EFFECTS OF DIABETES IN PREGNANCY.

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DIABETES IN PREGNANCY.

Know your health - mosely's kyh
pregnant women

Diabetes is most serious condition during pregnancy and can cause problems to both mother and developing foetus. Proper management of diabetes during pregnancy is required to prevent birth defect to foetus and other health problems.
There are two groups of diabetes in pregnancy:

  • Pre-gestational diabetes
Refers to the type 1 or type 2 diabetes that preexist prior to pregnancy. Pre-gestational diabetes is associated with many maternal and foetal complications during pregnancy compared to gestational diabetes.
  • Gestational diabetes
Is defined as glucose intolerance that is first diagnosed during the pregnancy and can be disappear after the end of the pregnancy.

RISK FACTORS FOR DIABETES IN PREGNANCY.

  • Overweight (obesity)
  • High blood pressure (hypertension)
  • Previous history of diabetes
  • Family history with diabetes (runs through family)
Know your health - mosely's kyh
low carbs diet


HOW DOES PREGNANCY TRIGGERS DIABETES.

The risk of developing high blood sugar state (hyperglycemia) and high blood acid (ketosis) is becomes high during pregnancy also insulin requirement increases during pregnancy renal threshold for glucose (RTG) is increase means glucose is excrete in urine.

EFFECTS OF DIABETES IN PREGNANCY.

Both mother and developing foetus are affected with high blood sugar (hyperglycemia):
                 
    Maternal effects are:
  • Dysfunction (disease) of one or more peripheral nerves (diabetic neuropathy)
  • Disorders or diseases of stomach (gastropathy)
  • Diseases of retina that leads to loss of vision (retinopathy) 
  • Diabetic ketoacidosis (DKA)
  • Maternal death
  • Complication during labour such as obstructed labour due to big baby
  • Infections such as Urinary tract infections (UTI), respiratory tract infections, vulvovaginitis.
  • Cardio-renal complications (myocardial infarction, coronary arterial disease, Nephropathy) 
   Foetal effects are:
  • Miscarriage (spontaneous abortions usually in first trimester) 
  • (Excess amniotic fluid in amniotic sac) Polyhydraminios
  • Congenital malformations (cardial anomalies, renal anomalies, gastrointestinal tract anomalies)
  • Preterm labour - labour before 37 weeks of gestation age
  • Excess weight of new born (macrosomia)
  • Intra-uterine foetal death (IUFD)
  • Respiratory distress syndrome (RDS)
  • Diseases of the heart (cardiomyopathy)
  • Neonatal mortality and morbidity

DIAGNOSIS OF DIABETES IN PREGNANCY.

Diagnosis of diabetes in pregnancy is based on patient's symptoms and signs such as abnormal excess amount of urine (polyuria), excess thirst (polydypsia), and excess eating or appetite (polyphagia). 
According to World Health Organization (WHO), diabetes refers as raised fast blood glucose level of 7 mmol/l or more, raised random blood glucose level of 11.1 mmol/l or more.

TREATMENT FOR DIABETES IN PREGNANCY.

Treatment plans of high blood sugar in pregnancy involves both pharmacological strategies and non pharmacological strategies.

Non pharmacological managements:
  • Diet 
Necessary nutriets for both mother and foetal, control of sugar intake and prevent starvation that cause ketosis.
Know your health - mosely's kyh
low carbs meal recommended for diabetic pregnant women
  • Regular exercises
  • Education and counseling.
Pharmacological managements involves:
  • Insulin therapy 
  • Oral hypoglycemia therapy (not recommended during pregnancy)

Location: Dar es Salaam, Tanzania

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