Diabetes mellitus (a condition where there is high levels of glucose in the blood) is of special concern during pregnancy because of the many risks for both mother and baby. In order to carry on a healthy pregnancy, expectant mothers should realize how important it is to maintain a normal glucose level, whether it is by diet control and exercise or with medication.
Women with established diabetes prior to pregnancy need regular monitoring of their blood sugar levels from the time pregnancy is planned – both for conceiving (Causes of Infertility) and maintaining a healthy pregnancy. If you previously had a normal blood sugar level but have developed diabetes during your pregnancy, you are suffering from a condition known as gestational diabetes. It is very possible that your blood sugar will return to normal after delivery of your baby, but there will remain a chance that you will develop diabetes in subsequent pregnancies or later in life.
A part of the pre-pregnancy health screening, you doctor will consider all these factors.
Diabetes in pregnancy may be of two types :
Both forms of pregnancy diabetes can be either type 1 or type 2 diabetes.
In type 1 diabetes, there is absolute lack or deficiency of insulin (which is needed to control blood sugar levels) while in type 2 diabetes there is reduced effectiveness of insulin. Type 1 diabetes can be treated by diet and insulin injections – oral hypoglycemics (drugs for lowering blood sugar levels) are of no use here.
Type 2 diabetes can be treated by diet, oral drugs and/or insulin. However, during pregnancy, only diet and insulin are the forms of treatment since the safety of oral drugs in pregnancy is still not proven.
As the baby grows within the uterus, the nutritional demands on the mother are greater. This is necessary for the baby’s development and nutrients reach the baby from the mother’s blood through the placenta. During pregnancy a number of hormonal changes occur in the body. In the course of supplying adequate glucose to the baby, certain hormones restrict the action of insulin so that the mother does not develop hypoglycemia (low blood sugar).
As a result, more than the usual amount of insulin has to be secreted by the pancreas to be able to keep the blood sugar within the normal range. If the body is unable to cope with this situation, gestational diabetes develops.
Most women do not have any symptoms of gestational diabetes, or even if they do, they are generally mild and may be confused with normal symptoms of pregnancy. This may include :
Often diabetes is detected only after a routine blood sugar test during pregnancy. It is for this reason that antenatal care should include screening for gestational diabetes between 24 and 28 weeks of pregnancy.
