PLANNING FOR A HEALTHY PREGNANCY
For women with diabetes, preparing for pregnancy requires good planning and preparation. Having decided to start a family, the primary concern of every potential parent with diabetes is the health of their future child. The key to a healthy pregnancy is to keep glucose levels under control, which can be challenging during pregnancy due to constantly changing hormone levels.
With proper care and management, a healthy pregnancy and delivery are perfectly possible for women with diabetes. Whether thinking about becoming pregnant or if already pregnant, careful planning can help ensure a healthy baby. For a woman with diabetes, there are additional factors worth considering before, during and after delivery.
The body changes during pregnancy
During pregnancy, the body goes through many changes affecting insulin requirements, during which it is essential to keep blood glucose levels under tight control. This is critical because pregnant women can be subject to the following:
Pregnant women can be more prone to low blood glucose levels, especially while sleeping and overnight.1
High blood glucose levels before and during early pregnancy are linked to a higher risk of miscarriage, birth defects and can create additional risks for the baby.2
Morning sickness, post-prandial hyperglycaemia and changing hormone levels can disrupt a pregnant woman’s eating and injection schedule, making it harder to stay within the target range, which can affect the growing baby.3,4
Every day can be different with diabetes. It is important to understand how the body changes over the course of the pregnancy in order to achieve better control.
Read the real-life stories of other women with diabetes and discover how they have found their way to a happy pregnancy thanks to better glucose control.
PREGNANCY AND CONTROL
Keeping fluctuations at bay and conceiving twins. Aarti shares her story.
When she wanted to start a family, Aarti decided to change from insulin injections to insulin pump therapy. Aarti and her husband conceived twins and experienced no complications during the pregnancy, with the pump keeping glucose fluctuations at bay.
"I'd recommend the insulin pump to all diabetics, especially parents hoping to conceive because the biggest gift you can give your baby is good health. The pump has been the best decision of my life."
- Dr Aarti Mangtani
Gestational diabetes (also referred to as gestational diabetes mellitus, or GDM), is a form of diabetes occurring during pregnancy. The condition usually goes away after the pregnancy. Gestational diabetes is diagnosed when blood glucose levels appear higher than normal during the pregnancy.
During pregnancy, the placenta produces hormones to help the baby develop. These hormones can block the action of the mother’s insulin, resulting in insulin resistance. Consequently, the mother’s insulin requirements are 2 – 3 times greater than usual1.
Managing gestational diabetes
Initially, gestational diabetes can be managed with lifestyle changes: healthy eating and physical activity. However, some women will require additional insulin to manage their gestational diabetes. This insulin may be administered via insulin injections or an insulin pump.
Is insulin pump therapy right for my gestational diabetes?
Women who require insulin may be prescribed an insulin pump. An insulin pump might be right for you if you experience any of the following:
- Three or more insulin injections per day
- Difficulty in managing high and low glucose values
- Fear of hypoglycaemia (lows), especially at night
- HbA1c outside the target range
- Difficulty following your prescribed insulin regimen for diabetes management
- Fear of needles
- Seeking more flexibility in your diabetes management
If you’ve tried managing your gestational diabetes using insulin injections, yet experience repeated episodes of hypoglycaemia, insulin pump therapy might be especially beneficial for you2.
Research indicates insulin pump therapy is an effective treatment to improve glycaemic control in women with gestational diabetes3. Studies suggest that the major advantages of using insulin pump therapy include:
- Decreased variability in insulin3
- Decreased risk of hypoglycaemia3
- Improved control of the dawn phenomenon3
- Improved glycaemic control3,4
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Nielsen, L., Pedersen-Bjergaard, U., Thorsteinsson, B., Johansen, M., Damm, P., & Mathiesen, E. (2007). Hypoglycemia in Pregnant Women With Type 1 Diabetes: Predictors and role of metabolic control. Diabetes Care, 31(1), 9-14. http://dx.doi.org/10.2337/dc07-1066
Moley, K. (2001). Hyperglycemia and apoptosis: mechanisms for congenital malformations and pregnancy loss in diabetic women. Trends In Endocrinology & Metabolism, 12(2), 78-82. http://dx.doi.org/10.1016/s1043-2760(00)00341-6
Correa, A., Gilboa, S., Besser, L., Botto, L., Moore, C., & Hobbs, C. et al. (2009). Diabetes Mellitus and Birth Defects. Obstetric Anesthesia Digest, 29(1), 40-41. http://dx.doi.org/10.1097/01.aoa.0000344708.41667.f0
Balaji, V. & Seshiah, V. (2011). Management of diabetes in pregnancy. J Assoc Physicians India, 59, 33-36.