With good control, diabetes does not pose a threat to the bearing and birth of a healthy baby. However, pregnancy in diabetes is associated with certain risks, so it is very important to have all the information about possible complications and take the necessary steps to prevent them. Compensating for diabetes several months before conception will eliminate certain risks and complications. To avoid unnecessary unrest in early pregnancy, it is necessary to achieve effective control of diabetes.
In addition to the normalization of blood sugar levels, it is necessary to undergo a full examination. It is recommended to check for the presence of other complications associated with diabetes – as a rule, such a check includes:
-Diagnosis of the nervous system
-Examination for weight problems
-Blood pressure check
The main thing is preparation
Surely, you already understand that the normalization of blood sugar levels before pregnancy is the most important recommendation for future mothers with diabetes. Control of diabetes and care for your health will ensure the most favorable course of pregnancy for both you and your unborn child. The first weeks of pregnancy are the most important period in terms of fetal development, so be prepared.
Pregnancy is not only joyful moments. Many women have to face various problems, and some even have concerns about pregnancy. In this regard, it is very important that you have a reliable support group – for this, contact your partner, relatives and relatives for help. Explain the necessary information to them – so they can provide the necessary support, and, most importantly, you will not be alone. Remember that effective assistance is only possible if specific requests for help are made from you.
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DIABETES BEFORE CONCEPTION AND AT EARLY STAGES OF PREGNANCY
If you have type 1 or type 2 diabetes, you probably know a variety of diets and you understand how certain foods affect your body (especially blood sugar levels). During the planning period of pregnancy, you are undoubtedly concerned about the issue of probable changes. It all depends on what foods are included in your normal diet.
You may need to reduce the consumption of certain foods (for example, potatoes). A recent study in the United States found that women who consumed five servings of potatoes per week had a 50% higher risk of developing gestational diabetes compared to women who did not consume potatoes1. Despite the fact that potatoes do not belong to the products that cause diabetes, according to the researchers, there is enough scientific evidence that the potato does increase the risk of developing gestational diabetes. Since potatoes are characterized by a high glycemic index (GI), their consumption leads to a sharp release of glucose into the blood immediately after a meal. Ultimately, this leads to jumps in blood sugar levels to rates outside the recommended range. In this regard, if the potato has a strong place in your usual diet, use caution and, possibly, reduce the number of servings.
For women who are not insulin-dependent (the majority of patients with type 2 diabetes), it is crucial to monitor the amount of carbohydrates consumed before conception, since this indicator will have a direct effect on blood sugar levels that will be difficult to control without insulin therapy. A steady carbohydrate intake throughout the day will reduce the risk of sugar spikes and will help maintain blood sugar levels within a safe range.
We understand that during pregnancy a woman eats for two, however, the increase in the amount of food should not occur due to an increase in the amount of processed foods and food that increases blood sugar levels. Elevated levels of sugar (glucose) in the blood and ketone bodies (especially during the first trimester) increase the risk of congenital abnormalities2 — this is why it is so important to normalize blood sugar levels even before pregnancy. If you have severe and frequent episodes of hyperglycemia, you may need to postpone pregnancy until you have better control of your diabetes.
If you are planning a pregnancy, remember to avoid certain types of foods, including:
Raw eggs and boiled soft-boiled eggs, or fried eggs
>Fish high in mercury (swordfish, shark, marlin) 3
>Foods high in carbohydrates, which are completely or practically no >Nutrients
HbA1c Level During Pregnancy
As recommended by the National Institute for Health and Excellence Excellence (NICE), the HbA1c target for women with diabetes planning pregnancy is 4.3 mmol / L (774 mg / dL) 4 before conception . In case the indicator exceeds the recommended one by 10% or more, it is recommended to postpone pregnancy planning until the best compensation for diabetes is achieved. If you have type 2 diabetes and need to lower your HbA1c level, a recent study found that using MiniMed insulin pump reduces HbA1c levels by 1.1% compared to multiple daily injections (MUIs), in which the level of decline in the group research accounted for only 0.4%
Before you conceive, discuss your diabetes treatment with your team of medical professionals and select the one that will help you to make the next pregnancy as smooth as possible. As the woman’s body changes during pregnancy, so does the need. Ask all your questions to ensure the most effective management of blood sugar levels. This is a time of careful planning, attention to detail and comprehensive analysis.
Type 2 Diabetes
Since the use of certain antidiabetic drugs for type 2 diabetics is prohibited during pregnancy, you can be transferred to therapy with insulin injections. Often after childbirth, you will be able to return to the reception of the tablets. A recent study found that treating type 2 diabetes with an insulin pump6 MiniMed can improve diabetes control, as well as reduce the usual 120–150 monthly insulin injections prior to the infusion set being administered 2-3 times a week.
For more information, contact our MiniMed team.
Type 1 diabetes
Patients with type1 diabetes should consider using an insulin pump in conjunction with a continuous glucose monitoring system, since research has shown their effectiveness in women who tried to lower HbA1c levels before conception. Unlike an insulin pump, multiple daily injections (MEI) do not allow for equally effective management of sugar levels, which change under the influence of hormones during pregnancy.
Insulin Needs During Pregnancy
As you probably already know, insulin requirements during pregnancy constantly fluctuate, which means that the usual diet and exercise will have different effects on blood sugar levels. To cope with such fluctuations, you can use a system of continuous monitoring of glucose, which demonstrates its effectiveness in therapy as with an insulin pump, so and with a syringe handle. In the course of our study, it was found that when measuring blood sugar levels using a conventional glucometer, 60% of low blood sugar (glucose) levels in the blood go unnoticed7. On the contrary, our NMG system with a new generation Enlite sensor performs measurements around the clock and informs about low and high rates.
If you suffer from an insulin-dependent form of diabetes (type 1 diabetes and sometimes type 2 diabetes), your need for insulin during pregnancy can increase significantly – many women inject insulin at a dose that is 3–4 times higher than the standard dose.
Most women point out that since insulin gets into the bloodstream rather slowly, it helps to inject insulin 30-40 minutes before eating to avoid sudden surges in sugar.
Starting from week 28, you need to undergo an ultrasound scan regularly to monitor the development of the child and the amount of amniotic fluid.
In addition to maintaining blood sugar within the target range, there are other aspects that need to be addressed to ensure the success of the future pregnancy. A few tips to help strengthen your health:
-Avoid alcohol consumption
-Eat a balanced diet.
-Plan your pregnancy well in advance (this is especially important with diabetes).
Medtronic MiniMed team will be happy to advise you if you are thinking about having a baby. We will provide you with the necessary information, advice and support to help you better plan your pregnancy. As a rule, during the consultation such key issues are considered – medication, type of insulin used, method of treating diabetes, current diet and exercise. As soon as we have an understanding of the features of your current lifestyle and circumstances, the MiniMed team may provide you with even more specific recommendations regarding the changes necessary for a successful pregnancy.