women s health issues
Diabetes During Pregnancy
Treatment of Diabetes During Pregnancy
Close monitoring of the woman and fetus Diet, exercise, and sometimes medications to control the blood sugar level Aglucagonkit (to be used if blood sugar levels decrease too much) Sometimes a medication to start labor To reduce the risk of problems, doctors usually do the following: Involve a diabetes team (including nurses, a nutritionist, and social workers) and a pediatrician. Promptly diagnose and treat any pregnancy-related problems, no matter how trivial Plan for delivery and have an experienced pediatrician present Make sure that intensive care is available for the newborn (if needed) The risk of complications during pregnancy can be reduced by controlling the level of sugar in the blood. The level should be kept as near normal as possible throughout pregnancy. Doctors advise women who have diabetes and who are planning to become pregnant to immediately start taking Treatment if they have not already done so. These steps include following an appropriate diet, exercising, and, if needed, taking Most pregnant women with diabetes are asked to measure their blood sugar level several times a day at home using a home blood sugar monitoring device. If blood sugar levels are high, women may need to take an oral hypoglycemic medication orinsulin. Treatment sometimes causes blood sugar levels to decrease too much (called Hypoglycemia ). Hypoglycemia, if severe, causes confusion and loss of consciousness and can occur without any warning. If a woman is prone to episodes of hypoglycemia (for example, if she has had type 1 diabetes for a long time), she is given a Controlling diabetes is particularly important late in pregnancy because then, the blood sugar level tends to increase. A higher dose ofinsulinis usually needed. Women are often asked to count the number of times they feel the fetus move each day. If all is well, they should feel at least 10 movements (kicks, flutters, or rolls) within 2 hours. Usually, the fetus moves 10 times in less time. Women should report any sudden decreases in movement to the doctor immediately. Doctors Fetal monitoring by doing tests such as fetal heart rate monitoring, nonstress tests, or biophysical profiles (using ultrasonography). Monitoring often begins at 32 weeks of pregnancy or sooner if complications develop—for example, if the fetus is not growing as much as expected or if the woman develops high blood pressure. If any of the following are present, doctors may remove and analyze a sample of the fluid that surrounds the fetus (amniotic fluid): Women have had pregnancy-related problems in previous pregnancies. The due date is uncertain. Blood sugar has not been well-controlled. Care during the pregnancy has been inadequate. Women are not following their treatment plan as directed. This procedure, called Amniocentesis , helps doctors determine whether the fetus’s lungs are mature enough to breathe air and thus determine when the baby can be delivered safely. If labor has not started by 39 weeks, doctors may start labor using a medication (see Induction of Labor ). Usually, vaginal delivery is possible. During labor and delivery, many women with diabetes need to be given a continuous infusion ofinsulinthrough a catheter inserted in a vein. In newborns of women with diabetes, hospital staff members measure blood levels of sugar, calcium, and bilirubin because these newborns often have abnormal levels. The newborns are also observed for symptoms of these abnormalities. For women with diabetes, the requirement forinsulindramatically drops immediately after delivery. But the requirement usually returns to what it was before pregnancy within about 1 week. After delivery, gestational diabetes usually disappears. However, many women who have gestational diabetes develop type 2 diabetes as they become older. 