Contents:
- Medical Video: Gestational Diabetes: Managing Risk During and After Pregnancy Video - Brigham and Women’s Hospital
- Check your blood sugar
- Insulin and diabetes pills
- Food
- Sports
Medical Video: Gestational Diabetes: Managing Risk During and After Pregnancy Video - Brigham and Women’s Hospital
Pregnancy is an unforgettable experience. Sometimes you will feel very happy but sometimes you also feel worried about the presence of the baby. It's fun and thrilling when you hear a baby's heartbeat or feel the first small kick. This can also be frustrating and even frightening.
Because we already know more about diabetes than in the previous article, there are no more obstacles that stop you from planning a pregnancy even if you have diabetes. For the best treatment before giving birth, arrange a team that includes:
- Doctors are trained to treat diabetic patients and who have also treated pregnant women with diabetes
- Obstetricians who handle high-risk pregnancies and have treated other pregnant women with diabetes
- Pediatricians or neonatologists (doctors for newborns) who understand and can treat specific problems that occur in babies of women with diabetes
- Registered dieticians who can design your food plan according to your needs during and after pregnancy
- Diabetics who can help you deal with your diabetes during pregnancy
It is important to remember that YOU are the leader of your health care team. Record each question you have and make sure to ask your health care team.
Check your blood sugar
Your body will definitely change as your baby grows. Because you have diabetes, all changes that occur will affect your blood glucose level. Pregnancy can also make symptoms of low blood sugar difficult to detect. During pregnancy, control of your diabetes will usually become more complicated. You can do blood glucose checks regularly at home, this is very important for yourself and your baby during before and after pregnancy.
Blood glucose targets are designed to help you minimize the risk of birth defects, miscarriages, and help prevent your baby from being born too large. If you have difficulty maintaining glucose levels according to your target or even often have low blood glucose levels, try consulting your health care team about changing your treatment plan. Look for the right tips by working with your health care team to determine specific targets before and during pregnancy.
The American Diabetes Association recommends the following targets for pregnant women with diabetes:
- Before eating (preprandial) and before bed / night: 60-99 mg / dl
- After eating (postprandial): 100-129 mg / dl
- A1C: less than 6%
* Postprandial glucose measurements must be carried out 1-2 hours after you start eating
Check your blood glucose level at the time your doctor has determined; for example eight tests per day and will include a check of glucose levels after eating.
Write down the results of your blood glucose check and still follow the food and exercise menu plan that you have set. Make changes to your diet and insulin plan only with the advice and approval of your doctor's team.
Insulin and diabetes pills
Insulin is a drug that is always chosen by many diabetic patients to control blood glucose during pregnancy because insulin is the most effective drug for lowering blood glucose and will not be channeled through the placenta so it is safe for babies in the womb. Insulin can be injected with a syringe, insulin pen, or insulin pump. All of these methods are safe for pregnant women.
If you have type 1 diabetes, your pregnancy will affect your insulin treatment schedule. During several months of pregnancy, your body's insulin requirements will rise and this will occur during the last three months of pregnancy. The need for more insulin is caused by the hormones produced by the placenta. The placenta produces hormones that help the baby's growth. At the same time, this hormone inhibits the work of insulin in the mother. As a result, insulin requirements will increase.
If you have type 2 diabetes, you also need to plan what you have to do. If you are taking diabetes pills to control your blood glucose, you may not be able to use the pill while pregnant. Because the safety of using diabetes pills during pregnancy has not been established, your doctor may ask you to switch to insulin. Insulin resistance that occurs during pregnancy also often reduces the effectiveness of diabetes pills in maintaining blood sugar levels.
For women with gestational diabetes, planning a food menu and exercise activities can help keep blood glucose levels under control. However, if your blood glucose level is still high, your doctor will usually start changing your treatment with insulin.
There have been very few published studies about analyzing the safety and effectiveness of oral medications (which are taken by mouth during pregnancy). Unlike insulin, oral medications can reach unborn babies through the placenta. For this reason, doctors do not recommend their use during pregnancy. But now oral medications are more often used than in the past by some health care providers to control blood glucose levels which are not effective only with diet and exercise.
Food
During pregnancy, you and your nutritionist or doctor may need to change your diet plan to avoid problems that can affect blood glucose levels. For most women, the focus of a good diet plan during pregnancy is to improve the quality of the food you eat and not just increase the amount of food eaten. A food menu plan that is well designed to help you avoid problems with blood glucose levels and also to provide the nutrients your baby needs to grow.
Incorporating a variety of different foods and paying attention to portions of food is key to a healthy diet. Healthy eating is very important before, during, and after pregnancy for the rest of your life. Eating healthily is by consuming a variety of foods, including:
- vegetables
- grains
- milk-free products
- fruits
- peanuts
- lean meat
- poultry
- fish
Many people think that eating to meet the needs of two people is to eat more than usual. This is not true. You only need to increase your calorie intake by around 300 more calories every day. Instead, consult a dietitian or doctor to limit your weight gain during pregnancy.
Your dietitian will monitor your weight. If you start pregnancy at a normal weight, try adding between 6 and 11 kg. If you are obese early in your pregnancy, try to consult with your dietitian to limit your weight to around 6-11 kg.
Target body weight during pregnancy
If your weight ... increases to ...
Less 12-18 kg
Normal 11-15 kg
Overweight 7-11 pounds
Obesity 11-20 pounds
This is an average benchmark to give an idea of how much weight you should get. Talk to your doctor about the goals of a particular weight during pregnancy.
Sports
Exercise is an important part of treating diabetes. Can you maintain your exercise program during pregnancy? Is it safe to start an exercise program when you are pregnant?
Discuss your exercise plan with your health team to ask for guidance. Pregnant women often question whether it is safe to exercise during pregnancy. Regular physical activity is not only safe for pregnant women, but also has health benefits to avoid problems in pregnancy, such as varicose veins, leg cramps, fatigue, and constipation. For women with diabetes, exercise, especially after eating, can help the muscles drain glucose in the bloodstream and help keep your blood sugar levels within your target range. But if you experience one of the following conditions (see list below), then you will need to talk to your health team about the risks of exercise during pregnancy.
- High blood pressure
- Eye, kidney or heart problems
- Small or large blood vessel damage
- Nerve damage
In general, starting a strenuous exercise program during pregnancy is not a good idea. The choice of exercise that is good for pregnant women is by walking, light aerobics, swimming, or water aerobics. Activities that must be avoided during pregnancy are:
- Activities that put you at risk of falling or getting a stomach injury
- Activities that cause pressure on your stomach (exercises that are done while lying on your stomach / stomach)
- Scuba diving
- Intense exercise, like walking too fast
- Activities with bouncing or jerking movements (horse riding or heavy aerobics)
