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Diabetes in pregnancy

Diabetes is the disease of active age the number of diabetes are increasing rapidly and in India about one and half cores are estimated to be suffering from the disease and about the same number have adult diabetes. Young women in their reproductive life may also suffer from diabetes or pregnancy stress may increase their blood glucose level, which is called as Gestational diabetes mellitus. Insulin hormone is secreted by pancreas. Deficiency of insulin or lack of response of tissues to insulin causes diabetes in which blood glucose level increases, glucose may appear in urine, along with increase in thirst, appetite and weight and weight loss. Because of diabetes many organs like heart, brain, nerves, eyes, kidney etc are damaged in long run. Before use of insulin for treatment in the long run, successful, uneventful pregnancy was rare event in diabetic women. They use to conceive with difficulty. Those who did conceive, the outcome was often used to be disastrous

Mother's Risk

Pregnant diabetic ladies have greater chances of Ketosis as compared to non-diabetic women. These women should never do fasting as eighteen hours fasting by pregnant women is equivalent to seventy two hours fasting of non-pregnant woman.

In pregnancy the risk of involvement of eyes due to diabetes increase many fold and damage to eye is rapid.

If women are diabetic ,the chances of pre-eclampsia in which they suffer from high blood pressure, swelling in body and appearance of protein is increased which leads to serious condition if not treated promptly.
  • Chances of abortion, pre term delivery in diabetic pregnant women increases many times.
  • Diabetes decreases the body resistance and they have increased risk of infections during pregnancy or/and during delivery or after delivery which may be life threatening.
  • Diabetic women usually have larger babies (500gm heavier and 2-3 cm larger) which can create grave problems during pregnancy and delivery.
  • If women are suffering from diabetes from long time before getting pregnant, it leads to arteriosclerosis, decreased blood flow and the baby may be very small.
  • Foetus can die in mother’s womb.
  • The babies of a diabetic mother may develop birth defects, brain disorders and low intelligence. with strict control of diabetes about 97 percent of Foetus can survive.
  • Baby born to diabetic women have increased chances of lung diseases, which is often fatal.
  • Baby of diabetic may have increased chances to have very high hemoglobin in blood, jaundice or calcium level in blood.
  • Baby of diabetic mother may develop muscle weakness.
  • Babies may be born before full maturation and development and these premature babies may die soon. After birth due to infections or other causes.
  • Baby of a diabetic mother may have increased chances to have hypoglycemia (low blood glucose level), which leads to convulsion.
    • Gestational Diabetes:

    When abnormal glucose level is first time detected during pregnancy and it returns to normal following termination of pregnancy or 2-3 weeks after delivery. risk of gestation diabetes in those who are over 30 year, obese, have a close blood relative who is diabetic ,in previous pregnancies baby may have been born dead or given birth to larger babies. Every pregnant woman should have blood glucose measurement in 1st three month and then in 24th, 28th week of pregnancy. If women are suffering from gestational diabetes their blood glucose should be measured every 8 to 10 days and they should be given 6 to 10 units of Insulin injection before breakfast every day so that problems to them and their baby can be minimized.

    Pre- gestational Diabetes:

  • If women have diabetes and get pregnant ,the risk of eye, kidney damage, eclampsia increases and problems to Foetus can occur. Blood glucose level of these women should be tightly controlled by insulin injections to have successful outcome of pregnancy Oral hypoglycemic pills should not be used to control diabetes in pregnant women. In these women, daily measurement of blood glucose should be done and dosage of Insulin must be adjusted so that fasting glucose level one hour after meals should not exceed beyond 129mg/dl and glycosylated hemoglobin A-C should be maintained less than 8%.

  • Diabetic women of childbearing age have to be careful in planning the family. Child bearing must be complete before 30 years of age.

  • Diabetic women should avoid oral pills or loops, cupper-T as birth control measures.

  • Before getting pregnant they should normalize the blood glucose level by Insulin injections, which will decrease the birth risks and death in the babies.

  • In first trimester of pregnancy, Careful control of blood glucose by Insulin is necessary to prevent problems both in mother and baby.

  • In second trimester, alphas foetopsorein should be measured at 16 to 20 weeks to detect neural tube defects and other abnormalities. If found that Foetus is suffering from these nay defect, abortion can be advised.

  • In third trimester at least weekly blood glucose should be measured to detect pre- eclampsia and other problems in women and baby at the earliest so that appropriate measures can be taken.

  • If diabetic women have excellent blood glucose control, the pregnancy can be continued up to full term and normal delivery is possible but in more than half diabetic women cessarian section is required.

  • In diabetic women delivery must be in hospital only.

  • In diabetic women after one baby, sterilization is advised.

  • Pregnancy poses grave threat to life of both mother and baby in diabetic women. Before use of insulin to control diabetes, successful pregnancy was a rare. Only very tight control of blood glucose by injections of insulin can avoid these problems to some extent. Now with tight control of glucose, most problems in women can solve but baby may still be in danger. Diabetic women should be advised about the risk to them and the baby before they plan pregnancy and should be ready to take all the precautions and risk.
    • Ayurvedic Supplements for Diabetes in pregnancy:

    Eat Neemguard regularly as it is anti Diabetes and as it is completely herbal, it is safe for regular usage. A regular dosage of Neemguard will prove very beneficial.

       
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