Diabetes in pregnancy

I had a request from one of my very favourite readers to speak a bit about diabetes in pregnancy (thanks for the request!), so, we will start a short series this week. It may seem as though there isn’t that much to say in this area, but in fact this field has recently undergone quite a shake-up. Some recommendations are being revised and more questions are popping up; so stay tuned for more news in future!{{more}}

Overall, women who have diabetes during pregnancy are thought of in two categories: 1) those who had diabetes before they became pregnant and 2) those who developed it while pregnant, then have it disappear shortly after birth. Women with diabetes Types 1 and 2 tend to fall into the first group, while the second group of women usually has a form of diabetes called gestational diabetes. This week we will go through some general information for everyone, but during the next few weeks, our discussions will focus on one group or the other.

You will hear many health practitioners say that they have never seen a person so dedicated to taking care of their diabetes as a diabetic woman carrying a child. And I must agree with this from what I have noted during my practice, and even in myself. (Recall that I had mild gestational diabetes myself, when I was pregnant.) The obvious reason behind this is a protective instinct for the child you are carrying: you see, diabetes has been known for some time to be a cause of birth defects and many birth complications in babies. The higher the blood sugars, the more likely the complications.

Some of the more common complications in babies born to mothers with poorly controlled diabetes include being of very large size (greater than 9 pounds at birth), low blood sugars after birth, premature delivery, electrolyte problems, lung problems and increased chances of developing diabetes in the future. The mother herself is also at risk for other complications, including very high blood pressure and preeclampsia. Some of you may be saying: “So you have a big baby, what’s the big deal?” Well, large babies are more difficult to deliver and this increases the chances of needing a C-section or other complicated delivery, including need for the use of forceps or vacuum. Large babies also have higher chances of shoulder problems coming through the birth canal and a host of other issues, so “big chubby baby” is cute but may have more difficulties than he/she needs on this first entrance into the world. Not to mention the looming higher chances of developing diabetes as this little baby grows up—who needs that extra risk when it can be avoided in so many cases?

So, for the sake of the mothers and babies, staying as healthy as possible during the pregnancy is paramount. If you have diabetes before becoming pregnant, your goal is to be as well controlled as possible, even before you become pregnant, then taking VERY GOOD care during the pregnancy to keep everything in check. We’ll go through several issues in the weeks to come, so sit tight and keep reading!

Take care and stay healthy Vincies!

Anita Ramsetty, MD endodocs@endocrinehelp.com
Medical Director Endocrine Care Group
www.endocrinehelp.com
Tel: 843-798-4227