Low Carb For Type 1 Diabetes And Pregnancy
Standard advice for all types of diabetes can be conflicting.
Sadly, most advice is not enough to help many people get their blood sugar levels stable, and under control.
I often see women with gestational diabetes being prescribed high carb, low fat diets, and its very concerning.
Interestingly, theyre given shopping lists with specific brand names mentioned smells like sponsorship to me.
High carb, low fat diets serve to keep diabetics blood sugar levels high, their bellies hungry and craving more carbs.
For a type 1 diabetic, this can mean its harder to get your blood sugar levels under control or stable with insulin.
Read about this team of doctors who previously had type 1 or 2 diabetes, and have completely managed their condition with a low carb diet.
Also, I highly recommend The Diet Doctor website, full of great information written by doctors who are educated about nutrition.
How Diabetes May Affect Your Baby
Babies born to women with diabetes are often much bigger, a condition called “macrosomia.”
Because their mothers have high blood sugar levels, they get too much sugar through the placenta. The baby’s pancreas senses it and makes more insulin to use it up. That extra sugar gets converted to fat, making a large baby.
Many hospitals keep an eye on babies of mothers with diabetes for several hours after birth. If you regularly have high blood sugar levels while you’re pregnant , your baby may get dangerously low blood sugar right after they’re born. Their insulin is based on your high sugar, and when it’s suddenly taken away, their blood sugar level drops quickly and they’ll need glucose to balance it out.
Their calcium and magnesium levels may be off, too. Those can be fixed with medication.
Some babies are too big to be delivered vaginally, and you’ll need a cesarean delivery or c-section. Your doctor will keep an eye on your baby’s size so you can plan for the safest way to give birth.
How Can I Prepare For Pregnancy If I Have Diabetes
If you have diabetes, keeping your blood glucose as close to normal as possible before and during your pregnancy is important to stay healthy and have a healthy baby. Getting checkups before and during pregnancy, following your diabetes meal plan, being physically active as your health care team advises, and taking diabetes medicines if you need to will help you manage your diabetes. Stopping smoking and taking vitamins as your doctor advises also can help you and your baby stay healthy.
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Fact: Women Who Prefer Multiple Daily Injections Can Have Very Healthy Pregnancies Too
An insulin pump and continuous glucose monitor are two tools that can certainly help many women achieve better blood sugar management before and during pregnancy but it can be done with multiple daily injections , too.
The trade-off of using MDI to manage your diabetes instead of an insulin pump is that youll need to take many more injections per day. If you arent willing to take an additional injection to bring a 160 mg/dL blood sugar down to 100 mg/dL, for example, then using MDI during pregnancy may not be the right choice for you. Pressing the buttons on a pump to receive those extra doses of insulin might be easier for you.
Another challenging aspect that comes with MDI is that none of todays long-acting insulins have been studied for their safety in pregnancy. There is no reason to believe any of these insulins are harmful to a baby, either, but there just isnt any data on it. Women have been using these insulins during pregnancy over the last decades with the outcome of healthy, beautiful babies!
If possible, every woman with type 1 diabetes should consider using a CGM before/during/after pregnancy to make healthy blood sugar levels more achievable. Trying to achieve this range without a CGM can mean pricking your finger to test blood sugar at least 10 to 15 times per day. A CGM will give you so much more information, support, and safety compared to constant finger pricks.
Signs Of Type 1 Diabetes In Kids
Of course, as a parent, you hope your child does not develop type 1 diabetes. However, it is important for you to be aware of the symptoms of the disease in children, so that you can recognize them early and get your child tested.
- Frequent urination and thirst: Having high blood sugar eliminates fluids from the body, which will lead to increased thirst and the need to take more bathroom breaks throughout the day.
- Fatigue: If your child is constantly tired, it may be a sign that their body is having trouble turning sugar in the bloodstream into energy.
- Changes in vision: High blood sugar levels can lead to blurred vision or other eyesight problems.
- Fruity smelling breath: If your childs breath smells fruity, it could be a result of excess sugar in the blood.
- Extreme hunger and unexplained weight loss: When your childs muscles and organs arent receiving enough energy, it can trigger extreme hunger. And sudden weight lossespecially if they are eating moreshould not be ignored.
- Unusual behavior: If your child seems more moody or restless than normaland its in conjunction with the symptoms aboveit could be cause for concern.
The signs of type 1 diabetes may differ slightly for kids of different ages. If you have a toddler or teen, learn more about the symptoms they might experience.
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Fact: There Are Many Factors That Determine How Your Child Will Be Born
The sad fact is that women with diabetes are 5 times more likely to deliver a stillborn baby compared to women who do not have diabetes. However, its important to note that blood sugar levels, cigarette smoking, diabetic kidney disease were also likely factors in the population that produced that statistic.
In recent years, obstetrics protocol for all pregnant women has evolved to inducing or delivering via C-section by 38 to 39 weeks. So if youve demonstrated tight blood sugar management throughout your pregnancy, and there are no concerns, you should be able to wait until you go into labor naturally, without pressure to undergo an early C-section.
Whether or not you have type 1 diabetes, your delivery plan is really more of a hope. At the end of the day, none of us knows how our baby will come into the world. You may need an emergency C-section for reasons completely unrelated to your diabetes.
Or you may go into labor at 35 weeks before anyone has even begun discussing inducing labor or scheduling a C-section.
There are so many variables that affect how a baby is born the most important thing is that both you and baby are as healthy and safe as possible on the big day.
What Is The Long
Over a period of many years, high glucose levels can cause damage to the eyes, kidneys, and nerves.
Lifelong insulin treatment is essential for people with type 1 diabetes. Maintaining healthy glucose levels over the long term greatly reduces your childs risk of developing diabetes complications later in life. Your diabetes team will teach you how to balance insulin, food, and exercise to maintain safe and healthy blood glucose levels.
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When To Call A Doctor
Type 1 diabetes may cause sudden, extreme swings in blood sugar that can be dangerous. If you notice any of the symptoms of diabetes in your child, itâs important to get them a physical exam as soon as possible, so their doctor can begin treatment right away.
The doctor will do a simple urine test to check for glucose in the urine and a finger stick to measure preliminary blood glucose level. A more involved test, called an oral glucose tolerance test, can tell for certain if itâs type 1 diabetes. Your child will need to follow a special diet before this procedure.
If your child has already been diagnosed with type 1 diabetes, call your doctor if you notice any of these signs of a low blood sugar emergency:
What Causes Diabetes In Pregnancy
The placenta supplies a growing fetus with nutrients and water. It also produces a variety of hormones to maintain the pregnancy. Some of these hormones can block insulin. This usually begins about 20 to 24 weeks into the pregnancy.
As the placenta grows, more of these hormones are produced, and insulin resistance becomes greater. Normally, the pancreas is able to make additional insulin to overcome insulin resistance, but when the production of insulin is not enough to overcome the effect of the placental hormones, gestational diabetes results.
Pregnancy also may change the insulin needs of a woman with preexisting diabetes. Insulin-dependent mothers may require more insulin as pregnancy progresses.
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Fact: The Healthier Your Blood Sugar Levels Are The Easier Getting Pregnant Will Be But Women With Type 1 Diabetes Can Have Difficulty Getting Pregnant Just Like Anyone Else
Its easy to assume that because your body struggles to produce insulin, it will struggle to become pregnant, too.
The truth is that whether or not you have type 1 diabetes, you may have difficulty getting pregnant because some women simply do. Consistently high blood sugars and a high A1C are the most likely way type 1 diabetes would make getting pregnant more challenging.
Research has found that women with T1D have slightly decreased fertility rates especially in those with existing complications like retinopathy or neuropathy. Women with type 1 are more likely to have irregular menstrual cycles and delayed ovulation but again, these are associated with consistently high blood sugar levels.
But for women without complications and reasonable blood sugar management, overall fertility rates have improved significantly over the past couple of decades thanks to better insulin and management options.
Fortunately, theres something you can do about this: work with your healthcare team to improve your overall blood sugar management and bring your A1C down to a healthier level.
Update Your Medication Regimen
Some medications and supplements are not considered safe during pregnancy. You will want to have an extensive talk with your healthcare provider about each medication and supplement prior to conception. If you are on any medication that prevent cardiovascular disease such as blood pressure and cholesterol, please consult with your healthcare provider before altering your medication routine.
Discuss medication dosages with your doctor so that you understand which medications might be required during pregnancy and how much you should take. Be prepared for an increase in your insulin dose during pregnancy.
In order for your insurance company to cover these increased requirements, your doctor will have to regularly update your prescriptions and you will have to ensure that your pharmacy receives them in a timely manner. It is important to think ahead about these situations. You will have better things to do than battle with your pharmacy and insurance companies while you are pregnant.
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What Leads To Diabetes
Type 1 and type 2 diabetes have different causes, but there are two factors that are important in both. You inherit a predisposition to the disease, then something in your environment triggers it.
Thats right: genes alone are not enough. One proof of this is identical twins. Identical twins have identical genes. Yet when one twin has type 1 diabetes, the other gets the disease, at most, only half the time. When one twin has type 2 diabetes, the other’s risk is three in four at most.
Target Blood Glucose Levels Before Pregnancy
When youre planning to become pregnant, your daily blood glucose targets may be different than your previous targets. Ask your health care team which targets are right for you.
You can keep track of your blood glucose levels using My Daily Blood Glucose Record. You can also use an electronic blood glucose tracking system on your computer or mobile device. Record the results every time you check your blood glucose. Your blood glucose records can help you and your health care team decide whether your diabetes care plan is working. You also can make notes about your insulin and ketones. Take your tracker with you when you visit your health care team.
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Key Points About An Infant Of A Mother With Diabetes
Two types of diabetes can happen in pregnancy. One is gestational diabetes and the other is pre-gestational diabetes.
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All women are screened for gestational diabetes. This is done between weeks 24 and 28 of pregnancy.
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Having diabetes during pregnancy can harm your baby.
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Your babys treatment depends on how well you control your blood sugar in the last part of pregnancy and during labor and delivery.
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Controlling your blood sugar is the best way to reduce your babys risks.
Type 1 Pregnancy Risks And How To Minimize Them
Editors Note: This page is part of a series on diabetes and pregnancy. for more great resources and personal stories.
Theres a lot to consider when trying to get pregnant or being pregnant as a Type 1 woman. Theres of course, the maternal desire to do everything you can for your unborn child so that he or she may have the best life possible. An ideal pregnancy is a full-term and uneventful one, the outcome a healthy, happy baby.
Having Type 1 diabetes doesnt mean you cant have that it just means that you have to be more vigilant, more prepared because of the heightened risks involved. But youre a Type 1, so you already know how to do that. In fact, youve been doing it ever since D-day, so take a deep breath and trust yourself.
All pregnancies have the chance for complications, but having Type 1 makes you more susceptible to specific ones. Here are the most important things to do in order to lower those risks:
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Sleep Quality And Sleep Architecture
Children and adults with type 1 diabetes subjectively report poorer sleep quality than healthy control subjects. Objective measures based on polysomnography demonstrate that children with type 1 diabetes spend more time in stage 2 sleep and less time in stage 3 sleep compared to healthy children . Young adults with type 1 diabetes also exhibit more stage 2 sleep and tend to have less deep sleep during the first half of the night compared to healthy control subjects . Differences in neuroendocrine correlates of sleep were also reported growth hormone and epinephrine levels were elevated throughout the night and adrenocortotropic hormone levels were higher during the first 4 hours of the night in young adults with type 1 diabetes . It is apparent that important differences may exist in sleep patterns of people with type 1 diabetes compared to those of people without diabetes. However, larger studies including a wider clinical and age spectrum are needed to fully characterize sleep derangements and their impact on health and disease progression.
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:
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Breastfeeding With Type 1 Diabetes
Note: This article is part of our library of resources for Type 1 mothers. Check out more of our articles and personal stories for Type 1 Pregnancy.
For many moms with Type 1 diabetes, giving birth is only a small part of their story of living beyond. Breastfeeding presents its own set of challenges and rewards for new mothers and as well as those who have done it before. Here is some information on how the basics of breastfeeding and how it may impact your Type 1 diabetes management.
Get Your Weight In The Target Range
Being overweight can make conception difficult and increase the risk of pregnancy complications, such as preeclampsia. Extra weight can raise a womans insulin resistance . It is common for women with type 1 diabetes, even those within normal weight range, to experience some level of insulin resistance during pregnancy.
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Dont Forget Prenatal Vitamin And Mineral Supplements
Folic acid, zinc and B6 are all important for conception and development of a healthy child, but different women have different needs. Ask your physician about how much of each vitamin and mineral to take in supplement form, and if he or she would recommend additional vitamins.
IMPORTANT NOTE: If you do not already have a glucagon kit, now is the time to get a prescription from your doctor, purchase one, and familiarize yourself and your family members with how and when to use it.
Effects Of Diabetes On The Baby
Diabetes Effects on the Baby
Diabetes makes a pregnancy high risk. This is because diabetes can cause many potentially negative effects on the baby as well as the mother. Blood sugar is the baby’s food source and it passes from the mother through the placenta to the baby.
When a woman has diabetes and her blood sugars are poorly controlled , excess amounts of sugar are transported to the baby. Since the baby does not have diabetes, he/she is able to increase the production of insulin substantially in order to use this extra sugar. This abnormal cycle of events can result in several complications including:
Macrosomia
Macrosomia refers to a baby born weighing more than 4,000g or born at greater than the 90 percentile for the gestational age. In response to the excess amounts of sugar that the baby receives, large amounts of insulin are produced by the baby in order to convert the sugar into body fat. That is, the baby is being “overfed” while inside the uterus.
Neonatal Hypoglycemia
Neonatal hypoglycemia is defined as low blood sugars in the baby after birth. If the baby’s pancreas is making large amounts of insulin in response to the mother’s high blood sugars, it will continue to do so for a time after delivery. Since the sugar supply from the mother is no longer present once the baby has delivered, blood sugar can drop too low . The baby can become fussy, jittery or may even have a seizure or breathing problems.
Other Neonatal Metabolic Problems
Stillbirth
Birth Defects
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