Ideally, a woman affected by type 1 diabetes should consult her doctor before becoming pregnant. This is important to optimally control blood sugar levels, adjust the medications; treat the medical conditions related to diabetes and initiate a course of folic acid supplements.
A woman needs to be constantly evaluated for her condition when she's suffering from type 1 diabetes during pregnancy. What makes the treatment difficult is that she cannot be given medicines that are given to common people because even a small alteration in diet or medication can prove to be harmful for the continuation of pregnancy. But, the good news is that there are certain harmless ways of treating diabetes or at least, reducing its complications. Some of these ways are mentioned below:
Blood pressure of diabetics can go high during pregnancy and it should therefore, be measured constantly. During the first half of pregnancy, you may actually expect high blood pressure to improve, but it will plummet to its baseline only in the second half. Medications for maintaining normal blood pressure during pregnancy include hydralazine, methyldopa, beta blockers and calcium channel blocking agents. Your doctor would advise you on the harmless dosage of these drugs.
If you have been taking drugs like captopril, lisinopril and enalapril that are Angiotensin converting enzyme (ACE) blockers or such drugs – ARBs, valsartan and losartan that are angiotension II receptor blockers; stop immediately. They are not safe for the foetus and hence, the pregnant woman should not take them.
Women with diabetes are more likely to develop gestational hypertension (high blood pressure during pregnancy). Symptoms include the passing of protein in the urine and blood pressure that stands at a level more than 140/90. If the condition worsens, the only option left is to deliver. If it is not time yet, the woman may have to be hospitalised so that her condition is monitored.
At times steroids are given so that the lungs of the foetus develop faster. These steroids increase blood sugar levels in the pregnant woman.
Conducting Eye Examination
Women with type 1 diabetes need to get their eyes checked by an opthalamologist before and during the first 3 months of pregnancy. Eye examinations before and during pregnancy with close monitoring and necessary treatment can prevent the condition from worsening and leading to loss of vision.
A woman suffering from diabetic nephropathy (kidney disease caused by diabetes), is likely to find her condition having worsened after pregnancy. Diabetic Nephropathy increases the risk of delivering an underdeveloped infant is because of reduction of blood flow to the placenta. A woman with this condition is monitored by dipstick protein testing and other tests depending on the patient’s condition. In some severe cases, dialysis or even kidney transplant may become necessary, especially if the kidney is not able to take the load.
Medical treatment of type 1 diabetes during pregnancy may not be necessary if you follow certain precautions for the same. A better lifestyle and the doctor's help can make one safer to deliver a healthy baby.
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