‘Care can make pregnancies safer for diabetic women’

Diabetes can make a pregnancy much more complicated but with good care and planning, women with either type-I or type-II diabetes mellitus can have safe pregnancies and healthy babies. An article published in the latest edition of Diabetes Digest, a Diabetic Association of Pakistan publication, advises women suffering from diabetes to bring about a few changes in their lifestyle before planning to conceive.
“Measures such as not smoking, keeping average blood glucose level under control, daily intake of 400 to 800 micrograms of folic acid, proper intake of nutrient rich foods, doing away with unsafe foods and regular exercise (minimum 30 minutes walk) can help expecting mothers to achieve their pregnancy goals.
All would-be mothers with diabetes were advised to see their doctor even before they get pregnant, as during this ‘preconception’ visit, their doctor may assess their general health and adjust drug schedule accordingly.
The women planning to conceive were also advised to visit endocrinologists as well as obstetrician as it is extremely crucial as ‘pre-existing diabetes’ automatically makes the pregnancy high-risk even if it goes along without a hitch.
“In addition to higher chances of miscarriage, there are two major types of risks that the mother’s diabetic condition poses to a developing baby. The first occurs in the earlier part of the pregnancy when organs are beginning to grow and serious birth defects can occur. The second concern comes later in the pregnancy, when babies of diabetic mothers run a risk of growing too big (this is known as macrosomia) and can create problems during delivery while harming the baby as well.
“All of these problems are best prevented, first and foremost by keeping the blood glucose level in check. Would-be mothers need to ensure that their average blood glucose over the past two to three months must be below seven percent before they conceive. The doctors, during the women’s preconception visit could help them determine a safe average blood glucose goal and devise a way to get there before pregnancy.
“Mothers with type-II diabetes, which is treated with diet and exercise, oral medications, or a combination, may need to go inject insulin for the pregnancy duration or even before. The doctor may also discuss ways to reduce the weight of would-be mother as this would not only help getting blood sugar under control but also protect against possible pregnancy induced complications,” it was stated in the article.
Obesity was cited to increase pregnancy-related complications like high blood pressure and increased chances of caesarean section.
“About three months before conception, the women need to necessarily ensure taking 400 to 800 micrograms of folic acid daily, which can prevent birth defects. Diabetic women also need to have some additional screening, besides regular tests and immunisation, and should get their cholesterol, thyroid function and blood pressure checked.”
Hypothyroidism or abnormally low thyroid function was cited to be common, especially among women with type-I diabetes, and affecting the developing nervous system of the baby. “Women with diabetes must also get a comprehensive eye examination before conceiving, as pregnancy can stimulate the development of retinopathy, a common complication of diabetes.”