Controlling blood glucose (BG) during pregnancy is crucial for both mother and baby. In my opinion, this is easier said than done.
I have used the expression “it takes a village” numerous times when referring to my experience.
As a T1D (Type 1 diabetic) I knew to plan ahead. My A1Cs were in good shape. I had already started prenatal vitamins and folic acid.
My high risk pregnancy was difficult compared to a regular one. I used my “village” and all of my energy to regulate my BG. As a result, I had a healthy delivery with no complications. All of the stress and dedication were well worth the effort.
Below are things you might expect during pregnancy. I also share some of my experiences.
Work with an endocrinologist and a high-risk obgyn group. Find a pediatrician or neonatologist, a dietician and various forms of support. My “village” was helpful, but I still felt isolated and different from other women going through pregnancy.
It is advised by the Juvenile Diabetes Research Foundation to deliver your baby in a well–equipped hospital instead of a home birth. If I had a complication during my delivery, I wanted every option available to me.
According to Dr. Vanessa A. Barss and Dr. John T Repke, controlled BG during the first trimester minimizes the risks of birth defects and miscarriage. During the second and third trimesters, controlled BG levels are beneficial to the size of the baby. Due to the varying level of glucose in the blood, women with diabetes have possibilities of either a premature or macrosomic baby (above 9 pounds at term).
Plan for changing insulin requirements. Insulin is safe to administer because it does not cross the placenta.
Insulin requirements increase during pregnancy, especially the third trimester. I gave three times my normal amount. Also expect to increase you daily BG testing each day.
Check with a dietitian to help plan how to increase your nutrients, without adding more calories and carbohydrates in order to keep your BG regulated. Exercise is usually recommended unless you are under doctor restrictions.
Speak with your doctor about possible complications, including high blood pressure, the risk of pre-eclampsia, eye, kidney and heart problems. Risk of nerve damage and damage to both the large and small blood vessels should be discussed.
It might sound impossible, but having a healthy baby can be done as a diabetic. With new technology and careful planning, a healthy mother and baby can be a reality.
My pregnancy was one of the hardest things I’ve ever gone through, but my result is my most wonderful contribution to this world.
By Marianne Tetlow “The Diabetes Coach”
The Diabetes Coach is a comprehensive resource and consulting group for individuals or families with a loved one dealing with diabetes. Helping you to move forward while managing the ups and downs. www.diabeteslifestylecoach.com/
Sources:
“Patient information: Care during pregnancy for women with type 1 or 2 diabetes mellitus (Beyond the Basics)”, uptodate.com, Retrieved April 11, 2012, http://www.uptodate.com/contents/patient-information-care-during-pregnancy-for-women-with-type-1-or-2-diabetes-mellitus-beyond-the-basics
“Type 1 Diabetes and Pregnancy”, Juvenile Diabetes Research Foundation jdrf.org, Retrieved April 11, 2012.
http://www.jdrf.org/index.cfm?page_id=103524
“Prenatal care”, American Diabetes Association, www. diabetes.org, retrieved April 11, 2012.
http://www.diabetes.org/living-with-diabetes/complications/pregnant-women/prenatal-care.html
Reviewed April 12, 2012
by Michele Blacksberg RN
Edited by Jody Smith