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 Diabetes

March 2010
Diabetes during Pregnancy
Dr R N Mehrotra
 
There is a kind of diabetes that affects only pregnant women, called gestational diabetes. This happens because their hormones cannot use the sugar (glucose) in the blood to the optimum.The level of sugar in their blood thus becomes higher than normal. After delivery, the glucose tolerance returns to normal
 

The Risk
High sugar levels in your blood can be unhealthy for both the mother and the baby. If this diabetes is not treated, the baby is more likely to have problems at birth.The baby may weigh much more than normal or develop low blood sugar on first day of life if breastfeeding is delayed. There is also an increased risk of jaundice. The mother may have a more difficult delivery or need a caesarean section if the baby is very large.

Diet Modification
If you have gestational diabetes, you will need to follow a diet suggested by your doctor, exercise regularly and take blood tests to check your blood sugar level. You may also need to take medicines to control your blood sugar. Your doctor may ask you to change some of the foods you eat. You may be asked to see a dietician to help you plan your meals. You should not eat foods that contain simple sugar, such as cakes, cookies, candy or ice cream. Instead, eat only foods with natural sugars, like fruits.If you feel hungry between meals, eat foods that are healthy for you, such as raisins or a fruit. Complex sugar, which is found in high-fibre foods like whole grains, is good for both you and your baby.

It is also important to eat well-balanced meals. You may need to eat less at each meal, depending on the weight you gain during your pregnancy. Your doctor or dietician will talk to you about this.

Exercise
Your doctor will suggest that you exercise regularly at a level that is safe for you and the baby. Exercise will help keep your blood sugar levels normal, and it can also make you feel better. Walking is usually the easiest type of exercise, but swimming or other exercises you enjoy, work just as well. Ask your doctor for some recommended activities.

If you are not used to exercising, try doing it only for five to 10 minutes every day. As you feel better, you can increase your exercise time to 30 minutes or more per session. The longer you exercise and the more often you exercise, the better the control of your blood sugar will be. You do need to be careful about how you exercise. Ask your doctor what would be safe for you. Don’t exercise too hard or get too hot while you are exercising. If you become dizzy or have back pain or other pain while exercising, stop and call your doctor. If you have uterine contractions (labour pains, like stomach cramps), vaginal bleeding or your water bag breaks, call your doctor right away.

Testing Time
Your doctor will ask you to have regular blood tests to check your blood sugar levels. These tests will let your doctor know if your diet and exercise are keeping your blood sugar level normal. A normal blood sugar level is less than 90 mg per dl when you’re fasting (not having eaten for a number of hours before the test) and less than 120mg per dl two hours after a meal. If your blood sugar level is regularly higher than these levels, your doctor may ask you to begin taking medicine (either oral antidiabetics or insulin) to help lower your blood sugar level. You may be asked to see a specialist if you have to start taking insulin.

Post Delivery
While you’re in the hospital after your baby is born, your sugars would return to normal. Insulin would thus be discontinued. You would require to undergo a Glucose Tolerance Test after six weeks of delivery. However, gestational diabetes makes you have a higher risk for diabetes in your next pregnancy and also later in life. Even if the gestational diabetes goes away after your baby’s birth, it is important that you continue to exercise, watch your weight and eat a healthy diet. If you do, you may not get diabetes when you are older. If you are obese and have a family history of diabetes, do check your sugars at least once a year.

 

Dr. R N Mehrotra, Sr. Consultant - Endocrinology & Diabetes, Apollo Health City, Hyderabad

    
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