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?

Diabetes is a condition where the blood sugar level rises in your body either due to less insulin level in the body or reduced sensitivity of the body to insulin. The foods you eat have a major role in controlling your blood sugar levels. You need to pick your foods wisely to prevent your blood sugar levels from spiking.


The various foods that you should be eating if you have diabetes are:

1. Dark chocolate: chocolate contains good amounts of flavonoids that help in improving insulin sensitivity and limits food cravings. It also reduces your chances of heart attack.

2. Blueberries: blueberries are rich in fiber that helps you in managing your blood sugar levels. They also contain anthocyanins that assist in regulating your blood sugar levels.

3. Fish: fish is rich in omega 3 fatty acids that reduce inflammation in the body, thus reducing your chances of heart problems. Fish is also a good source of protein that helps you in feeling fuller.

4. Olive oil: olive oil is rich in antioxidants that help in reducing your chances of heart diseases and diabetes.

5. Oranges: make sure you eat plenty of oranges as they are rich in vitamin c and they reduce the risk of diabetes. You may also opt for broccoli or strawberries.

The various foods you should avoid are:

1. White rice: white rice is a refined grain which, when consumed, tends to spike your blood sugar levels. You can instead opt for brown rice.

2. Bananas: banana may contain vitamins and minerals, but are also rich in carbohydrates. Instead, opt for fruits like berries that are not only rich in fiber and antioxidants, but also have a low glycemic index.

3. Sugary foods: the term sugary foods is used to describe foods such as pastries, cakes, and cookies. These foods are carbohydrate rich and do not contribute much in making the body healthy. Instead, replace them with natural foods such as chickpeas and peanuts.

4. Dried fruit: various dried fruits contain a high concentration of sugar, which happens due to the dehydration process by which they are formed. So replace them with fresh fruits such as guava and peaches to control your blood sugar levels.

Amongst all other dry fruits, almonds and walnuts can be had in moderation as they contain essential fatty acids and do not affect blood sugars.

Foods to Eat and Avoid When You Have Diabetes

While some couples conceive with ease, conceiving a child can be extremely difficult for others. In cases where a woman is not able to get pregnant despite having regular intercourse in tune with her biological cycle, infertility tests may be suggested to investigate the reason behind this. In most cases, these tests are suggested if a year has gone by without intercourse resulting in a pregnancy. Women may also be said to be infertile, if they cannot carry a foetus to full term. 

Infertility can affect both men and women and can be triggered by a number of different reasons. In some cases, it is treatable while in others, alternative ways of having a family may need to be discussed. Hence, it is very important to understand the different types and triggers for infertility and to undergo complete infertility investigations. Some of the common types of infertility investigations are as given below.

Blood tests: A blood test of both partners is used to assess the general health of the couple and to identify any health factors that may be impeding fertility.
Tests for women: 
Hysterosalpingogram: This is an X ray that can identify if a blockage or any other issue in the fallopian tubes are the cause for infertility.
Pelvic ultrasound: This is used to have a look at the anatomy of the female reproductive system and to check for fibroids.
Laparoscopy / hysteroscopy: This is used to get a clearer picture of the ovaries, uterus and other parts of the reproductive system.
Tracking cycle: Ovulation and the thickness of the uterus lining may also affect infertility, This can be diagnosed by tracking and assessing the menstrual cycle.
Tests for men
Semen analysis:This test is used to get an idea of sperm concentration, motility and the appearance of sperm in a man s semen. In some cases, the semen may not include any sperm cells. In such cases, a follow up investigation may be required to assess if sperm cells are being created in the testicles. This is known as testicular sperm aspiration or a testicular biopsy.
Sperm DNA: The DNA in sperm also plays an important role in fertility. This test is used to assess the sperm DNA integrity and to see how it may affect embryo development and chances of an on-going pregnancy.
Infertility treatment depends on the cause identified by the above tests and hence it is important for both partners to undergo complete testing.

Complete Infertility Investigation - Why is It Important?


Many overweight and obese people have darkened and a rather flaky texture behind neck, darkening in armpits and other parts of body with creases and folds like elbows, knees or knuckles. This is commonly mistaken as smudge of dirt, uncleanliness or lack of hygiene. Some people think that it is due to repeated friction caused by necklace or chains etc. In fact it is a sign of'diabetes' which is already developed or might develop in future.

This darkening is due to excessive cell growth and differentiation of fibroblasts caused by excess of insulin in the body especially in obese individuals and type 2 diabetes patients.

In obese individuals and type 2 diabetes patients excess amount of fat especially abdominal fat (tummy fat) causes resistance to action of insulin secreted by pancreas and tends to hamper its action. In return, body produces more and more insulin from pancreas to keep blood sugar under control. This excess amount of insulin secreted by body promotes this skin cell growth leading to the visible condition called'acanthosis nigricans' in medical terms.

After producing excess amount of insulin pancreas start exhausting, this converts into diabetes. At this stage diabetes can be prevented by simple lifestyle modifications &amp; focussed weight loss.

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Are Dark Cracks Behind Neck A Sign Of 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

Thyroid disorders are conditions that affect the thyroid gland, which is a butterfly-shaped gland in front of the neck. There are specific kinds of thyroid disorders that include:

Hypothyroidism
Hyperthyroidism
Goiter
Thyroid Nodules
Thyroid Cancer
Epidemiology, Incidence, and Prevalence
It has been estimated that about 42 million people in India suffer from thyroid diseases.

Hypothyroidism

Hypothyroidism occurs when the thyroid gland produces an insufficient amount of thyroid hormone. It can develop from problems within the thyroid gland, pituitary gland, or hypothalamus. 

Symptoms of hypothyroidism can include:

Fatigue
Poor concentration or feeling mentally "foggy"
Dry skin
Constipation
Feeling cold
Fluid retention
Muscle and joint aches
Depression
Prolonged or excessive menstrual bleeding in women
Common Causes of Hypothyroidism

Hashimoto's thyroiditis (an autoimmune condition that causes inflammation of the thyroid gland)
Thyroid hormone resistance
Other types involving inflammation of the thyroid, such as acute thyroiditis and postpartum thyroiditis
Hyperthyroidism

Hyperthyroidism refers to the excessive production of thyroid hormone, a less common condition than hypothyroidism. Symptoms of hyperthyroidism are usually related to increased metabolism. In mild cases, there may not be apparent symptoms.

Signs and symptoms of hyperthyroidism can include:

Tremors
Nervousness
Fast heart rate
Fatigue
Intolerance for heat
Increase in bowel movements
Increased sweating 
Concentration problems
Unintentional weight loss
Common causes of hyperthyroidism

Graves' disease
Toxic multinodular goiter
Thyroid nodules that overexpress thyroid hormone (known as "hot" nodules) 
Abnormal secretion of TSH
Thyroiditis (inflammation of the thyroid gland)
Excessive iodine intake
Goiter: A goiter is an enlargement of the thyroid gland, regardless of cause. A goiter may be associated with hypothyroidism, hyperthyroidism, or a normal thyroid function. 

Thyroid Nodules: Nodules are lumps or abnormal masses in the thyroid. Nodules can be caused by benign cysts, benign tumors, or less commonly, by cancers of the thyroid. If nodules are excessively large, they may cause symptoms related to compression of nearby structures. 

Thyroid Cancer: Thyroid cancer is more common among adult women than men or youth. About 2/3rd of cases occur in people under age 55. There are different kinds of thyroid cancers depending upon the specific cell type within the thyroid that has become cancerous. Most cases of thyroid cancer have a good prognosis and high survival rates, especially when diagnosed in its early stages.

Investigations

Blood tests are done to measure levels of thyroid hormones. Blood tests are also done to identify antibodies against thyroid tissue, such as titers of antithyroglobulin, antithyroperoxidase, or TSH receptor-stimulating antibodies.

Treatment

Thyroid disorders can be treated with medications or, in some cases, surgery. The treatment will depend on the particular disease of the thyroid.Medications can be given to replace the missing thyroid hormone in hypothyroidism. Synthetic thyroid hormone is given in pill form by mouth. When hyperthyroidism is present, medications can be used to decrease the production of thyroid hormone or prevent its release from the gland. 

Thyroid Disorder - What All Should You Know 

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