Saturday, July 20, 2013

Diabetics and Gestational Diabetes

Gestational Diabetes is form of diabetes that can only develop in pregnant women, usually diagnosed in the second trimester.

This is however different for women with pre-existing diabetes prior to their pregnancy, i.e. for women who are already treated for diabetes and are already diabetics before they become pregnant. Unfortunately, diabetes in pregnancy is associated with risks to the woman and to her developing baby.

As research shows, in pregnant women with diabetes the control of blood sugars may be more difficult, especially in the first trimester. Additionally, the signs of hypoglycaemia may become less apparent and some women may not recognise them as quickly as they used to before they were pregnant. As a result, this may lead to poor sugar control and particularly with hypo- and/or hyper-glycaemia in first trimester, to an increase miscarriage and abnormalities.

To prevent this from happening, tight control of blood sugar levels at more frequent intervals and efficient diabetes management is essential.

When the woman with diabetes is planning to get pregnant, she should inform her diabetic nurse and/or doctor about her wishes. The diabetic nurse and/or doctor should then offer pre-conception diabetic care and advice focusing on preventing the risk factors and enhancing the management of diabetes prior to and during the pregnancy.

The woman with diabetes planning to get pregnant needs to establish a good control of her blood sugars before her pregnancy and continue this throughout the pregnancy. She should also be aware of the risks of hypoglycaemia and the possible unawareness of signs of having a 'hypo', especially in the first trimester.

The woman who is diabetic prior to her pregnancy should:

1. Make sure that her blood sugar levels are well controlled, especially in the first trimester.

2. Always record her blood sugar levels and contact her diabetic nurse specialist and/or a doctor if concerned.

3. Have a list of contacts available for emergencies and if any advice is required.

4. Be monitored more closely by her diabetic nurse specialist and/or diabetic consultant.

5. Visit diabetic clinic at more regular intervals.

6. Have a full understanding of her diabetes and its possible effects on pregnancy.

7. Have monthly blood test to check for levels of the long-term glucose in the blood (HbA1c).

8. Be offered an additional ultrasound scan to check the baby's growth.

9. In the third trimester visit diabetes midwife and discuss her labour and how it might be affected by diabetes.

10. Be explained the preparation for labour and the postnatal care.

11. Know her insulin regime to be used during and after delivery.

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