April 16, 2015

Diabetes During Pregnancy – Part 2

Why did I change the topic from gestational diabetes to diabetes during pregnancy. The material is pointing to all types of diabetes and this made the topic more comprehensive than just covering only gestational diabetes. Part 1 was for all women. Hopefully this part will cover the rest.

Most women who have gestational diabetes deliver healthy babies. However, untreated or uncontrolled blood sugar levels can cause problems for you and your baby.
Complications in your baby can occur as a result of gestational diabetes, including:
  • Excess growth. Extra glucose can cross the placenta, which triggers your baby's pancreas to make extra insulin. This can cause your baby to grow too large (macrosomia). Very large babies are more likely to require a C-section birth.
  • Low blood sugar. Sometimes babies of mothers with gestational diabetes develop low blood sugar (hypoglycemia) shortly after birth because their own insulin production is high. Prompt feedings and sometimes an intravenous glucose solution can return the baby's blood sugar level to normal.
  • 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.
  • Death. Untreated gestational diabetes can result in a baby's death either before or shortly after birth.
Complications in the mother can also occur as a result of gestational diabetes, including:
  • Preeclampsia. This condition is characterized by high blood pressure, excess protein in the urine, and swelling in the legs and feet. Preeclampsia can lead to serious or even life-threatening complications for both mother and baby.
  • Subsequent gestational diabetes. Once you've had gestational diabetes in one pregnancy, you're more likely to have it again with the next pregnancy. You're also more likely to develop diabetes, typically type 2 diabetes, as you get older.
About 25 years ago, a family friend developed gestational diabetes and did what was necessary to have a healthy baby. When the doctor told her that she could have gestational diabetes with future children, she told the doctor she would not. I don't know what she did, but she had two more children and did not have gestational diabetes. About a year ago, she surprised me when she sent me an email and asked why she now had type 2 diabetes.

I asked her if the doctor had told her this could happen, and she admitted that he had, but after her third baby was born, he said that her chances had gone down. I asked if she had eased up on her care and forgot what she had done to avoid gestational diabetes. This caused a pause in our emails and I did not push it. A month has now passed since she finally replied. I know how difficult her response was and she had to admit that she had stopped the level of care she had set for herself with the children, but that she was now off all medications and would work to stay off for as long as she could.

I congratulated her for that and asked if she knew that she was now in a battle to manage diabetes for the remainder of her life. Yes, was her response and her children and husband were helping her. She also stated that her husband also has type 2 diabetes and the children are aware of the possibility of genetics and the odds of type 2 diabetes affecting them.

I could write a lot more, but instead I will urge you to read this which is a reasonable discussion of gestational diabetes. Then I suggest reading this article which covers the three types of diabetes.

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