Pregnancy is undoubtedly an exciting but equally daunting experience in the life of every woman. But if you have diabetes and intend to become ‘a mother-to-be’, then the planning requires a whole new level of care and comfort. The reason being diabetes is the leading lifestyle disorder across the world. However, there is no need to worry too much because all you need to do is to follow some simple steps to keep diabetes in control and prepare for pregnancy.
Diabetes and Pregnancy – Steps of Preparation
According to the International Diabetes Federation reports of 2015, it is estimated that around 415 million people had suffered from diabetes and the numbers might reach to 642 million by 2040[1]. Diabetes is the leading disorder in India where there are 73 million cases reported until 2018[2]. In India alone, diabetes during pregnancy, known as gestational diabetes, complicates nearly 4 million pregnancies annually[3]. It goes without saying that you will need to be more careful and vigilant to handle the issues related to diabetes and pregnancy.
1. Consult With Your Doctor
You need to consult with your doctor at least a few months before you plan to conceive. Your doctor will order the HbA1c test to check your blood glucose level and how well it is faring for the past few months. It will also give a clear idea of whether your diabetes is under control or not. Moreover, you will also be advised to get tested for various parameters to check for complications related to diabetes for kidneys, heart, and nerve damage.
2. Know Your Experts
Getting in touch with an expert to control diabetes and plan your pregnancy is important but what is more important is to consult the right expert. Knowing your experts/doctors can help you to consult the right doctors at the right time and get correct information. While you can consult a general physician, you should also consult the following specialist doctors and healthcare professionals:
-A doctor who specializes in diabetes like an endocrinologist or diabetologist
-An OBS/GYN, preferably with experience in treating diabetic women
-An expert in prenatal care
-A dietician/nutritionist to help you create the perfect diet plan to control your blood glucose level
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3. Do Not Smoke
Smoking increases the probability of premature birth or giving birth to a stillborn baby, especially if you have diabetes. The risk of pregnancy complications is much higher if you have diabetes and if you smoke. Moreover, secondhand smoke can also impair the growth and development of the fetus if you are pregnant.
4. Stay Active
You should stay active not just during pregnancy but right from the time you plan to get pregnant. This is because physical activity can help you to manage blood pressure, blood glucose level, and cholesterol levels in the desirable range[4]. Furthermore, it will help in strengthening your muscles and bones and improving the function of the heart. However, you should consult your physician before adopting any particular physical activity including yoga, especially if you are planning to exercise for the first time during pregnancy. In most cases, brisk walking for 30 minutes is the ideal activity that will help you stay active and control diabetes, thereby helping you to get pregnant in a healthy way.
5. Watch That Diet And Weight
You should not have a BMI exceeding 27 if you have diabetes and are trying to get pregnant[5]. You should consult a dietician to create a perfect diet plan to manage your nutrition and weight. The diet plan will help you to not only manage your blood sugar but also manage your nutritional needs. Folic acid is a vital vitamin for you during and before pregnancy. Additionally, consult with your doctor and dietician to know whether you should take iron or calcium supplements.
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6. Check Your Ketone Levels
Your body will start making ketones if you do not eat enough or if your blood glucose reaches very high levels. Ketones in blood or urine indicate that your body is not using glucose for energy instead it is using fat. If a large amount of fat is burned by the body then it will be harmful to both the mother and the baby[5]. Consult with your doctor to check for ketones and how to manage them if you have any.
Diabetes and Pregnancy: Should You Worry?
Follow the steps mentioned above to manage your diabetes and get in the best possible state for pregnancy. However, there are still a few concerns that you may have. Rest assured, your concerns are normal, valid and easy to address. So, here are some of the concerns about diabetes and pregnancy:
Can Diabetes Affect your Baby?
The development of a baby’s organs such as the lungs, brain, kidneys, and the heart begins during the first two months of the pregnancy. During these months, if the blood glucose levels are high then it can lead to birth defects. Furthermore, if blood glucose levels are high then it can lead to premature birth, stillbirth, or the baby could be born with neurological and physical problems such as being overweight, hypoglycemia, neural defects, problems with breathing and risk of diabetes in adulthood.
How Can Diabetes Affect You During Pregnancy?
There are a lot of hormonal changes during pregnancy which causes your blood glucose levels to fluctuate. Therefore, during pregnancy, you may need to change the way you manage diabetes. You may also need to alter your medication, diet, lifestyle, and routine as per the expert’s advice. Each woman’s body reacts in a different way so you should consult a doctor before making any changes in your lifestyle and medications.
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What Health Problems Can Occur During Pregnancy?
Preeclampsia is a condition that occurs during pregnancy and is characterized by high blood pressure. There is a possibility of suffering from this condition if you have high blood glucose and excess protein during the last five months of your pregnancy. Preeclampsia can cause problems for both you and the baby. If you have preeclampsia by the 37th week of your pregnancy, your doctor may want early delivery. However, before the 37th week, the doctor may consider ways to help the development of the baby before birth.
Diabetes and pregnancy is tough to handle and demands the utmost care. The implications and results of improper management are potentially fatal for both you and the baby. However, as mentioned above, all the concerns and fatal outcomes of diabetes and pregnancy are manageable with the right guidance, diet, and choices. What you need to remember is that if you plan your pregnancy in a better way then you can have a healthy baby and avoid health complications.
You should check your blood and urine daily for blood glucose levels. You should also need to stay informed and vigilant. Even though discomfort during pregnancy is normal, you should consult your doctor as it can help you in dealing with issues at an early stage. So, do not fear if you have diabetes as it can be managed and requires little effort.
Comment below and let us know if you or anyone you know dealt with diabetes and pregnancy.
(The article is reviewed by Dr. Lalit Kanodia, General Physician)
Recommended Reads:
Top 5 Pregnancy Tips Every Woman Must Know
Medical Tests That Are A Must During Pregnancy
References:
1. Tripathy JP, Thakur JS, Jeet G, et al. Prevalence and risk factors of diabetes in a large community-based study in North India: results from a STEPS survey in Punjab, India. Diabetol Metab Syndr. 2017 Jan 23;9:8.
2. International Diabetes Federation. International Diabetes Federation – IDF 2018 Hyderabad [Internet]. idf.org. 2018 [cited 27 September 2018]
3. Mishra S, Bhadoria AS, Kishore S, Kumar R. Gestational diabetes mellitus 2018 guidelines: An update. J Family Med Prim Care 2018;7:1169-72.
4.. Pregnancy if You Have Diabetes | NIDDK [Internet]. National Institute of Diabetes and Digestive and Kidney Diseases. 2018 [cited 19 September 2018].
5. Correa A, Gilboa SM, Botto LD, et al. Lack of periconceptional vitamins or supplements that contain folic acid and diabetes mellitus-associated birth defects. American Journal of Obstetrics and Gynecology. 2012;206(3).pre