The Effects Of Diabetes On An Unborn Baby
The baby of a woman with Type 1 or Type 2 diabetes may be born with birth defects, especially if the blood sugar is out-of-control. Since the organs form in the first two months of gestation, damage can be caused to the brain, spine and heart. The baby may grow too large and suffer nerve damage in the birth canal during the birthing process. This can happen in cases of gestational diabetes as well. Preterm birth may cause breathing problems, bleeding in the brain, heart problems and difficulties with the intestines and vision. Low birth weight leads to poor eating, inability to stay warm and failure to gain weight.
Many of these conditions can also appear in the baby of a woman with gestational diabetes, although there is a lesser chance of birth defects because the diabetes develops later in pregnancy, usually after the babys organs are formed.
Why Is Diabetes In Pregnancy A Concern
The mother’s excess amounts of blood glucose are transferred to the fetus during pregnancy. This causes the baby’s body to secrete increased amounts of insulin, which results in increased tissue and fat deposits. The infant of a diabetic mother; is often larger than expected for the gestational age.
The infant of a diabetic mother may have higher risks for serious problems during pregnancy and at birth. Problems during pregnancy may include increased risk for birth defects and stillbirth. It also increases the risk for birth defects, including problems with the formation of the;heart, brain, spinal cord, urinary tract, and gastrointestinal system.
Unlike insulin-dependent diabetes, gestational diabetes generally does not cause birth defects.; Women with gestational diabetes generally have normal blood glucose levels during the critical first trimester when baby’s organs form.
A newborn infant of a diabetic mother may develop one, or more, of the following:
Can A Diabetic Have A Healthy Pregnancy
By;;|;;Submitted On May 20, 2010
It was not that many years ago that diabetic women where not encouraged to get pregnant. At that time, it was felt that diabetic pregnancies had too many risks. The good thing is that with the right care many of these dangers can be lessened or even eliminated.
So now you are pregnant! What is the first thing you should do? Get your health care team organized.
This team should include all of the health care professionals that you will need throughout your pregnancy. They will monitor both you and your baby, helping to forestall any complications that should arise. If some should occur, they will be in a position to take appropriate action. Don’t forget to include family members in this team. You will need their support. as well as the support of the professionals.
Your support team will develop a good action plan that will include some very basic steps. No matter how good this plan is, it will of be no value if you don’t follow it. Having a baby when you are diabetic requires a high level of commitment, there is little room for complacency. How well your pregnancy turns out, will depend on how well you follow these directions.
Keeping your blood sugar levels in control is the primary goal all through your pregnancy. This cannot be over stressed. Maintaining good control is the key to a successful diabetic pregnancy. By doing this you will avoid many of the complications that could occur to you and your baby.
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What Causes Gestational Diabetes
Gestational diabetes comes from hormonal changes, and the way our bodies convert food into energy.
A hormone called insulin breaks down the glucose from food and delivers it to our cells. Insulin keeps the level of glucose in our blood at a healthy level. But if insulin doesnt work right or we dont have enough of it, sugar builds up in the blood and leads to diabetes.
During pregnancy, hormones can interfere with the way insulin works. It may not regulate your blood sugar levels like its supposed to, which can lead to gestational diabetes.
Will I Pass On Type 1 Diabetes To My Baby
It is natural for people with type 1 diabetes;;to worry about the possibility of passing the disease on to their children. Reassuringly, the disease does not develop in;a majority of;people with genetic risk factors. But that said, your child will still have a greater risk of developing type 1 than the general populationon average, this risk is about;fifteen times greater for someone with a relative who has the disease.;;Besides;having a parent with the disease, your childs risk of inheriting type 1 can be impacted by additional factors like:;
- Where you live ;
- How old you were when you developed type 1 diabetes;
- The presence of diabetes-related autoantibodies in your body
- Whether one or both parents have the disease
- Your age when the baby is born ;
- Having certain immune system disorders in addition to type 1
It is important to remember that ones genetic makeup is not the only factor at play. In fact, 80 percent of people with type 1 diabetes have no family history of the disease.;;;Researchers are still trying to understand exactly;how genes and environmental factors interact to determine a persons risk of developing type 1 diabetesfor example, certain viruses that target beta cells, causing the bodys autoimmune response to go awry and attack healthy cells. According to ADA, early diet may also play a role in the development of the disease; it is less common in people who were breastfed and in those who began eating solid food at later ages.;;
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Growing Baby Growing Impact
Gestational diabetes affects the mother in late pregnancy, after the baby’s body has been formed, but while the baby is busy growing. Because of this, gestational diabetes does not cause the kinds of birth defects sometimes seen in babies whose mothers had diabetes before pregnancy.
However, untreated or poorly controlled gestational diabetes can hurt your baby. When you have gestational diabetes, your pancreas works overtime to produce insulin, but the insulin does not lower your blood glucose levels. Although insulin does not cross the placenta, glucose and other nutrients do. So extra blood glucose goes through the placenta, giving the baby high blood glucose levels. This causes the baby’s;pancreas;to make extra insulin to get rid of the blood glucose. Since the baby is getting more energy than it needs to grow and develop, the extra energy is stored as;fat.
This can lead to macrosomia, or a “fat” baby. Babies with;macrosomia;face health problems of their own, including damage to their shoulders during birth. Because of the extra insulin made by the baby’s pancreas, newborns may have very low blood glucose levels at birth and are also at higher risk for breathing problems. Babies born with excess insulin become children who are at risk for;obesity;and adults who are at risk for;type 2 diabetes.
Managing Well After Delivery
Some new mothers have better blood glucose control in the first few weeks after delivery. For many, it’s a period of odd blood glucose swings. Check your blood glucose levels frequently following delivery to avoid either high or low blood glucose levels until you get an idea of how much insulin your body needs. Its important to check your blood glucose often during this time, keeping records of your levels to help you and your team adjust your insulin dose.
Some of the normal physiologic changes that occur in pregnancy can make it more difficult to keep sugar levels in the necessary narrow range, Dr. Kovac cautions.
If you have type 2 diabetes, your doctor will decide which medication you should take after delivery. You will usually be able to go back to the same medications you were taking before pregnancy, as long as they were controlling your diabetes well. This may be modified if you are breastfeeding.
Continue your healthy habits that kept your blood glucose levels on target during pregnancy. Eat healthy meals and get proper nutrition. Watch for signs of depression and talk to your doctor or health care provider if you think you are experiencing symptoms. Rest whenever your baby is sleeping.
Be good to yourself: take a warm bath, read, walk with a friend and accept offers of help.
Breastfeeding is good for women with diabetes, but it may make your blood glucose more unpredictable. To help prevent low blood glucose levels due to breastfeeding, try these tips:
Your Diabetes Treatment In Pregnancy
Your doctors may recommend changing your treatment regime during pregnancy.
If you usually take tablets to control your diabetes, you’ll normally be advised to switch to insulin injections, either with or without a medicine called metformin.
If you already use insulin injections to control your diabetes, you may need to switch to a different type of insulin.
If you take medicines for conditions related to your diabetes, such as high blood pressure, these may have to be changed.
It’s very important to attend any appointments made for you so that your care team can monitor your condition and react to any changes that could affect your or your baby’s health.
You will need to monitor your blood glucose levels more frequently during pregnancy, especially since nausea and vomiting in pregnancy can affect them. Your GP or midwife will be able to advise you on this.
Keeping your blood glucose levels low may mean you have more low-blood-sugar attacks . These are harmless for your baby, but you and your partner need to know how to cope with them. Talk to your doctor or diabetes specialist.
Elective Early Delivery With Diabetes During Pregnancy
Women who develop gestational diabetes, as well as women with preexisting mild diabetes that is well controlled, can usually carry to their due date safely though their babies are a bit more likely to be born prematurely.
But when moms normal blood sugar levels have not been well maintained throughout pregnancy, if the placenta deteriorates early or if other problems develop late in pregnancy, baby may be delivered a week or two before term.
The various tests mentioned above help a physician decide when to induce labor or perform a C-section late enough so the fetal lungs are sufficiently mature to function outside the womb, but not so late that the babys safety is compromised.
If your baby is delivered early, dont worry if shes placed in a neonatal intensive care unit immediately after delivery. This is routine procedure for babies born before 37 weeks.
Your baby will be observed for respiratory problems and for hypoglycemia .;You should be able to get your baby back soon so you can start nursing, if thats your plan.;
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What Is The Treatment For Gestational Diabetes Mellitus
Specific treatment for gestational diabetes will be determined by your doctor based on:
Your age, overall health, and medical history
Extent of the disease
Your tolerance for specific medications, procedures, or therapies
Expectations for the course of the disease
Your opinion or preference
Treatment for gestational diabetes focuses on keeping blood glucose levels in the normal range. Treatment may include:
How Gestational Diabetes Can Impact Your Baby
We don’t know what causes gestational diabetes, but we have some clues. The placenta supports the baby as it grows. Hormones from the placenta help the baby develop. But these hormones also block the action of the mother’s insulin in her body. This problem is called insulin resistance.;Insulin resistance;makes it hard for the mother’s body to use insulin. She may need up to three times as much;insulin.
Gestational diabetes starts when your body is not able to make and use all the insulin it needs for pregnancy. Without enough insulin, glucose cannot leave the blood and be changed to energy.;Glucose;builds up in the blood to high levels, called;hyperglycemia.
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Gestational Diabetes Poses Risks For Mom Baby
Study confirms numerous hazards, and experts stress the condition must be treated immediately
A team of French researchers analyzed data from more than 700,000 births in France occurring after 28 weeks of pregnancy in 2012.
Compared to other pregnant women, those with gestational diabetes were 30 percent more likely to experience preterm birth, 40 percent more likely to require a C-section, and 70 percent more likely to have preeclampsia/eclampsia, a dangerous spike in blood pressure.
Risks weren’t confined to the mother, however. Babies born to women with gestational diabetes were 80 percent more likely to be of significantly larger-than-average size at birth; 10 percent more likely to suffer respiratory issues; 30 percent more likely to experience a traumatic birth, and 30 percent more likely to have heart defects, the study found.
Babies born after 37 weeks to women with gestational diabetes also had an increased risk of death, compared to babies born to women without the condition, the study authors said.
The study clearly shows that gestational diabetes “is a disease related to adverse pregnancy outcomes,” concluded a team led by Dr. Sophie Jacqueminet, of the Pitie-Salpetriere Hospital in Paris.
The study was published Feb. 15 in the journal Diabetologia.
How Do You Know If You Have Gestational Diabetes
Your health care provider tests you for gestational diabetes with a prenatal test called a glucose tolerance test. You get the test at 24 to 28 weeks of pregnancy. If your provider thinks youre at risk for GDM, you may get the test earlier.
If your glucose screening test comes back positive, you get another test called a glucose tolerance test to see for sure if you have gestational diabetes.;
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The 3 Types Of Diabetes
Insulin-Dependent Diabetes Mellitus : IDDM is usually first diagnsed in people under the age of 25 and results in absolute insulin deficiency. Type 1 diabetics have to take insulin every day.
Non-Insulin Dependent Diabetes Mellitus : Type 2 diabetes is mostly seen in adults. Type 2 diabetics can make enough insulin to prevent ketoacidosis but not enough to meet the total body needs.;
Gestational Diabetes Mellitus : Gestational diabetes develops during pregnancy and goes away during the postpartum period.
Most of what is discussed in this section pertains to women with pre-existing, not gestational, diabetes. Once someone with;gestational diabetes;delivers their baby, they get routine postpartum care and are treated as if they are “cured” unless their 6- to 8-week postpartum glucose tolerance test proves otherwise.
Contrary to popular belief, breastfeeding is compatible with all of them. Breastfeeding:
- May lower your baby’s risk of getting diabetes
- Helps you lose weight/prevent obesity
- Helps your body use insulin in a positive way
Work With Your Health Care Team
Regular visits with members of a health care team who are experts in diabetes and pregnancy will ensure that you and your baby get the best care. Your health care team may include
- a medical doctor who specializes in diabetes care, such as an endocrinologist or a diabetologist
- an obstetrician with experience treating women with diabetes
- a diabetes educator who can help you manage your diabetes
- a nurse practitioner who provides prenatal care during your pregnancy
- a registered dietitian to help with meal planning
- specialists who diagnose and treat diabetes-related problems, such as vision problems, kidney disease, and heart disease
- a social worker or psychologist to help you cope with stress, worry, and the extra demands of pregnancy
You are the most important member of the team. Your health care team can give you expert advice, but you are the one who must manage your diabetes every day.
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Get Your Team In Place
Dr. Kovac advises that once a woman with diabetes becomes pregnant, she should be followed closely by a health care team with experience in managing diabetes in pregnancy. The members of the team include:
- A doctor trained to care for people with diabetes who has cared for pregnant women with diabetes
- An obstetrician who handles high-risk pregnancies and has treated pregnant women with diabetes
- A pediatrician or neonatologist who knows how to address special problems that may occur in babies of women with diabetes
- A registered dietitian who can help you alter your meal plan as your needs change during and after pregnancy
- A diabetes educator who can help you manage your diabetes during pregnancy
A caveat: because of the high level of care needed for both mom and baby during and after delivery, home births are not advised for women with diabetes.
How Can My Diabetes Affect Me During Pregnancy
Hormonal and other changes in your body during pregnancy affect your blood glucose levels, so you might need to change how you manage your diabetes. Even if youve had diabetes for years, you may need to change your meal plan, physical activity routine, and medicines. If you have been taking an oral diabetes medicine, you may need to switch to insulin. As you get closer to your due date, your management plan might change again.
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What Should A Pregnant Diabetic Eat
Gestational diabetes diet
- Plenty of whole fruits and vegetables.
- Moderate amounts of lean proteins and healthy fats.
- Moderate amounts of whole grains, such as bread, cereal, pasta, and rice, plus starchy vegetables, such as corn and peas.
- Fewer foods that have a lot of sugar, such as soft drinks, fruit juices, and pastries.
Fact: Your Blood Sugars And A1c Level Prior To Getting Pregnant Can Have A Big Impact On Your Babys Development
Your diabetes management during the 6 months before getting pregnant can have a significant impact on the health of that growing fetus, because your blood sugar levels impact the health of your eggs.
While not all pregnancies are planned, one of the best things you can do as a woman with type 1 diabetes who wants to become pregnant is to spend at least 6 months preparing for pregnancy by maintaining an A1C below 7 percent, recommends Jennifer Smith, RD, CDE, pregnancy coach and coauthor of Pregnancy with Type 1 Diabetes.
That way, by the time a pregnancy test turns up positive, the mindset of keeping your blood sugars mostly in the 80 to 150 mg/dL range will feel more natural and it will boost your confidence for doing so when theres a bun in the oven, too!
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