Pregnancy and Diabetes

Diabetes is a condition in which the body does not produce enough insulin or does not utilise it properly. Insulin is a hormonal substance. It aids the transport of blood sugar (glucose) into body cells for use as fuel. When glucose is unable to enter cells, it accumulates in the circulation. This results in high blood sugar levels (hyperglycemia).

High blood sugar levels can create issues throughout the body. It has the potential to harm blood vessels and nerves. It has the potential to injure the eyes, kidneys, and heart. High blood sugar during pregnancy might cause birth abnormalities in the developing infant.

Diabetes is divided into three types

Diabetes type 01 - Diabetes type 1 is an autoimmune disease. The immune system attacks the insulin-producing cells in the pancreas.

Diabetes type 02-. This occurs when the body is unable to produce enough insulin or utilise it properly. It isn't an autoimmune condition.

Diabetes during pregnancy03 - This is a situation in which a woman who has never been diagnosed with diabetes develops high blood glucose levels and other diabetic symptoms during pregnancy. It affects 3 to 9 out of every 100 pregnant women.

What causes gestational diabetes?

Before becoming pregnant, some women develop diabetes. This condition is known as pregestational diabetes. Others may develop a kind of diabetes that only occurs during pregnancy. This condition is known as gestational diabetes. The way a woman's body uses glucose changes during pregnancy. This might aggravate diabetes or result in gestational diabetes.

The placenta is an organ that provides nourishment and oxygen to a growing fetus during pregnancy. Hormones are also produced by the placenta. Estrogen, cortisol, and human placental lactogen can inhibit insulin in late pregnancy. Insulin resistance occurs when insulin is inhibited. Glucose cannot enter the cells of the body. The glucose remains in the bloodstream, causing blood sugar levels to rise.

During pregnancy, who is at risk for diabetes?

Diabetes risk factors in pregnancy vary depending on the type of diabetes:

Type 1 diabetes most commonly affects children and young adults, but it can strike anyone at any age.

Women who are overweight are more prone to get Type 2 diabetes.

Women who are overweight are more prone to develop gestational diabetes. It's also more likely in women who have previously experienced gestational diabetes. Women who have a family member with Type 2 diabetes are more likely to develop it. It is also more common in women who have twins or other multiples.

What are diabetic symptoms during pregnancy?

Diabetes has no noticeable symptoms. The majority of women are unaware they have it until they get tested.

How is diabetes detected during pregnancy?

Between 24 and 28 weeks of pregnancy, nearly all nondiabetic pregnant women are evaluated for gestational diabetes. During this time, a glucose screening test is performed. You drink a glucose drink and then have your blood glucose levels checked two hours later.

A 3-hour glucose tolerance test will be performed if this test reveals a high blood glucose level. Gestational diabetes is diagnosed if the findings of the second test are abnormal.

How is diabetes managed during pregnancy?

Treatment will be determined by your symptoms, age, and overall health. It will also be determined by the severity of the ailment.

Treatment focuses on maintaining normal blood glucose levels and may include:

• A cautious diet consisting of low-carbohydrate foods and beverages

• Exercise

• Monitoring blood glucose levels

• Injections of insulin

• Hypoglycemia oral medications

What difficulties might diabetes cause during pregnancy?

The majority of issues occur in women who have diabetes prior to becoming pregnant. Complications could include:

• More insulin shots are required.

• Low blood glucose levels, which if left untreated can be fatal.

• Ketoacidosis is a condition caused by excessive blood glucose levels that can be fatal if left untreated.

Type 2 diabetes is more frequent in women who have gestational diabetes later in life. They're also more likely to develop gestational diabetes if they have second child. If you have gestational diabetes, you should be checked a few months after the birth of your child and then every three years after that.

The following are some of the baby's potential complications:

• Stillbirth is a condition in which a baby is born (fetal death). Diabetes increases the risk of stillbirth in pregnant women. Due to poor circulation or other disorders such as high blood pressure or damaged tiny blood vessels, the baby may grow slowly in the uterus. Stillbirths are caused by diabetes for unknown reasons. Women with poor blood glucose management and blood vessel alterations have a higher risk of stillbirth.
• Malformations in children. Babies born to diabetes mothers are more likely to have birth abnormalities. Some birth abnormalities are so severe that they result in stillbirth. The majority of birth abnormalities arise during the first trimester of pregnancy. Diabetic moms' babies are more likely to develop birth abnormalities in the heart and blood vessels, the brain and spine, the urinary system and kidneys, and the digestive system.
• Macrosomia. This is the term for a baby who is significantly larger than average. The baby receives all of its nourishment from the mother's blood. If the mother's blood sugar is too high, the baby's pancreas produces extra insulin to utilise the glucose. As a result, the infant develops fat and becomes exceedingly huge.
• Birth trauma. Due to the baby's huge size and difficulties in delivery, birth damage is possible.
• Hypoglycemia. Following delivery, the baby's blood glucose levels may be low. If the mother's blood glucose levels have been elevated for a long period, this problem can arise. As a result, the baby's blood contains a lot of insulin. The baby's insulin level remains high after delivery, although the mother's glucose is no longer present. The newborn's blood glucose level plummets as a result of this. After birth, the baby's blood glucose level is checked. If the level is too low, the newborn may require intravenous glucose.
• Breathing problems (respiratory distress). Too much insulin or glucose in a baby's system can prevent the lungs from fully developing. This can make it difficult for babies to breathe. This is more frequent in newborns born before 37 weeks.
• Preeclampsia. Preeclampsia is more likely in women who have Type 1 or Type 2 diabetes during pregnancy. They should take low-dose aspirin (60 to 150 mg per day) from the end of the first trimester until the baby is born to reduce the risk.

Is it possible to avoid diabetes while pregnant?

Diabetes cannot be prevented in all cases. Type 1 diabetes usually develops in childhood. Losing weight can help you avoid type 2 diabetes. Exercise and a healthy diet can also help avoid Type 2 diabetes.

How is diabetes treated during pregnancy?

Pregnant diabetics, especially those on insulin, may require further testing and monitoring of their babies. This is due to the increased chance of a stillbirth. These tests may involve the following:

• Counting fetal movement This entails calculating the number of movements or kicks over a specific time period and looking for a change in activity.

• Ultrasound. This is an imaging test that creates images of blood arteries, tissues, and organs using sound waves and a computer. Ultrasounds are used to examine the operation of internal organs and blood flow through blood arteries.
• Stress-free testing The heart rate of the baby was recorded in response to movement in this test.
• Profile biophysical. This is a test that combines nonstress and ultrasound testing to examine the baby's movements, heart rate, and amniotic fluid.
• Doppler flow measurements This is a form of ultrasound that measures blood flow using sound waves.

A diabetic mother's baby can be delivered vaginally or by a cesarean section. It will be determined by your health and the estimated weight of the baby by your pregnancy care provider. In the final weeks of pregnancy, your health care provider may recommend an amniocentesis test. This test removes some of the liquid from the water bag. The fluid can be tested to see if the baby's lungs are fully developed. In babies whose moms have diabetes, the lungs mature more slowly. If the lungs are mature, the doctor may suggest an induced labor or a cesarean delivery.

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