About 1-2% of pregnant women in India have Type 1 or Type 2 diabetes and one in every four to five develop diabetes in pregnancy, which has increased in recent years.
If a woman is diabetic and is planning to get pregnant, let her not worry!
She can come to WMN pre-pregnancy/diabetic clinics and get the necessary information and support.
If a woman is diabetic and is planning to get pregnant, let her not worry!
She can come to WMN pre-pregnancy/diabetic clinics and get the necessary information and support.
Appropriate management of women with diabetes in pregnancy can stop the diabetes inheritance of the baby and hence the future generations. Pregnancy provides a window of opportunity for the women and her family to make lifestyle changes and keep diabetes at bay.
In Bengaluru, Dr. Latha Venkataram, is the first to start Diabetes and pregnancy clinics with a diabetologist, fetal medicine specialist and dietician in the same clinic. She is ably joined by Dr. Shreelakshmi to run Diabetes and pregnancy clinics. Dr. Latha Venkataram, with her rich experience is an advisor on the Public Health Foundation of India (PHFI) panel for diabetes and pregnancy at the National level.
What are the different types of diabetes?
Diabetes is a disease that affects how the body turns food into energy. There are three main types of diabetes: Type 1, Type 2, and Gestational diabetes.
How will diabetes affect my pregnancy?
Diabetes during pregnancy can negatively affect the health of women and their babies.
Among women with any type of diabetes, high blood sugar throughout pregnancy increases the risk of:
Excessive birth weight of babies.Higher than normal blood sugar in mothers can cause their babies to grow too large. Very large babies may have birth injuries or need a C-section birth.
Early (preterm) birth.High blood sugar may increase women’s risk of early labor and delivery.
Serious breathing difficulties.Babies born early to mothers with gestational diabetes may experience respiratory distress syndrome.
Low blood sugar (hypoglycemia).Sometimes babies of mothers with gestational diabetes have low blood sugar (hypoglycemia) shortly after birth.
Untreated gestational diabetes can result in a baby’s death either before or shortly after birth.
Obesity and Type 2 diabetes later in life.Babies of mothers who have gestational diabetes have a higher risk of developing obesity and Type 2 diabetes later in life.
Mental Health Issues in childhood – ADHD, ASD, behavioral problems may develop in children born to diabetic mothers.
Gestational diabetes may also increase the woman’s risk of:
High blood pressure and preeclampsia. Preeclampsia is a serious complication of pregnancy that can threaten the lives of both mother and baby.
Having a surgical delivery (C-section).The woman is more likely to have a C-section if blood sugars are not well controlled.
Future diabetes.If the woman has gestational diabetes, she is more likely to get it again during a future pregnancy. She also has a higher risk of Type 2 diabetes as she gets older.
What increases the woman’s chance of developing diabetes during pregnancy?
Age more than 30 years
Overweight/obesity
Lack of physical activity
Previous gestational diabetes or prediabetes
Polycystic Ovary Syndrome (PCOS)
Diabetes in an immediate family member
Previously delivering a baby weighing more than 4kg
Preventive strategies
What should she do to reduce the risk of Type 2 diabetes or gestational diabetes in future?
The following steps reduces the woman’s chances of diabetes:
Achieving a healthy Body Mass Index (BMI).Being overweight and obese is a strong risk factor for diabetes. Losing even a few kilos can help prevent Type 2 diabetes.
Increase physical activity-to 30-45 minutes a day, at least 5 days a week. The activity can be broken up into smaller chunks of time like brisk 10–15-minute walks 3 times a day.
Make healthy food choices.Eat a variety of fruits and vegetables, limit fat intake to 30% or less of daily calories and limit portion size to help improve weight loss and prevent Type 2 diabetes.
Achieving best outcomes for the mother and her baby
1. What should the woman do if she has diabetes before pregnancy?
For women with Type 1 or Type 2 diabetes, it is important to see her doctor before getting pregnant.
Get pre-conception care. This provides an opportunity to discuss changes in blood sugar levels, adjust medications, and check for and treat related health problems, such as high blood pressure.
Reduce weight and achieve a healthy Body Mass Index
Achieve a healthy lifestyle and be in the pink of health.
2. What should the woman do if she has diabetes during pregnancy?
Managing diabetes well can help the woman have a healthy pregnancy and a healthy baby without complications.
To manage her diabetes:
She needs to see her doctor as recommended.
Monitor blood sugar levels
Follow healthy eating plan developed with her doctor or dietician.
Need to be physically active
Take medications & insulin if necessary, as directed
To achieve near normal pregnancy and reduce complications, it is important to keep sugars as normal as possible and as safely as possible before conceiving and throughout the pregnancy.
The ideal sugar levels to be maintained are:
Fasting glucose <92 mg/dL
One-hour postprandial glucose <140 mg/dL
Two-hour postprandial glucose <120 mg/dL
The steps to achieve normal sugars…
Moderate intensity physical activities (if allowed by your doctor) – such as walking for 30 minutes each day, and
Medical Nutrition Therapy (MNT) – This is an individualized nutrition plan developed for a pregnant woman by a dietician familiar with managing diabetes in pregnancy. The food plan should provide adequate nutritional and calorie needs, achieve glycemic goals, and promote weight gain according to recommendations. MNT can reduce the incidence of pregnancy complications and improve pregnancy outcomes.
Medications can be tablets or insulin injections as per the doctors recommendation
3. What should a women with gestational diabetes do after delivery?
For women who had gestational diabetes, sugars return to normal after delivery. But these women are also more likely to develop Type 2 diabetes later in life. If a woman had gestational diabetes earlier, it is important to get tested for diabetes 4 to 12 weeks after her baby is born. If she does not have diabetes at that time, make necessary lifestyle modifications and continue to get tested yearly to make sure your blood sugar levels are in a healthy range.
Gestational diabetes develops when hormones from the placenta cause insulin resistance, impairing the body’s ability to manage blood sugar effectively. This condition is particularly prevalent during the second half of pregnancy when these hormonal changes are most pronounced.
Gestational diabetes increases the mother’s risk of several health issues, including preeclampsia (a serious condition that causes high blood pressure and can threaten the health of both mother and baby), the need for cesarean delivery, and the potential development of type 2 diabetes later in life .
Babies born to mothers with gestational diabetes may face several challenges, such as higher birth weight, which can lead to complications during delivery, respiratory problems at birth, hypoglycemia (low blood sugar), and an increased risk of developing obesity and type 2 diabetes later in life.
A combined clinic offers a multidisciplinary approach to managing high-risk pregnancies like those complicated by gestational diabetes. This approach ensures integrated care, where obstetricians, diabetes educators, dietitians, and other specialists collaborate to tailor a comprehensive care plan. This coordination can improve pregnancy outcomes by ensuring the mother’s blood sugar levels are carefully monitored and managed, thus reducing the risk of complications for both mother and baby
