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Updated: November 11, 2009 17:34 IST

Diabetes in pregnancy

GITA ARJUN
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It's World Diabetes Day on November 14. Here are the answers to some FAQs on gestational diabetes

November 14 is World Diabetes Day. As obesity in India increases, women are becoming more susceptible to diabetes. Diabetes in pregnancy can affect the health of both the mother and her unborn child. If the diabetes is not well-controlled, there is an increased chance for miscarriage, birth defects and other problems in the pregnancy.

There are three types of diabetes: Type 1 diabetes which requires daily insulin injections for control, Type 2 diabetes which is usually controlled with diet, exercise and tablets, and gestational diabetes which is diabetes first detected in pregnancy.

Here are a few frequently asked questions about diabetes and pregnancy:

How does gestational diabetes differ from Type 1 or Type 2 diabetes?

A woman who develops diabetes during pregnancy is said to have gestational diabetes. Some women have more than one pregnancy affected by diabetes which may disappear after the pregnancy ends. The worrisome part is that more than 50 per cent of women with gestational diabetes will develop Type 2 diabetes later. If not controlled, gestational diabetes can cause the baby to grow very large and can lead to problems with delivery for the mother and the baby. Gestational diabetes might be controlled with diet and exercise, or it might require the administration of insulin. Type 1 and Type 2 diabetes often are present before a woman gets pregnant. If not controlled before and during pregnancy, Type 1 and Type 2 diabetes can lead to miscarriage or birth defects. The mother also becomes susceptible to problems such as high blood pressure, kidney disease, or blindness.

Will my baby develop diabetes?

Babies born to mothers with diabetes are not born with diabetes. If the mother's diabetes was not well-controlled during pregnancy, the baby will produce large quantities of insulin while still in the womb. This can lead to low blood sugar levels immediately after birth and the baby must be watched very closely until its body adjusts to the amount of insulin it makes.

Large babies are more likely to become obese and to develop Type 2 diabetes later in life. Unless they are trained to develop healthy eating and regular exercise habits as they grow up, they have a greater chance for obesity and Type 2 diabetes.

Does the father's diabetes affect the pregnancy?

Diabetes in the father does not affect the developing baby during pregnancy. However, depending on the type of diabetes the father has, the baby might have a greater chance of developing diabetes later in life.

How does pregnancy affect a woman with diabetes?

When a woman with diabetes is pregnant, her blood sugar can undergo many fluctuations because of the hormones associated with pregnancy. Unless the sugar levels are well controlled around the time of conception, she could have a miscarriage or have a baby with birth defects. She is also at higher risk for developing high blood pressure. High blood pressure during pregnancy might lead to a baby being born early and can also result in complications for the mother. The amniotic fluid can increase alarmingly, leading to preterm labour. The major problem common to a pregnant woman with uncontrolled diabetes is that her baby grows too large. This can increase the risk of complications during delivery.

How does the mother's diabetes affect the baby?

A woman, who has Type 1 or Type 2 diabetes that is not tightly controlled, has a higher chance of having a baby with a birth defect. Since the organs of the baby form during the first two months of pregnancy, often before a woman knows that she is pregnant, it is important to achieve tight control of sugar levels when planning a pregnancy. Babies of diabetic women also tend to be large.

Newborns of diabetic women can have problems of low blood sugars, newborn jaundice and low levels of calcium immediately after birth.

How can I optimise my pregnancy if I have diabetes?

Keeping blood sugar levels in tight control before and during pregnancy is the secret to a successful, uncomplicated pregnancy. This way, you can lessen your risk of having a baby with a birth defect. A healthy, balanced diet, and a strict exercise programme, along with regular monitoring of sugar levels are essential. Regular checkups with your obstetrician for high blood pressure and the baby's growth will prevent complications.

The author is an obstetrician and gynaecologist practising in Chennai and has written the book 'Passport to a Healthy Pregnancy'.www.passport2health.in

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