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Diabetes and Pregnancy

What is diabetes mellitus?
How can pregestational diabetes affect my pregnancy?
How can pregestational diabetes affect my baby?
If I have diabetes and wish to become pregnant, is…
How can I control my diabetes during pregnancy?
How does my health care provider know if my blood…
Can pregnancy affect my glucose level?
How can my diet affect my pregnancy?
How can exercise help during my pregnancy?
Will I take medications to control my diabetes during…
How will diabetes affect labor and delivery?
If I have diabetes, can I breastfeed my baby?

What is diabetes mellitus?

  • Diabetes mellitus is caused by a problem with insulin.
    • Insulin
      • Moves glucose out of the blood
      • Into the body?s cells where it can be turned into energy.
    • Glucose cannot get into cells and instead stays in the blood when
      • The body does not make enough insulin
      • Or does not respond to it
    • As a result, the level of glucose in the blood increases.
  • Over time, high blood glucose levels can damage the body
    • Causing serious health problems
      • Heart disease
      • Vision problems
      • Kidney disease
  • Pregestational diabetes
    • Diabetes that is present before pregnancy

How can pregestational diabetes affect my pregnancy?

  • Problems that can occur in women with diabetes:
    • Birth defects
    • High blood pressure
    • Hydramnios
      • What is hyramnios?
        • Increased amount of amniotic fluid
        • In the amniotic sac that surrounds the baby.
      • Possible complications
        • Preterm labor and delivery.
    • Macrosomia
      • What is macrosomia?
        • Very large baby
        • The baby receives too much glucose from the mother and can grow too large.
      • Possible complications
        • A large baby can make delivery more difficult.
        • Increased risk of having a cesarean delivery.

How can pregestational diabetes affect my baby?

  • Problems that can occur with babies
    • Problems with breathing
    • Low glucose levels
    • Jaundice
    • Need for special care nursery
      • Most babies do well after birth
      • Some may need to spend time in a special care nursery.
  • Prevention of these problems
    • Proper planning and control of your diabetes

If I have diabetes and wish to become pregnant, is…

  • Yes
  • Controlling your glucose level is important
    • High glucose levels can cause birth defects
    • These defects happen before you may know you are pregnant.
      • The baby?s organs are developing in the first 8 weeks of pregnancy
  • Getting your glucose level under control may require modifications to your
    • Medications
    • Diet
    • Exercise program.

How can I control my diabetes during pregnancy?

  • With a combination of
    • Eating right
    • Exercising
    • Taking medications as directed by your health care provider.
  • Prenatal visits
    • Your health care provider will schedule frequent prenatal visits

How does my health care provider know if my blood…

  • Hemoglobin A1C te
    • A blood test called used to track your progress.
    • Gives an estimate of how well your blood glucose level has been controlled
      • During the past 4?6 weeks.

Can pregnancy affect my glucose level?

  • Hypoglycemia
    • Low blood glucose levels
  • Pregnancy increases the likelyhood of hypoglycemia in women with diabetes
  • Predisposing factors
    • If you do not eat enough food
    • If you skip a meal
    • If you do not eat at the right time of day
    • If you exercise too much.
  • You and family members should watch out for symptoms of hypoglycemia
    • Dizziness
    • Feeling shaky
    • Sudden hunger
    • Sweating
    • Weakness.

How can my diet affect my pregnancy?

  • A well-balanced, healthy diet is a critical part of any pregnancy
  • Your baby depends on the food you eat for its growth and nourishment
  • In women with diabetes, diet is even more important.
  • Not eating properly can cause your glucose level to go too high or too low

How can exercise help during my pregnancy?

  • Exercise helps keep your glucose level in the normal range
  • Helps controlling your weight;
  • Boosting your energy
  • Aiding sleep
  • Reducing backaches
  • Reduce constipation and bloating

Will I take medications to control my diabetes during…

  • Changes to insulin
    • If you were taking insulin before pregancy
      • Your insulin dosage usually will increase while you are pregnant
  • Insulin safety in pregnancy
    • Insulin is safe to use during pregnancy
    • It does not cause birth defects.
  • Insulin Pump
    • If you used an insulin pump before you became pregnant
      • You probably will be able to continue using the pump.
    • You may need to switch to insulin shots.
  • If you normally manage your diabetes with oral medications
    • Your health care provider may suggest a change in your dosage
    • Or that you take insulin while you are pregnant.

How will diabetes affect labor and delivery?

  • Labor may be induced earlier than the due date
    • Especially if problems with the pregnancy arise.
    • Induced labor: started by drugs or other means
  • While you are in labor, your glucose level will be monitored closely
    • Typically every hour.
  • If needed, you may receive insulin through an intravenous (IV) line.
  • If you use an insulin pump, you may use it during labor.

If I have diabetes, can I breastfeed my baby?

  • Experts highly recommend breastfeeding for women with diabetes.
  • Advantages
    • Breastfeeding gives the baby the best nutrition.
    • It is good for the mother as well.
    • Shed weight
      • It helps new mothers shed the extra weight
      • That they may have gained during pregnancy
    • Return of uterus to pre-pregnancy state
      • Causes the uterus to return more quickly

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