Pregnancy with diabetes - Know the risks to avoid complications

By Dr. Meghana Reddy, Senior Consultant, Obstetrics and Gynecology, Columbia Asia Hospital, Whitefield 
Pregnancy is a beautiful phase in a woman’s life. From cravings for favorite food to shopping for the baby, most women spend time to provide the best for their baby. While everyone is busy planning for the new member, the mother’s nutrition and well-being often takes a back seat. In this crucial stage, taking all precautions to be fit and healthy is very important for the mom. 

In the past decade, the average age for bearing a child has gone up. This delay could lead to women getting affected by some health conditions and diabetes is one of them. It could be either pre-existing diabetes or gestational diabetes, which can cause problems during pregnancy in women and their developing foetus. Poor control and management of the condition can increase the risk of birth defects and other health complications among mothers. 

Pregnancy with pre-existing diabetes:
Pregnancy with pre-existing diabetes needs to be planned well. Controlling the blood sugar level before conception and during the pregnancy period can ensure healthy pregnancy period, easy delivery and a healthy baby.  If diabetes is badly managed, the to-be-mother may develop complications like eye disease and kidney disease. Also, there is an increased chance of developing pre-eclampsia, a condition with high blood pressure during pregnancy, which can cause problems for the baby. An unmanaged diabetic condition during pregnancy may lead to premature or stillborn babies. 

Pregnancy with gestational diabetes:
This kind of diabetes is diagnosed during pregnancy. Like other types of diabetes, gestational diabetes affects how the cells use sugar. Gestational diabetes causes high blood sugar that can affect pregnancy and the baby's health. In most cases, gestational diabetes can be controlled by regular exercise and a healthy diet. 
In women with gestational diabetes, blood sugar returns to normal soon after the delivery. But they are at a higher risk of getting type 2 diabetes. Therefore, it is important to follow a healthy diet plan and exercise regime post the delivery. 

Symptoms of diabetes: 

Being thirsty and urge to urinate often, blurred vision, yeast infections are some of the common symptoms of diabetes. 
Risk factors for diabetes 
•    Obese or overweight
•    Lack of physical activity
•    Polycystic ovary syndrome
•    Immediate family member with a diabetic condition
Complications due to diabetes during pregnancy:
•    Excess birth weight: If the blood sugar level of the to-be-mother is higher than normal, it can cause their babies to put on additional weight.
•    Premature delivery: It may increase the risk of premature birth.
•    Breathing difficulty among new-born: Babies may face respiratory distress syndrome.
•    Low blood sugar: Babies may face low blood sugar often called as hypoglycaemia shortly after delivery. If the hypoglycaemia episodes are severe, it might cause seizures in babies. 
•    Obesity and type 2 diabetes: Babies have the risk of developing type 2 diabetes later in life. Also, they are prone to develop obesity. 
•    Stillbirth: Untreated gestational diabetes can result in stillbirth of the baby. 
•    Preeclampsia: It can lead to pre-eclampsia, a serious complication of pregnancy that causes high blood pressure
•    C-section delivery:  Diabetes during pregnancy can increase the probability of c section delivery.
Prevention:
Following healthy habits during pregnancy will help in reducing the risk of gestational diabetes and also type 2 diabetes in future. 
Listed below are the few tips which can be followed during pregnancy. 
•    Follow healthy diet: Consume food rich in fibre content and low in fat to avoid excess calories. Consume fruits, vegetables and whole grain in right proportion. 
•    Keep yourself active: Exercising is one of the healthy habits one can follow. Regular exercise for 30 minutes helps keep one fit and active. 
•    Maintain a healthy weight: Losing those extra kilos before getting pregnant can help in having healthy pregnancy. Overeating, consuming excessive sweets can be harmful for the pregnant women. 
•    Avoid gaining excessive weight: Gaining weight is common during pregnancy period. However, gaining too much weight too quickly can increase the risk of gestational diabetes. 
Pregnant women are recommended to follow regular follow-up sessions with the gynaecologist. Regular tests and visit to the doctor can help you monitor your health as well as the health of the foetus. While choosing the hospital for the delivery, it is important to keep in mind the following:
•    It should have multispecialty services under one roof and should have infrastructure to combat any unforeseen complications in mother and baby
•    There should be clearly defined protocols for clinical and non-clinical care
•    The hospital should maintain digital records of you and your baby, so that future follow ups of the baby throughout childhood is available
•    Your health insurance is valid 
•    The hospital should have a Neonatal intensive care unit in case your newborn is sick
•    There should be a postpartum breast feeding support
With hospitals placing the safety of patients at the forefront, all the necessary precautions are being followed diligently for the patients to visit.