Pregnancy progresses, the metabolic adaptation intensifies, reaching great importance during the last 20 weeks of pregnancy. All these metabolic changes lead to a number of considerations when they occur in a diabetic woman:

* In some patients, Diabetes first appears during pregnancy.
* The conventional criteria for diagnosis of diabetes are not applicable during pregnancy
* As the pregnancy progresses there is an increase in insulin needs.
* The usual criteria of strict metabolic control are not applicable during pregnancy

Detection of Diabetes Mellitus (DMG)

The data suggest a DMG are:

* Glycosuria (glucose in urine) in a second fasting urine sample (see below).
* A history of:

* Abortions unexplained.
* Newborns large for gestational age.
* Malformations in the newborn.
* Significant maternal obesity (90 kg or more).

Some minor data are multiparity, toxemia of pregnancy and recurrent preterm birth repeated. The presence of more than one data increases the likelihood that a disorder in glucose metabolism.

Glycosuria (glucose in urine) is a frequent finding, as 15% of pregnant women have, so the search for cases based on this information alone is ineffective. The validity of this test may increase when using a second fasting urine sample, the urine is released into the wake despises and collected a second sample 15 minutes later when the patient is still fasting.

Suspected cases of DMG should be seen every 15 days by the endocrinologist, is working together and the obstetrician. Measures should be taken prenatal routine. There should be special emphasis on weight control. Each visit must be a blood sugar after eating. If this test does not exceed 120 mg / dl), evidence of oral glucose tolerance should be deferred until the 37 th -38 th weeks of gestation, at which time it is more likely to give positive. If at any visit after eating glucose exceeds 120 mg / dl, it should be a test of glucose tolerance without delay. If the test is negative in early pregnancy, however, diagnosis, and the test should be repeated at 37-38 weeks, before making a final decision. Patients who have a negative tolerance test at 37-38 weeks is considered normal.

If the test is positive you can make the diagnosis of gestational diabetes and the patient is given a controlled diet and you are in the same way that a diabetic clinic. If the criteria for ideal glycemic control are not achieved soon, we start treatment with insulin. The existence of a high need for insulin during pregnancy does not necessarily indicate that diabetes persists after birth.

MONITORING OF DMG

After the test should be repeated postpartum glucose tolerance. If the test is still positive, the patient has a diabetes clinic (which was revealed for the first time during pregnancy). If not, the correct diagnosis is gestational diabetes mellitus. As some patients with DM develop clinical DMG then they should be advised to maintain a normal body weight and requested to attend an annual review, or immediately if you become pregnant again.

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One of the most important aspects of pregnancy that should be paid attention to is proper nutrition. This cannot only be achieved by eating a variety of foods from different food groups but also by taking in prescribed supplementation. Since not all pregnant women are very tuned into eating a broad range of foods that are good sources of crucial nutrients during pregnancy, taking in supplements such as calcium, multivitamins and iron is necessary to support the growing baby inside the womb.

Ideal nourishment

Generally, pregnant women are advised to eat well-balanced meals that comprise of foods coming from all food groups so she can provide the proper nourishment for the baby and herself. Good nutrition by eating healthy foods and a well-balanced diet does not only ensure that the baby gets the nutrients he or she needs but this also help in minimizing some of the pains and discomfort caused by the symptoms of pregnancy.

To achieve optimum nutrition, pregnant women are advised to consume foods that are rich in folate, calcium, iron, vitamins, and minerals that can be found in whole grain breads, pastas, brown rice, fruits, vegetables, fish, lean meats and dairy products. The following are just some of the nutrients pregnant women need during the gestation period.

- calories. Pregnant women are advised to take in about 300 extra calories coming from a balanced diet of fruits, vegetables, protein, and whole grains are needed everyday to maintain a healthy pregnancy.

- protein. Protein nourishment is very important during pregnancy because it provides the building blocks for the baby’s growth especially in proper brain development. Pregnant women with diabetes are advised to aim for 30 grams of protein or more daily that should come from various animal and dairy products such as cheese, eggs, fish, chicken, beef, lamb, yogurt, cereals, grains, pasta, legumes, beans, peanuts, broccoli, peas, and leafy green vegetables.

- Vitamin C. Enough supply of Vitamin C is quiet significant for a pregnant woman because it strengthens her immunity and helps in building strong collagen, bone and teeth for the growing baby. Since Vitamin C cannot be restored in the body, a fresh supply is needed daily to ensure that the mother gets enough of this nutrient. Excellent Vitamin C sources include green leafy and yellow vegetable as well as yellow fruits.

- calcium. For bone and tooth formation, calcium intake is another significant nutrient pregnant woman should increase. Experts say that about 1,200 mg of calcium daily is recommended for lactation and pregnancy. Calcium sources include dairy products and green leafy vegetables.

- iron. Iron is a very important mineral needed to avoid the possibility of iron-deficiency anemia during pregnancy. The recommended iron intake for pregnant women is 30 to 50 mg that should come from lean meats, dark green leafy vegetables, eggs, and whole grain cereals. But since it is difficult to get enough iron in diet intake alone, the doctor usually prescribes iron supplement.

Pregnant women with diabetes should be more particular about their eating patterns now more than before because maintaining proper levels of glucose can highly contribute to the overall of both mother and child.

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During the course of the pregnancy, the mother and the baby need all the energy and nutrients they can get. Pregnancy is indeed not the time to lose weight or go on a diet because having a nutritionally sound diet can increase the chances for the baby to have a normal birth weight, proper brain development, and reduce the risk of certain birth defects. All these and more should be of topmost consideration for pregnant women who have diabetes.

What you need to know

Diabetes has three types, the “type 1 diabetes” which is the least common type but predominantly diagnosed among kids and teens, the “type diabetes” which is the most common to all ages and the “gestational diabetes” which are common for women once they get pregnant. It can be said that among these three types of diabetes, “gestational diabetes” is the easiest to deal with because it usually ends once the woman gives birth. However, this is not always the case because there are also those that continue to suffer from the disease that can lead to “type 2 diabetes” if not monitored and given proper medical attention immediately.

Although almost pregnant women are expected to suffer from gestational diabetes at one point during their pregnancy, there are also those who suffer from it even before they conceive. In this scenario, dealing with diabetes can be harder and much more complicated. But now, with the help of modern technology and advances in the field of medical research, pregnancy for women who are diabetics is fairly easier and lesser risk when it comes to the overall health of the baby and the mother as well.

First things first

For women who are diagnosed with diabetes, getting pregnant should be an utmost decision to make. This is because it will greatly determine not just the baby’s health but the woman’s overall health condition as well. For women who are planning to get pregnant despite suffering from diabetes, the major consideration to ponder on is the readiness of the woman’s body. This is very important to ensure that the woman can meet all the challenges and difficulties that goes with pregnancy.

To know if the woman’s body is ready for pregnancy despite diabetes, she should undergo a thorough physical examination administered by a licensed physician. This is very important because the physician can tell if the body is ready for the demands of pregnancy and labor and the possible complications that might occur along the way.

Experts say that pregnant women who have diabetes will most likely develop related complications such as diabetic retinopathy, hypertension, kidney disease, autonomic neuropathy or nerve damage to the internal organs, and cardiovascular diseases.

What you can do

With proper daily management, many women were able to have successful deliveries. The following are just some of the things that helped them along the way:

- frequent self-monitoring of blood glucose (SMBG);

- administering insulin injections and identifying how to adjust the doses depending on results of their SMBG;

- controlling and treatment of hypoglycemia;

- maintaining an appropriate level of regular exercise or physical activities; and an

- appropriate meal plan specially designed for women who have diabetes.

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Reasons:

First you must know what Diabetes is. Glucose is a form of sugar which is found in many foods, including pastries, pasta, potatoes and bread. The body uses glucose, to be supplied with energy. Glucose is stored in the liver, muscle and fat tissue. Pancreas produces a hormone called insulin (hormones are chemical compounds produced in any part of the body being moved to other parts in order to show its effects there). Insulin is needed to enable glucose to enter the liver, muscle and fat tissues, thus reducing the amount of glucose in the blood. In diabetes blood glucose levels remain abnormally high. In many forms of diabetes that happens because the pancreas does not produce enough insulin. Instead, the problem is in the placenta.

During pregnancy the placenta to the baby food supplier gets affected. It also produces a large number of other hormones that affect the normal response of the body to insulin. This condition is called insulin resistance. “Most pregnant ladies do not suffer from diabetes because the pancreas starts to produce additional quantity of insulin to compensate for insulin resistance. But when the pancreas of a woman cannot produce extra insulin, blood sugar remained abnormally high and believes that the woman has diabetes in pregnancy.

Increased risk of developing diabetes in women who

1. Have as obese

2. Have diabetes in the family

3. Have previously wholesale baby with great weight

4. Had dead baby or the baby with the genetic defect

5. Have more than 25 – the age

Symptoms

Most women with diabetes in pregnancy do not have any symptoms, in which we can’t recognize the situation, so it is recommended that all pregnant women take a test for diabetes between 24 and 28 – the week of pregnancy. The symptoms are usually not harmful and not endanger the lives of pregnant:

* Ease of fatigue
* Nausea
* Vomiting
* Increased thirst
* Frequent urination
* Blurred vision
* Loss of weight regardless of the increased appetite
* Common infections of the urinary tract, and skin of vagina

Prevention:

There is no known method of prevention of diabetes, mainly because diabetes is due to the effects of normal hormones of pregnancy. But the effect of insulin resistance may be offset by carefully observing the diet, avoidance of overweight lifetime and maintaining a reasonable physical activity.

Suggested Reading:
+ Healthy Pregnancy With Exercise and Yoga
+ Eating to Beat Pregnancy fatigue

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