Pregnancy for women with type 1 or type 2 diabetes can be safe; provided they take efforts to keep the blood sugar level under control. Diabetic women can have healthy babies, if they follow doctor’s instructions religiously. Women who do not have diabetes may develop diabetes during pregnancy. This type of diabetes is called gestational diabetes. The risk of health complications for women with type 1 or type 2 diabetes is much higher than that for women with gestational diabetes. Various lifestyle factors, for example, sedentary lifestyle and wrong diet that lead to obesity; and certain genetic factors (a family history) are believed to be responsible for the development of type 2 diabetes in women.
What is Type 2 Diabetes?
Type 2 diabetes is a condition in which cells in the body develop insulin resistance. The cells do not respond to the hormone insulin and hence do not absorb glucose from blood. Therefore high blood glucose levels are noticed by the individual. To lower the high blood glucose levels, pancreas starts releasing more and more insulin. The capacity of the pancreas to produce insulin being limited, the amount of insulin eventually seems to be insufficient to lower the elevated blood glucose levels. Overworking hampers the capacity of the pancreas and finally, it starts secreting less insulin. Type 2 diabetes is more common in elderly but these days, children and young adults are also being diagnosed with type 2 diabetes. Excessive thirst, excessive urination, slow healing wounds, are some of the common symptoms of diabetes in women.
Health Complications due to Type 2 Diabetes During Pregnancy
Before the discovery of insulin, women with diabetes were at a high risk of complications during pregnancy. But today, they can have a safe pregnancy and delivery. Women with type 2 diabetes need to control blood sugar levels prior to conception. They need to monitor the blood sugar levels daily and adjust the insulin dose accordingly. Without blood sugar control and proper diet, a pregnant woman with type 2 diabetes, might have to face various problems, during pregnancy. Take a look at the complications that are caused by high blood sugar levels during pregnancy.
- High sugar levels in the first trimester lead to increased chances of miscarriage and birth defects (defects in the heart, spine, lip of the baby). Women with A1C > 8% or the average blood glucose > 180 mg/dL (10 mmol/L) have very high risk of miscarriage or birth defects. The blood test called A1C can be performed once in a month during pregnancy. A1C test helps to know the average blood sugar level for the last couple of months. Women should try to maintain A1C below 7% and if possible, below 6% (and an average blood sugar of 120 mg/dL or 6.7 mmol/L).
- Women who have high blood sugar levels during the third trimester, can have larger than normal size babies. The baby can be overweight. As a result, cesarean delivery is the only option for them. It can lead to injuries and other complications during childbirth.
- Elevated blood sugar levels during pregnancy can lead to a serious rise in blood pressure levels. Swelling in the face, feet are common symptoms of high blood pressure during pregnancy. The condition is known as preeclampsia which can show signs like high protein in urine. It is a serious condition and should be prevented from turning into eclampsia, with proper and prompt treatment.
Tips to Prevent Health Complications During Pregnancy
Monitor Blood Sugar Levels: Women who are living with type 2 diabetes should try to maintain normal blood glucose levels, right from the beginning. If they want to get pregnant, they should get examined by an endocrinologist (a diabetes specialist) prior to pregnancy. During pregnancy also, they should regularly consult the endocrinologist and the gynecologist, and check the blood sugar levels on a regular basis.
Follow Diabetic Diet: Type 2 diabetes pregnancy diet should include foods with low glycemic index. These foods release glucose in the bloodstream and prevent the blood glucose levels to rise. Thus they help maintain stable blood glucose levels. Wheat kernels, all bran, pearl barley, rye, cracked barley, apples, avocados, cherries, dried apricots, oranges, peach, plum, pear, asparagus, broccoli, cabbage, eggplant, zucchini, boiled kidney beans, multi-grain bread, low-fat yogurt, soy milk, etc. are some examples of low glycemic foods. Diabetic women can have sufficient dietary fiber by incorporating lots of fruits and vegetables in the diet. Fiber helps keep a check on the blood sugar levels. The diet should contain complex carbohydrates like those found in beans, nuts, vegetables and whole grains. Complex carbohydrates are slowly digested and they do not lead to severe fluctuations in blood sugar levels. Women with type 2 diabetes should consume low fat low protein foods. They can enjoy fish, lean meat, soy, walnuts, seeds, poultry, legumes and liquid vegetable oils. They should avoid saturated fat, processed foods, excess salt, foods with MSG, etc.
Consult the Doctor Regularly: Women with diabetes not only need more insulin during pregnancy but they also need different doses at different times. The doses of insulin might keep on changing during pregnancy. Frequent consultation with the doctor is essential to manage the blood glucose levels. Optimal number of calories, carbohydrate intake and types of snacks/meals throughout the day should be planned after consulting the doctor. Calorie intake can vary according to the weight and activity of the woman. Women should get their eyes and kidneys checked regularly. They can take prenatal multivitamins and folic acid supplements after consulting the doctor. Oral diabetic medicines are avoided during pregnancy, as far as possible.
Exercise Regularly: Pregnant women with diabetes can continue with moderate exercises like brisk walking. Without exercises, only diet cannot help control blood sugar levels. Exercises are essential for hormonal balance and normal metabolic functions.
Blood Sugar Levels During Pregnancy
Pregnant women need to concentrate on managing their diabetes symptoms, more than ever. With the help of the doctor, they should properly plan their meals, insulin doses and activities. They should learn testing their own blood glucose levels; as they would be required to test the levels 2 – 4 times a day. The following table shows the desired blood sugar levels during pregnancy.
|Fasting blood glucose level||Less than or equal to 95 mg/dL (5.3 mmol/L)|
|Preprandial blood glucose level||Less than or equal to 100 mg/dL (5.6 mmol/L)|
|One hour post preprandial blood glucose level||Less than or equal to 140 mg/dL (7.8 mmol/L)|
|Two hour post preprandial blood glucose level||Less than or equal to 120 mg/dL (6.7 mmol/L)|
|Mean capillary glucose||Less than or equal to 100 mg/dL (5.6 mmol/L)|
|Glucose level at night||Greater than 60 mg/dL (3.3 mmol/L)|
Women with type 2 diabetes, may have to check blood sugar levels several times every day. Extra care, prior to conception and also during pregnancy, is essential for the safety of both the mother and the baby. With properly designed diet and exercise, diabetic women can enjoy pregnancy and have a healthy baby.