Pregnancy and Diabetes
In most pregnant mothers, the blood sugar tends to rise. It is known as Gestational diabetes. This happens due to hormonal imbalances in the mother’s system. It is therefore recommended that blood sugar tests are done during every pre-natal visit to the clinic. Children born to mothers, whose blood sugar was high during pregnancy, usually weight 4kg or more. Therefore mothers who have had big babies should have a blood sugar test.
Women with Pre-existing Diabetes
To prevent early pregnancy loss and very costly malformations in the infants of diabetic mothers, optimal medical care and patient education and training must begin before conception. Women with Type 2 diabetes who are taking oral glucose-lowering agents should be switched to insulin therapy for the pre-conception and pregnancy period.The following examinations are important before and during pregnancy.
- Blood pressure – goal 130/80 – 100/60
- Cardiovascular examination (heart problems)
- Neurological assessment (nerve damage)
- Examination of the lower extremities, for evidence of vascular disease, neuropathy, deformity or infection
- Pelvic exam, including pap smear
- Haemoglobin AIC (red blood cell count)
- Renal/ kidney function test
- Fundal examination (eye check-up)
- Regular blood sugar monitoring
If blood glucose levels are not monitored throughout the pregnancy, the mother is at risk for:
- Spontaneous premature delivery (miscarriage)
- High blood pressure
- Foetal death
- Still birth
- Renal failure
- Retinal damage (blindness)
- Urinary/ vaginal infections
Risks for infants of women with diabetes, or high blood glucose levels in pregnancy are:
- Hypoglycaemia (low blood sugar) in the first 72 hours of life
- Respiratory distress or problems
- Congenital anomalies
- Pre-maturity
- High or low birth weight
- Inter-uterine foetal death
