Pregnancy is a big milestone in a woman’s life but it can be as nerve-racking for those who have diabetes. Speaking with the OnlyMyHealth team, Dr Teji Dawane, Senior Consultant, Obstetrician and Gynaecologist, Motherhood Hospitals, Whitefield, Bengaluru, says that managing blood sugar levels while nurturing a growing life requires careful attention and proactive measures. “Whether it's pre-existing type 1 or type 2 diabetes or the development of gestational diabetes during pregnancy, women can navigate these challenges with the right strategies and support,” she adds. Let’s take a deeper look at the same.
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Pre-Existing Diabetes And Pregnancy
Diabetes is a chronic condition where the body has trouble regulating blood sugar levels. There are two main types that exist namely Type 1, which results from an autoimmune response and requires insulin treatment, and Type 2, often linked to lifestyle factors like obesity and can sometimes be managed with diet, exercise, and medications. Diabetes can also develop during pregnancy, known as gestational diabetes.
According to the US Centers for Disease Control and Prevention (CDC), when the blood sugar level is not well controlled in a pregnant woman with pre-existing type 1 or type 2 diabetes, it could lead to problems for the mother and the baby.
Some of the common issues include birth defects, an extra large baby, the increased need for a C-section to deliver the baby, high blood pressure or preeclampsia, early or preterm birth risk, and in severe cases, miscarriage or stillbirth.
Can Women With Diabetes Have A Healthy Pregnancy?
The good news is that women with diabetes can have a healthy pregnancy.
This can be achieved with precise blood sugar management and vigilant monitoring, says Dr Dawane.
“There are two main scenarios: pre-existing diabetes, demanding optimal blood sugar control before and during pregnancy, and gestational diabetes, often manageable through dietary changes, exercise, and, at times, medication,” she explains.
The doctor emphasises on regular prenatal care, check-ups, dietary adherence, and consistent medication use, while stressing on effective diabetes management under doctors' guidance to mitigate potential risks, ensuring maternal and foetal well-being.
Furthermore, discussing pregnancy plans with the doctor is crucial, she adds.
Important Things To Keep In Mind
Here are a few things to keep in mind if you’re pregnant and have pre-existing diabetes:
- Preconception care aimed at achieving stable blood glucose levels under the guidance of your doctor
- Regular monitoring of your blood sugar levels during pregnancy as the doctor advises
- Seeking consistent prenatal care from experienced doctors
- Maintaining tight control of your blood sugar levels with a tailored diabetes management plan
- Following a balanced diet with appropriate carbohydrate intake, adjusting based on blood sugar responses
- Avoiding smoking and drinking
- Incorporating regular, safe physical activity into your routine
- Discussing the safety of your diabetes medications during pregnancy; take folic acid every day
- Achieving a healthy pre-pregnancy weight and aiming for controlled weight gain during pregnancy
- Discussing your delivery plan with your doctor to ensure well-controlled blood sugar levels during labour and delivery
How To Manage Blood Sugar Levels
“During pregnancy, individuals with type 1 or especially type 2 diabetes often require increased insulin doses, especially in the last trimester, which is approximately weeks 26-40 due to escalating insulin resistance,” Dr Dawane says.
“Insulin injections are typically administered in the thigh for optimal absorption. Frequent communication with your doctor is essential for managing blood glucose levels and maternal and foetal health. Doctors may remotely review blood glucose and insulin doses, ensuring a personalised and responsive approach,” she adds.
In addition, a nutritionist can assist in planning a well-balanced diet. Remember, exercise is key in regulating weight and blood glucose, with brisk walking being a recommended moderate-intensity option, shares the doctor.