Diabetes During Pregnancy

When diabetes is diagnosed during the pregnancy for the first time, it is called gestational diabetes and is considered a pregnancy complication. Expectant mothers may be extremely concerned when the doctors tell them about this condition. Yet, gestational diabetes can be prevented and well-controlled with a healthy diet, exercise, and taking medication as needed. The blood sugar levels usually return to healthy levels after delivery. 

 Managing gestational diabetes, however, is very important to prevent complications that can affect the baby and the mother. 

How  gestational diabetes may affect the baby  

  • Premature babies. Uncontrolled blood sugar levels increase the risk of early labor and delivery. Sometimes the doctors recommend early delivery because the baby is too large. 
  • Increased weight at birth. Mothers with gestational diabetes may deliver larger babies- 9 pounds or heavier. Larger babies are more likely to be delivered via C section and more likely to have birth injuries. 
  • Respiratory distress syndrome. Babies are at risk for breathing difficulties, including respiratory distress syndrome, if the mothers have gestational diabetes. The lung complications may be explained by preterm delivery, insufficient oxygen to the lungs and metabolic changes that lead to a deficiency in surfactant. Surfactant is an essential compound for optimal lung function. 
  • Hypoglycemia (low blood sugar levels). Babies may develop low blood sugar right after being born. Doctors  manage this condition by giving intravenous glucose to bring the levels up. If left untreated, severe cases of hypoglycemia can lead to seizures and other complications. 
  • Long term complications. Research shows that babies of mothers with gestational diabetes are at higher risk to develop type 2 diabetes or become obese later on in life, compared with babies of mothers without diabetes.  
  • Untreated gestational diabetes can be fatal for the baby. There is increased risk of stillbirth- or death of the baby before or right after birth. 

Complications that may affect the mother 

  • Hypertension  and preeclampsia can be caused by gestational diabetes. Preeclampsia is a serious complication of pregnancy after 20 weeks of gestation. It is  characterized by high blood pressure, vision problems, kidney  and complications, shortness of breath, pain in the upper abdomen, sudden weight gain, fluid retention and low levels of platelets in the blood.  
  • C-section delivery. Mothers with gestational diabetes are at increased risk to require c-section due to gestational diabetes, especially if they develop preeclampsia and the baby is larger than normal.
  • Type 2 diabetes. Pregnant women who have gestational diabetes are more likely to develop type 2 diabetes later on in life.  

Gestational diabetes treatment 

There is a simple, easy way to prevent these complications for both expectant mothers and babies. The healthier the mothers, the better and healthier the pregnancy. Keep the blood sugar in check by adopting a healthy lifestyle, and taking medications, as needed. 

Expectant mothers need to adopt a healthy lifestyle. The healthier, the better, to prevent gestational diabetes and other pregnancy-related complications. Those with gestational diabetes require more follow-ups and close monitoring of the pregnancy. Regular blood sugar checks for the mother, and checkups for baby’s growth and development, with repeat ultrasound and other tests. The mother’s blood glucose levels have to be checked again 6-12 weeks after delivery and tested for diabetes every three years afterward.

  • Diet. Nutrition is important for the mother and baby. Diet should include fiber rich foods like vegetables, fruits and grains. Elimination  of highly processed foods is recommended to avoid excess weight and increased blood glucose levels. 
  • Regular exercise helps improve insulin sensitivity. Most pregnant women benefit from moderately intense exercises like brisk walking, aerobic or pilates. 
  • Maintaining a  healthy weight is important . Ideally, a woman should lose excess pounds before pregnancy. During pregnancy it is normal to gain some weight. However, too much weight gain can increase the risk of gestational diabetes. A combination of diet and exercise help avoid excess weight gain. 
  • Stress management. Stress can create additional problems, including spikes in the blood sugar levels. Yoga stretches, deep breathing and mindful meditation can all reduce stress and improve the mood.
  • Avoiding environmental pollutants- from second hand smoke, to other pollutants in the air. It may be worth investing into an air purifier at home, and avoid painting the home or other renovations that can lead to more chemicals in the environment.  Recent studies link air pollution with several pregnancy complications, including gestational diabetes, hypertension and preeclampsia, premature rupture of membranes, placenta praevia, and accrete.Air pollutants have a negative impact on the baby’s health, too. 

Lifestyle changes and monitoring blood sugar levels are often enough to manage gestational diabetes. However, about 10-20% of the women with this condition may need diabetes treatment with insulin. The use of oral diabetes drugs during pregnancy is controversial because some doctors believe more research is needed to determine its safety. Overall, the prognosis is good, as gestational diabetes is well managed and the delivery is successful. 

 

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