Pregnancy is a serious test for the health of a woman suffering from diabetes. Before insulin was used as a medicine, birth giving in women with diabetes was rare. Pregnancy occurred only in 5% of women and threatened their life, fetal death rate reached 60%. But why you should never fear diabetes? Treatment with insulin has allowed the vast majority of women with diabetes to have children. Although intrauterine fetal mortality is possible even with rational tactics of treatment and management of pregnancy, its likelihood can be significantly reduced with effective Canadian Health&Care Mall medication. Therefore, a woman with diabetes should necessarily be prepared for pregnancy under the supervision of an endocrinologist and continue monitoring throughout pregnancy.
Planning pregnancy in diabetes
A type 2 diabetes and pregnancy are concepts that require preliminary planning for their combination. If a woman wants to give birth to a healthy baby, she should be consciously ready to follow a strict regime: compliance with a certain diet, injections of insulin, periodic hospitalization. If before pregnancy she needed sugar-reducing drugs and a diet only, she needs much more while waiting for the baby. In addition, it should be taken into account that medication that lowers sugar are strictly forbidden to take during pregnancy, since it can cause congenital malformations in the baby. So a woman should know when not to take it. And this means that some time before the planned conception, a woman should necessarily switch to insulin.
Peculiarities of the course of diabetes mellitus in pregnant women
Pregnancy significantly affects the course of diabetes. At the first trimester of pregnancy, there is an improvement in the course of the disease (the blood glucose level decreases). At this time, the dose of insulin is reduced by 1/3. But already at the beginning of the second trimester (from the 13th week), on the contrary, there is a worsening of the disease, and the dose of insulin has to be increased. In the third trimester (from the 32nd week until the birth), it is again possible to improve the course of diabetes. Therefore, the dose of insulin is reduced by 20-30%.
During childbirth, blood sugar can fluctuate both in one direction and in the other. For example, under the influence of emotional influences (pain, fear), its number may increase. Important: weight gains during pregnancy has greater risk of having diabetes. At the same time, childbirth is a complex physical process, leading to fatigue. As a result of energy expenditure, the sugar level can be significantly reduced. After delivery, sugar in the blood rapidly decreases and then gradually rises, reaching the level that was before pregnancy.
What complications can diabetes cause during pregnancy?
In such women, the risk of developing late toxicosis (edema, increased blood pressure, impaired renal function and cerebral circulation) is significantly higher. Often, the disease affects the genitals, which is why women have spontaneous abortions, premature birth, intrauterine fetal death.
Who is in the risk group?
According to Canadian Health and Care Mall, a women has a predisposition to diabetes in the following cases:
- If both parents of a woman have diabetes,
- If her twin is a diabetic,
- If earlier a woman gave birth to children with a body weight of more than 4500 g;
- If a woman is obese;
- If she had usual miscarriages;
- With polyhydramnios;
- With glucosuria (the detection of sugar in the urine).
The fact that a woman suffers from a type 2 diabetes is most often known before pregnancy, but diabetes can first appear during the bearing of the baby.
Hospitalization and method of delivery
Due to the fact that during the pregnancy the need for insulin changes, earlier pregnant women rushed to the hospital as soon as they knew about their pregnancy. Today, future mothers with diabetes are hospitalized at least 3 times:
- After the first visit to the doctor;
- At the 20-24th week of pregnancy, when the need for insulin changes;
- At 32-36 week, when there is a threat of late toxicosis, requiring careful monitoring of the baby’s condition. During the last hospitalization, a decision is made on the timing and way of delivery.
Regardless of whether the pregnant woman will give birth naturally or she will undergo an operation, insulin therapy is not cancelled during delivery.
Do pregnant women with a type 2 diabetes need a special diet?
The main task in the treatment of diabetes in pregnant women is to maintain a normal blood sugar level at each moment of time: both before and after meals.
Canadian Health Care Mall advises eating at least 6 times a day, so that the supply of nutrients and energy is even throughout the day in order to avoid sudden changes in blood sugar.
The diet with diabetes of pregnant women should be designed in such a way as possible to completely exclude “simple” carbohydrates (sugar, candy, jam, etc.), limit the amount of complex carbohydrates to 50% of the total amount of food, and divide the remaining 50 % between proteins and fats. The truth about diabetes and fatty foods is that they are not compatible. Improper nutrition of a pregnant woman is fraught with a child’s future not quite healthy appetite and, as a result, obesity. The risk in this case is 40-90%. Instead, a woman should pay attention to a healthy tea for diabetes and grain, since eating brown rice could prevent diabetes.
The number of calories and a specific menu should be coordinated with a doctor-nutritionist.
How physical activity helps pregnant women with diabetes?
- Active outdoor activities increase the flow of oxygen into the blood, which the fetus needs. This improves its metabolism;
- Physical loads burn excess sugar, and sugar blood level decreases;
- Training helps to spend calories, prevent excess weight and even reduce it. This greatly facilitates the work of insulin, while a large amount of fat makes it difficult.
Increase physical activity
In most cases, a diet in combination with moderate physical loads can relieve the symptoms of a type 2 diabetes. This does not mean that you should exhaust yourself with daily training or buy a club card in the gym for the last money. Too much exercise is bad for diabetes.
- Pregnant women with diabetes can walk in the average tempo in the fresh air for several hours 2-3 times a week. The expenditure of calories with such walking is sufficient to lower blood sugar to normal, but it is necessary to follow the diet, especially if you do not take insulin.
- A good alternative to walking can be exercise in the pool and aqua aerobics. Such activity is especially relevant for those who had problems with excess weight before pregnancy, since excess fat complicates the effect of insulin.
Do I need to take insulin?
Insulin during pregnancy is absolutely safe for both the mother and the fetus, if used correctly. Insulin does not cause dependence and can be completely and painlessly cancelled after childbirth.
Insulin is used in those cases when diet and exercise do not give a positive result, that is, sugar remains elevated. In some cases, the doctor decides to prescribe insulin immediately when the situation requires it.
If the doctor prescribes insulin, do not give it up. Most of the fears associated with some myths on diabetes that are nothing more than prejudices. The only condition for correct treatment with insulin is the strict fulfillment of all prescriptions of the doctor (you can not skip the dose and time of admission or change it), including the timely analysis.
If you take insulin, you will have to measure blood sugar with a special device (called a glucometer) several times a day. Initially, the need for such a frequent measurement may seem very strange, but it is necessary monitoring blood glucose level carefully. The results should be recorded in a notebook and shown to your doctor. At the moment, the scientists are working out a new insulin to be inhaled.
Canadian Pharmacy Mall has complied an approximate list of examinations for the correction of diabetic (and any other) violations:
- Consultation of the endocrinologist;
- Full examination with a gynecologist and thorough treatment of urinary infections (if any);
- Examination with an ophthalmologist (with obligatory examination of the fundus), if necessary – burning of the affected vessels of the fundus to avoid rupture and hemorrhage;
- Comprehensive examination of kidney function;
- Consultation of a neurologist, cardiologist and therapist.
After birth, the placenta stops affect the metabolism in the woman’s body. Accordingly, the sensitivity of tissues to insulin increases. Therefore, the dosage of insulin should be significantly reduced to avoid severe hypoglycemia.
The dose of insulin can be reduced by approximately 50% after natural birth giving and by 33% in the case of caesarean section. A woman can continue living life with diabetes using insulin therapy, which allows to focus on the patient’s individual indications only, and not on other people’s “average” data. You can choose a suitable dosage of insulin by means of frequent measurements of glucose in the blood.