth.

● Women who have had a previous baby with very high birth weight (4.5 kg or more).

● Women with an immediate family member (brother, sister or parent) with diabetes.

● Some ethnic groups (South Asian, black Caribbean and Middle Eastern).

DiagnosisThe glucose tolerance test (GTT) can be used to test for GDM. The current National Institute for Health and Care Excellence (NICE) guidance recommends that:

● Woman who have had GDM in a previous pregnancy should be offered early self-monitoring of blood sugar (glucose) or a two-hour 75 g GTT as soon as possible after the first antenatal appointment. This is followed by a repeat GTT at 24-28 weeks of pregnancy if the first test is normal.

● Women with other risk factors (see above) should have a GTT at 24-28 weeks.

Treatment.

GDM can have major side effects on both you and your unborn child, but these can be significantly diminished with treatment.

Treatment involves adhering to dietary and exercise recommendations. You might need to take medications to reduce your blood sugar levels. Medications like metformin may be taken as pills, although insulin injections may also be required after your pregnancy.

After birth, insulin and other blood sugar-controlling medications are often withdrawn.

Although most GDM sufferers experience postpartum recovery, there is an elevated (2 in 3) risk that it may recur in a subsequent pregnancy. Diabetes is more likely to strike GDM-affected women in the future. It is advised that GDM patients:

● Avoid being overweight.

● Take regular exercise.

● Don't smoke.

● Try to avoid having pregnancies with only a short time (for example, a few months) between each pregnancy.

● Attend the six-week postpartum check and have a blood sugar test taken.

● Have their blood sugar level checked each year.

Advice for women who have diabetes before pregnancy?

The risk of problems for you and your baby can be greatly reduced by the following advice:

Avoid unwanted pregnancy. Planning a pregnancy is crucial, and using contraception is crucial as well.

The chances of stillbirth, miscarriage, congenital deformity, and newborn death are reduced by maintaining stable blood sugar (glucose) levels both before and during pregnancy.

All diabetics must adhere to the dietary, weight-control, and exercise recommendations given to them.

Make sure you have frequent eye exams, as well as appointments with your practise nurse, GP, or specialist, to be examined for any diabetes issues.

To lower the chance of birth problems in your unborn child, women who are hoping to become pregnant should take 5 mg of folic acid daily up until 12 weeks of pregnancy.

If you experience illness, you should check for ketones using ketone testing strips. The body produces ketones when there is not enough insulin present in the blood.

It is crucial to stop smoking before getting pregnant if you smoke.

What is the outlook?

Although you and your baby run the chance of experiencing a variety of issues, regular checkups and effective treatment will assist to ensure that you stay healthy and deliver a healthy baby