Diabetes And Pregnancy-Preparing For Pregnancy

Pregnancy And Type 1 Diabetes
Type 1 diabetes (diabetes mellitus) affects 1 in 300 hundred people in Great Britain.  This type of diabetes is an auto immune disease that lasts for life and currently there is no cure for it.  It can be diagnosed in childhood and those who have type 1 diabetes will need to take injections of insulin on a daily basis.

Conception And Type 1 Diabetes
For women with type 1 diabetes, conception and fertility should not be affected, but there is a higher risk of miscarriage.

However women who plan their pregnancies and manage to maintain especially good blood sugar control levels pre-pregnancy, have a higher chance of enjoying a healthy pregnancy and delivering a healthy baby.  It is a good idea to make a pre-pregnancy appointment with an obstetrician.

Pregnancy
Women with type 1 diabetes will be under the care of a consultant led team.  They are closely monitored throughout the pregnancy for their blood sugar levels, kidney and eyes function.  The medical team’s objective is to ensure that both the expectant mother and her baby are thriving.

Insulin doses may need to change during the 9 months, and in some cases, the doses may need to adjust at various stages.  Top medical care is a necessity as problems relating to kidney and eyes, which are associated with type 1 diabetes can deteriorate during pregnancy.

It is important to inform the medical team of any mood changes or changes in energy levels also, as this may mean that a change in the insulin dosage may be necessary.

Pregnancy And Type 2 Diabetes
More often than not type 2 diabetes is diagnosed in people of 40 years or more, but it can be diagnosed earlier than this.  Certain women are at a higher risk of being diagnosed at a younger age, and these are black, Middle Eastern and Asian women.  Those with type 2 diabetes do produce insulin but do not manage to use it efficiently throughout the body.  So a woman with this type of diabetes will experience dramatic hikes in her blood sugar levels.  Obesity is the major factor which predisposes a person to developing type 2 diabetes.

Conception And Type 2 Diabetes
Women who have type 2 diabetes can experience difficulty in conceiving but this can often be caused by their weight.  However if they lose weight pre-conception and manage to keep their weight in a healthy range, then this combined with close blood sugar monitoring will increase their chances of conception.

Like women with diabetes mellitus (type 1 diabetes) a pre-pregnancy health plan is the ideal approach if possible.

Pregnancy
Tablets which lower blood sugar are used to control type 2 diabetes and these may not be suitable for use during pregnancy.  These medications are ACE inhibitors, agiotensin-11 antagonists and statins, and those women who are taking these should ideally ask their doctor to switch them to a different medication.  During pregnancy however some women may need to be switched to insulin injections, and also for a period post-pregnancy.

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