Diabetes
is a condition that causes high levels of glucose in the
blood. Glucose is a sugar that is the body's main source
of fuel. Health problems can arise when the glucose
levels are too high or not well controlled. Diabetes is
of special concern during pregnancy. The form of diabetes
that occurs during pregnancy is called gestational diabetes.
Causes
Diabetes
occurs when there is a problem with the way the body makes
or uses insulin. Insulin is a hormone that converts the
glucose in food into energy. When the body doesn't make
enough insulin, or when insulin is not being used properly
by the body, the level of glucose in the blood becomes
too high. This is called hyperglycemia (high sugar levels
in the blood).
Because gestational diabetes can occur even when no risk factors or symptoms
are present, many health care providers test all pregnant women for diabetes.
Gestational diabetes goes away after the baby is born. More than half of
women who have gestational diabetes will develop diabetes, although usually
many years later. It's important to tell your health care provider if you
have had gestational diabetes in previous pregnancies.
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Testing
for Diabetes
The
test for diabetes is safe and simple. Samples of your blood
are taken after you drink a sugar solution, and the glucose
level is measured. A high level suggests that there may
be a problem with glucose control. If you have a high level
of glucose, you will receive a diagnostic test. This test
will diagnose diabetes if you have it.
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Effects
During Pregnancy
The risk of problems during
pregnancy is greatest when diabetes is not well controlled.
Some of these problems may increase the chance of a cesarean
delivery. This is why you need good blood sugar control
during pregnancy. Good control of glucose levels, before
and during pregnancy, can lower the risks.
If you are at risk of developing gestational diabetes,
you should understand the problems that may arise:
- Birth
defects--such as heart defects, kidney problems, and
spinal defects--occur more often in babies of women whose
diabetes was not well controlled before pregnancy.
- Macrosomia
(very large baby) occurs when the mother's blood sugar
level is high. This allows too much sugar to go to the
fetus. It can cause the fetus to grow too large. A too
large baby is not always good and can make delivery difficult.
For example, there may be problems delivering the baby's
shoulders.
- Preeclampsia
is high blood pressure during pregnancy. This can pose
problems for the mother and the baby. It may require
the baby to be delivered early. A woman with a mild form
of preeclampsia may need to stay in the hospital so that
she and her fetus can be monitored. Severe preeclampsia
can lead to seizures.
- Hydramnios
occurs when there is too much amniotic
fluid in the sac surrounding the fetus. This can
cause some women discomfort. It may result in preterm
labor (labor before 37 weeks) and delivery.
- Urinary
tract infections can occur without symptoms. If
the infection is not treated, it may spread from the
bladder to the kidneys and can harm the woman and her
fetus.
- Respiratory
distress syndrome (RDS) can make it harder for
the baby to breathe after birth. The risk of RDS is
greater in babies of mothers with diabetes.
Diet
A
balanced diet is important in pregnancy. The fetus depends on
the food you eat for its growth and nourishment. This is even
more
important if you have diabetes. Not eating properly can cause
glucose levels to change.
The
number of calories in your diet will depend on your weight,
stage of pregnancy, age, and level of activity. Your health
care provider may adjust your diet from time to time to
improve glucose control or to meet the needs of the growing
fetus. Usually the diet consists of several small meals
and snacks spread throughout the day. A bedtime snack is
important to keep glucose levels stable during the night.
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Exercise
Moderate
exercise is always good. For women with diabetes it is
especially important. Regular exercise reduces the amount
of insulin needed to keep blood glucose levels normal.
The amount of exercise that is right for each woman varies.
You and your health care provider will decide how much
and what type of exercise you need.
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