Diabetes And Conception
At one time, a woman with diabetes was advised against pregnancy. Thank Heaven, times have moved forward and today, with proper care before and during pregnancy, a woman with diabetes can enjoy the prospects of a healthy pregnancy and delivery.
Gestational diabetes does not occur until well into the pregnancy and happens to women who have not had diabetes prior to pregnancy. It often disappears after the baby is born. However, it can recur in the future, so a woman who experiences gestational diabetes may have to take steps to ensure her lifestyle and diet help her to stay free from the disease.
Pre-Existing Diabetes And Potential Problems
Women who have pre-existing diabetes must have complete control over their blood sugar before they conceive, for their baby's well being. The baby's organs and brain develop first, so blood sugar balance is critical. Most diabetic-related fetal birth defects happen before the mother even knows she is pregnant. High blood sugars in the first two weeks of the baby's development can be disastrous. In the later stages of pregnancy, out-of-control blood sugar can lead to several dangerous situations, among them a baby that has grown too large. Once defects have happened, they can't be undone, so it is imperative that control over blood sugar be established before conception.
Getting It Together
It takes about six months to be sure everything is "together" in terms of diet, exercise program, and insulin needs to ensure proper proportions for control of blood sugar prior to conception. Unless diabetes is not controlled well or is out-of-control, fertility is usually not affected. However, when preconception blood sugar is out of whack, birth defects such as macrosomia (babies over 9.5 pounds), immature lung development, cardiovascular or central-nervous-system malformation and cleft palate are all possibilities. The baby can develop high insulin levels of its own which can potentially lead to severe postpartum hypoglycemia in the baby after birth.
Risks Of Uncontrolled Blood Sugar
The mother with poorly controlled diabetes is at increased risk for miscarriage in the early weeks of pregnancy. The risk rate is twice as high for miscarriage in women with uncontrolled diabetes. Complications can arise in the diabetes itself, including neuropathy and retinopathy, both of which can worsen during pregnancy if blood sugar is not controlled well.
Things A Woman Can Do For Herself
A woman can take control of her life and diabetes before pregnancy by developing some lifestyle habits that are beneficial, not only during pregnancy, but lifelong as well. She can be as close to her ideal weight as possible before conception and follow a diet that keeps blood sugar under control. By staying balanced and avoiding either hyper- or hypoglycemia through the use of insulin and/or diet, a woman increases the odds for a good pregnancy.
Build A Support Team
The best thing a woman can do for herself is to have a team of support people to surround her prior to conception. An endocrinologist or doctor who specializes in diabetes and is skilled in dealing with pregnant women along with an educator/nurse is a good starting place. An ophthalmologist and dietician are wise additions as well as an obstetrician who is experienced with high-risk pregnancies and care of pregnant women with diabetes. The combination of expertise and support will go a long way to helping both mother and baby enjoy a healthy pregnancy and birth.