Pregnancy brings with it the need to be extra careful about the overall well-being of the mother-to-be. Extreme caution has to be taken in managing health, as antibiotics and a lot of other treatment modalities are best avoided during pregnancy. With diabetes becoming common in the younger ages and women choosing to delay pregnancy, there are multiple women who are diabetic and choose to get pregnant later in life.

With diabetes being a chronic and a lifestyle condition, it definitely has its effects on pregnancy. However, the key is to manage diabetes cautiously in such a way that its effects on pregnancy, both the mother and the developing baby, are minimal. The increased blood sugar levels from the mother pass on to the baby, so keeping a close watch on the blood sugar levels is very important.

The maximum effect of diabetes on the baby is during the first few weeks of pregnancy. It is when the vital organs (brain, heart, lungs and kidneys) are forming, and high blood sugar levels can be harmful. This is slightly tricky as most women realise they could be pregnant only after about 6 weeks. If pregnancy is planned, it is best advisable to keep a check on sugar levels much ahead of the pregnancy.
The baby could be used to high levels of sugar while in the womb, and once delivered, it could have too low sugar levels. This needs to be monitored.
Preeclampsia, which is increased protein in the urine and high blood pressure, can happen during the second trimester. This may require the baby to be delivered prematurely.
Babies born to diabetic mothers are often bigger. The baby s pancreas is used to higher sugar levels and so the extra sugar gets converted to fat, which is the reason for the bigger babies. This may also necessitate C-sections.
Pregnancy can induce the development of diabetic retinopathy, which may prevent vaginal delivery, as the woman may not be able to exert the required pressure.
Abnormal calcium and magnesium levels, which need to be monitored for a while after birth
Most diabetic women reach full term if the sugar levels have been under good control.
Diabetic pregnant women are high at risk. However, with advanced medical care, these risks and complications are managed very well producing healthy babies from normal deliveries with effectively no harm to the mother s health. Once a diabetic woman tests positive, it is advisable to seek medical help to plan diet/meal plan, physical activities, exercise regimen, lifestyle changes, and medication dose adjustments. This is not a one-time activity, but needs to be closely monitored with daily blood sugar levels throughout the pregnancy. 

How Can High Diabetes Affect Your Pregnancy?

'Congratulations! You're pregnant!' Almost all women long to hear these words and nothing should come in the way, even diabetes. So, if you are a Type 1 or Type 2 diabetic, here are a few things you should keep in mind to have a healthy baby.

1. Your blood sugar must be monitored regularly-
The most important thing you can do to have a healthy baby is to keep your blood sugar as close to normal before and during your pregnancy. Testing is recommended a minimum of four times a day. Glucose passes through the mother's blood to the fetus and hence if your blood sugar fluctuates, so will your baby's. High blood sugar levels are especially harmful during the first 8 weeks of pregnancy when the baby's brain, heart, kidneys and lungs are formed.

2. Your pregnancy is considered high risk-
High blood sugar levels can increase the risk of a miscarriage as well as the risks of your baby being born with birth defects. Diabetes can also increase the risk of developing preeclampsia during the second half of your pregnancy. This could result in a C section or premature birth. Thus, maintain regular checkups and keep your doctor in the loop of all your activities.

3. You should watch out for signs of ketosis-
When you have low blood sugar, the body produces ketones that can be passed on from you to your baby. This production of ketones is a result of the body's burning of fat instead of glucose to provide energy and can develop a condition called ketosis. Symptoms you should watch out for are stomach aches, nausea, fatigue, muscle stiffness, frequent urination and fruity breath.

4. You need Vitamins and Supplements-
Most women require vitamin and mineral supplements at the time of pregnancy. Of these, folic acid, iron, calcium and vitamin D are the most important. These supplements help in the healthy growth of the baby.

5. You should exercise regularly-
Maintaining a regular physical activity routine is very important for diabetics who are expecting a baby. This will help you regularize your blood sugar, relieve stress and strengthen your heart. Avoid activities that increase your risk of falling and aim for at least thirty minutes of daily exercise such as walking, swimming or yoga.

6. Check your medication-
Some medication can be detrimental during pregnancy such as cholesterol and blood pressure medication. Consult your doctor to find a suitable alternative if needed. You may also need to change the kind of insulin you take and its frequency and amount. As you get closer to the delivery date, your insulin requirement may even double or triple.

The key to preventing complications during pregnancy is controlling your diabetes. So take your insulin regularly, maintain regular checkups and eat healthy. You need to be seen by your obstetrician more frequently. Your pregnancy will be monitored closely by more frequent ultrasounds and NST. If your sugar level remains under control and pregnancy is advancing well, a natural onset of pains is aimed for and normal delivery is expected.

Diabetes - How To Handle It While Pregnancy?

Women tend to develop high levels of blood sugar during their pregnancy (especially within the 24th and 28th weeks), irrespective of whether they already had suffered from diabetes prior to their pregnancy. However, gestational diabetes, if not taken proper care of, might escalate the risks of developing diabetes in the near future for both the mother and the child, accompanied by complications in pregnancy or labor. Gestational diabetes is usually characterized by mild symptoms such as excessive urge to urinate, excessive thirst, blurred vision and fatigue.

Causes:
Insulin, a hormone produced by the pancreas, allows for the utilization of the glucose for energy. The food consumed is broken down by the digestive tract of the body, converting carbohydrates into glucose before releasing it into the bloodstream. The glucose is then absorbed by the cells to be used as an energy source. Now, at the time of pregnancy, the placenta (organ nourishing the fetus) connecting the baby to the blood supply also produces various other hormones in high levels, for instance, estrogen and human placental lactogen. Most of these hinder the normal functioning of insulin in the cells, hence raising the blood sugar count. With subsequent growth of the baby, the placenta keeps on producing more amounts of such insulin resistant hormones to an extent that they are capable of meddling with the development of the baby.

Treatment:
1. Monitoring the blood sugar count at least four to five times a day and keeping it under control might help to ease the complication.
2. A healthy diet consisting of whole grains, vegetables and fruits in the right proportion and limiting sugar or other highly refined carbs meets the nutrition and fiber requirement of the body. Guard against additional weight gain during pregnancy as that hampers the entire process.
3. Exercise or regular physical activities help to normalize blood sugar level by boosting glucose absorption in the cells. Furthermore, exercises also enhance the sensitivity of the cells towards insulin. This means that only a little amount of insulin production by your body would be enough for the transportation of sugar.
4. Medication, If exercise and diet fall inadequate, insulin injections are often administered to control blood sugar count.
5. Keeping the baby under close observation with the help of repeated ultrasound and other tests to record its growth and development is an essential part of the treatment plan.

Gestational Diabetes - How It Can Be Treated?

At this point of time, diabetes is one of the most chronic, fastest growing lifestyle disease in the world. Also known as diabetes mellitus, the condition is basically a metabolic disorder, wherein the human body cannot store and use fuel for the energy. This fuel or glucose is the one that powers all our bodily organs and ensures that we have the energy to carry out activities throughout the day.

And while diabetes is a popular medical condition, a lot of people don't have much information about it. Although, they know the major types of diabetes, they have no clue about the difference between them. Here we outline type I vs type ii diabetes-

***Type I diabetes- Formerly known as juvenile onset or insulin dependent diabetes, type I diabetes is the one in which your body's immune system destroys all kinds of cells that release insulin. Over a period of time, this results in elimination of insulin production from the body, because of which the cells cannot absorb glucose or sugar and produce energy. Type I diabetes have episodes of low blood sugar level and it cannot be problem. Symptoms usually start from childhood or young adulthood.

***Type ii diabetes- The adult onset or non-insulin dependent diabetes can develop at any age, particularly after the 30s, although the cases of same are rising rapidly among children. This type of diabetes involves production of insulin, but not in a right way, a condition known as insulin resistance. For this kind of diabetes, the person usually might not have symptoms before the diagnoses and there are rarely any episodes of low sugar level. It can be easily prevented or delayed by following a healthy lifestyle and indulging in regular exercising.

If you have any of the above symptoms or have more questions related to diabetes, click on consult privately to ask me.

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You Surely Know About Diabetes. But Do You Know Its Various Types?

Gestational diabetes is a form of diabetes where the blood sugar levels of the body increase during pregnancy. When you are expecting, your body is more repellent to insulin so that a larger amount of glucose is manufactured for the baby s nourishment. However, this excess blood glucose can build up within the body which causes gestational diabetes. This can lead to health problems for both the mother and the baby. At the end of the gestational period i.e. once the baby is delivered, blood sugar reduces to normal.

When are you at a risk for gestational diabetes?

Gestational diabetes can also be hereditary. If a family member or a relative has diabetes, you are more likely to develop gestational diabetes.

If you are overweight, you are more susceptible to developing gestational diabetes.

What causes gestational diabetes?

During pregnancy, the placenta connects your baby to the blood supply. This produces other hormones which reduce the levels of insulin. This increases the level of blood sugar in your blood. As your baby develops, your body manufactures more of such hormones which block your insulin levels leading to gestational diabetes. This usually occurs from the 20th week of your pregnancy.

Complications:

Increase in Birth Weight   Extra glucose crosses through the placenta which instigates the baby s pancreas to manufacture more insulin. This can make your baby very large. Sometimes, it becomes difficult for the baby to pass through the birth canal during childbirth as a result.

Premature Birth and Respiratory Diseases   High blood sugar may increase the risk of an early labor. It may make the baby due before the 37th week of pregnancy. This also makes the baby more susceptible to respiratory disorders.

High Blood Pressure   Gestational diabetes also raises your risks for high blood pressure. This can be fatal for you as well as your baby s health.

Treatment:

Book an appointment with a dietitian and follow a healthy eating schedule. Limit the amount of carbohydrates and ensure you have a healthy and balanced meal.

Do light exercises regularly during pregnancy. This helps you to control your blood sugar level. Physical activities which require low levels of energy utilization such as swimming and walking will control your blood sugar level without exerting you too much.

Taking insulin shots and medicine for diabetes will also control your blood sugar levels if you have a pre-existing condition.

Causes and Treatment of Gestational Diabetes

Insulin is the most common treatment prescribed for people affected with diabetes. Diabetes is condition where high amounts of glucose prevail in the blood for an extended period of time. However, there are some drugs that offer an alternative to insulin in treating diabetes, which are:

1. Liraglutide: Liraglutide is a glucagon-like peptide-1 (GLP-1) drug that causes the body to release greater amounts of insulin so as to facilitate the movement of glucose from the blood to the cells. People with type 2 diabetes generally use this treatment. It slows the digestion process and can cause symptoms of headache and nausea. 

2. Pramlintide: It's an artificially produced version of amylin. It is taken by both type 1 and type 2 diabetic patients, facilitates slower digestion of food and therefore, controls release of sugar in the blood. It can cause tiredness and nausea.

3. Dulaglutide:This treatment is for people affected with type 2 diabetes and it is administered once a week. It causes more insulin to be released and pass the glucose to the cells. It can cause loss of appetite, nausea and abdominal cramps as side effects.

4. Albiglutide: This treatment facilitates pancreas to release insulin and limits the glucagon hormone production. It is used by type 2 diabetes patients who have not taken well to other treatments. The side effects are skin reaction, respiratory tract infection and nausea.

5. Exenatide: It is a drug that causes pancreas to release insulin that facilitates movement of glucose to cells. It is a treatment for type 2 diabetes and it restricts release of glucagon in the body. The possible side effects are acidity, constipation and vomiting.

Common Insulin Alternatives

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