The problems of pregnancy in the diabetic may be considered under several headings:

Mental Problems

• Hypoglycemia – Hypoglycemia is common in the first half of pregnancy, especially in the first quarter. Fortunately, the fetus tolerates well hypoglycemia.

• Retinopathy (retinal damage)
Retinopathy is already present in many women at the beginning of pregnancy, and can progress in line is advanced. Regular ophthalmoscopy is therefore important. Paradoxically, the progression of retinopathy may be related to the initiation of a strict metabolic control. When neovascularization, photocoagulation can be controlled, and is not therefore an indication for termination of pregnancy.

* Nephropathy (kidney damage)
Diabetic nephropathy in pregnancy is defined as the presence during the first half of pregnancy proteinuria (presence of protein in the urine) is persistent, more than 400 mg in 24 hours, in the absence of infection.

Many patients also have high blood pressure and other complications resulting from kidney damage. These cases require careful monitoring and control of hypertension and diabetes mellitus, with early hospitalization and inducing labor.
Patients with functioning kidney transplants often have successful pregnancies.

FETAL PROBLEMS

* Malformations
Congenital malformations occur in 6-8% of children of diabetic mothers: they are three times more frequent than in the general population. The rate of malformations covers a broad spectrum, but the defects of the neural canal and cardiac injuries are quite common.

Therefore, you should advise the diabetic women to plan their pregnancy and with prior notice, in order to achieve the best possible control before conception takes place. Compliance with this advice may reduce the number of malformations

* Macrosomia (large size newborn)
* Neonates small for gestational age
Although normal in offspring of diabetic mothers is macrosomia, some babies are small for gestational age, due to intrauterine growth retardation. This is more common in diabetic patients with long evolution of vascular complications.

MORTALITY IN NEWBORN

* Respiratory distress syndrome (RDS) or hyaline membrane disease

When patients routinely pariahs at 36-37 weeks gestation due to lack of maturation of the lungs of the newborn, respiratory disturbance occurred many times it was deadly. Today this problem can be expected to time to avoid many deaths from this cause.

* Hypoglycemia -Neonatal hypoglycaemia is common, especially in children macrosomic. Strict metabolic control of the mother and newborn after birth reduces the frequency and severity of neonatal hypoglycaemia.

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Carrying a life inside the womb for nine months is probably the most wonderful experience any woman could ever have. In this stage called “pregnancy,” it is very important for an expectant mother to pay attention to good nutrition because this is very vital for her and her baby’s health. Pregnancy for regular women is complicated as it is, how much more for women who are suffering from a chronic illness such as diabetes?

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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Among diabetic pregnant women, the most common problem when it comes to their baby’s health is the condition called “macrosomia” or having a baby with large body. This is because the blood of the mother with diabetes is interchanged with that of the baby inside the womb. As a result, the baby will produce insulin to be able to glucose and this will lead to fat deposits, which causes the baby to grown larger compared to the regular ones.

What you can do

For a healthy lifestyle during pregnancy, it is ideal to maintain an appropriate weight gain, average consumption of various foods from different food groups, timely and prescribed vitamin and mineral supplementation, and lots of fluid intake. Sweets and fats should also be kept to a minimum level of consumption. The following are just some of the guidelines that pregnant women with diabetes can use to achieve healthy pregnancy despite the chronic disease:

1. Follow the appropriate meal plan religiously. More than ever, pregnant women should pay attention to what they eat and their eating patterns in general. This is very important because this stage—pregnancy itself—requires strict control of blood glucose levels in order to ensure that both the mother and baby are getting the right amount of key nutrients needed. In coming up with the right diet plan, it is best to seek the help of diabetes educator or a licensed dietitian to create the necessary adjustments needed to accommodate the needs not only of the fetus inside the womb but of the mother as well. In your meal plan, take note of calorie, carbohydrates and protein requirements every day because these will help you maintain normal blood glucose levels.

2. Regular Self-Monitoring of Blood Glucose or SMBG. Experts say that the only way to tell if the woman is successful in controlling her blood glucose is by monitor their levels by themselves regularly. Since being pregnant is a sensitive condition, soon to be mothers should monitor their blood glucose levels more frequently. Ideally, SMBG should be monitored four to 10 times a day.

3. Knowledge in administering insulin injections and adjusting the doses based on the results of SMBG. Sufficient supply of insulin is very crucial for pregnant women so they must know how to administer insulin injections by themselves in case no one is around when they need it. They should also ask from their physician how to adjust the doses of insulin after they are through with the SBMG. Knowing how to adjust the doses of insulin needed is very important to ensure that the body’s supply of insulin is stable.

4. Treating or controlling hypoglycemia. Pregnant women who are diabetics are more prone to hypoglycemia because of the hormonal changes in their body. Although studies show that there are no know effects of hypoglycemia in the baby, it is best to control or treat it as soon as possible so the soon to be mom won’t be having troubles during the course of conception.

5. Maintaining regular set of exercise or physical activities. This is also very important for pregnant women with diabetes because through this they can reduce the risk of hypoglycemia as well as being overweight. Since it is hard for pregnant women to do strenuous workouts, it is best to maintain the hobby of having light exercises that will keep the body moving.

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