Pregnancy and Diabetes
Diabetes, namely Diabetes; is a condition in which blood sugar is elevated to varying degrees. The source of sugar in the blood is bread, rice, potatoes, flour, and starchy foods. Insulin is a hormone that regulates the blood sugar level secreted from the Langerhans islets of the pancreas.
Diabetes creates problems in pregnancy in three different ways. It is listed as Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus, and Gestational Diabetes. Type 1 and Type 2 Diabetes Mellitus are diabetes diseases that exist before pregnancy. Gestational Diabetes is a disease that occurs during pregnancy and disappears after 90% of pregnancy.
Type 1 Diabetes: It is a condition that usually begins in childhood. The body does not produce insulin. This type of diabetes is called Insulin Dependent Diabetes Mellitus. The expectant mother, who is aware of this situation before she becomes pregnant, will adjust her insulin dose to the Endocrinologist, especially she will pay more attention to her diet than ever and will have a healthy birth with us after a healthy pregnancy process.
Type Diabetes: There is insulin production in the body, but it cannot function. It usually occurs in overweight people. It also occurs at a younger age in Asian races and Blacks, although it is more common after the age of 40. It is usually diagnosed before pregnancy or can be diagnosed during pregnancy. Insulin should be used during pregnancy while using tablets that adjust blood sugar levels before pregnancy.
Gestational Diabetes: It is a diabetes-specific to pregnancy. It only occurs during pregnancy. Although it can occur in any period of pregnancy, it occurs at a more frequent rate in the second trimester. It occurs as a result of the body’s inability to produce enough insulin to meet the demands of pregnancy. After the birth, everything will be fine and return to normal. However, the risk of developing Type 2 Diabetes in the future is high in the person who has Gestational Diabetes during pregnancy.
It means you do not have diabetes during pregnancy and there is an increased risk for your baby. The height of the risk depends on the type of diabetes. These risks are higher in Type 1 and Type 2 Diabetes cases.
- Since the baby will be large, delivery will be difficult, labor induction will be made with artificial pain, and possibly cesarean delivery will be performed.
- Abortions or Miscarriages are more common in pregnant women with diabetes.
- If you have Type 1 Diabetes, you may develop Diabetic Retinopathy, Vision problems, Diabetic Nephropathy, and serious Kidney problems may occur.
- Congenital Anomalies of the Heart and Nervous System in babies are seen more than in the normal population.
- The risk of death in the mother’s womb and the risk of death immediately after birth is increased.
- The baby may have to be hospitalized shortly after birth due to health problems such as Heart and Respiratory problems.
- The baby may be obese and diabetic at a later age.
How is Gestational Diabetes Recognized?
50 g OGTT (Oral Glucose Tolerance Test) is applied to every pregnant woman at the 24th week of her pregnancy. If the value exceeds 140 mg, 100 g OGTT is done this time. Values in 100 g OGTT; PLASMADA If the 1st hour is over 190, the 2nd hour is over 165, the 3rd hour is over 145, or the 1st hour is over 165, the 2nd hour is over 15, the 3rd hour is over 125 A diagnosis of GESTATIONAL DIABETES is made.
Who are Candidates for Gestational Diabetes?
- Those with a pre-pregnancy Body Mass Index over 30.
- Those who gave birth to a baby of 4500 g or more before
- Those who have had Gestational Diabetes.
- Genetic predisposition. (Diabetes history in the family)
- Racial predisposition.
Treatment of Diabetic Pregnant
The diabetic treatment protocol is adjusted according to your needs during pregnancy. If you have been taking antidiabetic medication before, it is replaced with insulin during pregnancy.
You will now measure your blood sugar more frequently and regularly. In terms of Diabetic Retinopathy, you should see the Eye Diseases Specialist more often, and have more frequent Urinalysis and Kidney checks for Diabetic Nephropathy. In addition, frequent checking of your blood sugar protects you against Hypoglycemic Attacks. Hypoglycemic Attacks are not harmful to your baby. However, you and your partner must learn to deal with these attacks. You should receive the necessary training from your Endocrinologist in dealing with Hypoglycemic Attacks.
How to Reduce Your Risk During Pregnancy If You Have Diabetes?
The first condition to reduce health risks for your baby and yourself is that you should get your diabetes under control before you conceive. So your Blood Sugar Regulation should be adjusted very well. For this, you should definitely consult an Endocrinology Specialist before your planned pregnancy. HbA1c level in the blood should be less than 6.1%. If it’s higher, you will need to do something to adjust your blood sugar right away.
The Folic Acid need of a diabetic pregnant woman is much higher than other pregnant women. In order not to develop Spina Bifida, Diabetic pregnant women have to take Folic Acid 5 mg/day (the daily need for Folic Acid of healthy pregnant women is 400 micrograms/day). It is necessary to continue with Folic Acid until the pregnancy is twelve weeks.