Wednesday, August 7, 2013

Garbh Sanskar: Pregnancy And Diabetes

When eating vegetarian, an optimum meal plan includes a variety of foods including a selection of vegetables, fruits, beans and legumes, whole grain products, nuts, seeds and healthy fats. When people include dairy products in their plans, non-fat and very low-fat selections are the best choice.

“Try beans as part of a healthy breakfast”

Diabetic women who get pregnant are three to four times more likely to have a child with birth defects than other women, according to new research.

Women with any type of diabetes during pregnancy risk a number of complications if they do not carefully monitor and manage their condition. Women with type 1 diabetes require more planning and monitoring before and during pregnancy to minimize complications. High blood glucose during pregnancy can lead to changes in the foetus which cause it to put on excess weight (macrosomia) and overproduce insulin. These can lead to problems in delivery, trauma to the child and mother, and a sudden drop in blood sugar (hypoglycaemia) for the child after birth.  Children who are exposed for a long time to high blood glucose in the womb are at higher risk of developing diabetes in the future.

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Manage Diabetes During Pregnancy

Keeping your diabetes under control during pregnancy can help prevent birth defects, prematurity, miscarriage or stillbirth.

  • Before you are pregnant, see your doctor to create a plan for a healthy pregnancy. Stick to a recommended check-up schedule.
  • Maintain a healthy diet before and during pregnancy, and get plenty of regular exercise.
  • Follow your doctor's recommendations for all medications.
  • Frequently check your blood sugar level, and strive to keep it as stable as possible.

There are a number of steps you can take many months before pregnancy that have an impact for the whole pregnancy. If you haven't taken care of yourself before and you haven't gotten your blood sugars under control before conception, the risk of miscarriage and birth defects is much greater. Your doctor will also check to see if you have any complications of diabetes such as eye or kidney disease that could impact your health and the health of your baby. That’s why it’s important to make an appointment with your physician before you get pregnant and develop a plan to be the healthiest you can be.

Not only should women who have diabetes talk to their doctors prior to becoming pregnant, but women who are at high risk of developing diabetes – who have a family member who has diabetes – should talk to their primary care physician before getting pregnant. Part of this discussion should be a fasting blood glucose test to make sure the level is not high and then ensure the person doesn't have diabetes that had gone undiagnosed.

Diabetes has great impact on pregnancy outcomes – making it a high-risk pregnancy. Patients really do need much more specialized care because their glucose needs to be controlled. Preterm delivery and hypertensive diseases of pregnancy are more common in pregnancies complicated by diabetes and the delivery may be complicated with a bigger baby. Still birth may occur when blood glucoses are very poorly controlled.
In the first trimester, if blood sugars are very high, birth defects can develop. The higher the blood sugar levels, the higher the risk of birth defects. Women who have very high blood sugar levels can have a 30 to 40 percent chance of birth defects. For women who have blood sugars that are well-controlled, the risk of birth defects decreases to about 2 percent, which is what we see in the general population.

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Changes in blood glucoses and insulin requirements occur throughout pregnancy. In the first few weeks of pregnancy, blood glucoses and insulin requirements may increase. This is followed by a decrease in blood glucoses and insulin requirements by approximately nine weeks of pregnancy. Then, as the pregnancy progresses and the placenta begins to grow, it makes hormones that raise the blood sugar. Beginning around 16 to 20 weeks, we begin to see a rise in blood sugars. In order to prevent blood sugars from getting too high and out of control, we monitor the blood sugars and make frequent adjustments to the patient’s insulin doses. If you have diabetes, the amount of insulin you need may double or triple by the end of pregnancy.  It is also common for you to experience low blood glucoses because the “tighter” control of blood glucoses needed for pregnancy. 

It is important to eat healthy food during pregnancy to avoid excessive weight gain. Excessive weight gain can also increase the risk of adverse pregnancy outcomes. Talk to your health care provider about the “plate method.” To get a mental picture of what you should be eating, divide your dinner plate into one half and two quarters. You should put veggies and fruit on half of your plate and  a lean meat and a whole grain on each of the quarters of your plate. You should also know how many carbohydrates to eat with meals.  Avoid eating low-fiber processed carbohydrates, which can spike your blood glucoses.  

During your pregnancy, you will also likely need more frequent eye exams to make sure that pregnancy does not cause changes in the back of your eye.

High blood sugars during pregnancy lead to uncontrolled fetal growth, so babies are born large for their gestational age. Large birth-weight babies are more likely to be obese and can sometimes have impaired glucose metabolism as children. The prevalence of pre-existing diabetes in pregnancy is increasing and this relates to the rise in obesity of our population.

Gestational diabetes occurs because of the temporary insulin resistant state of pregnancy. It usually happens between the 26th and 30th week of pregnancy. There are some risk factors for gestational diabetes. If you are overweight or obese or had a baby that weighed more or you have a family history of Type 2 diabetes or are 40 years of age and older, you have a much greater risk of gestational diabetes.

Women who are diagnosed with gestational diabetes during pregnancy will not have diabetes after they deliver, but their long term risk (of developing Type 2 diabetes) is very high - up to 50 percent in the first five to seven years after delivery. If you had gestational diabetes, it’s important to continue good nutrition and maintain a regular exercise program, try to achieve normal weight or BMI, and see your physician regularly post-delivery.

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The best advice is to make sure your blood sugars are under control before getting pregnant. You should try to lose weight by following a healthy diet and getting regular exercise, if you are overweight or obese, before pregnancy.  Remember, it is important to monitor your blood glucoses and make careful insulin adjustments during pregnancy. It is common that women with pre existing diabetes tend to have large birth weight babies but overall, the outcomes are usually very good.

Early and effective management of diabetes for pregnant women is critical in helping to not only prevent birth defects, but also to reduce the risk for other health complications for them and their children.The birth defects include: heart defects, defects of the brain and spine, oral clefts, defects of the kidneys and gastrointestinal tract and limb deficiencies.

The risk was twice as high in children whose mothers rarely ate vegetables during pregnancy, and lowest among children whose mothers ate vegetables every day of their pregnancy.

Important:

Diabetes can bring with it a seemingly never-ending list of things you can’t eat. To an extent this is true, but you don’t have to look at it that way if you learn to be smart about your food choices. If you choose your carbs wisely, you don’t have to always give up dessert. You do, however, have to give up something in its place in order to have good blood sugar control.

The key is learning which carbs to avoid in order to maximize your carb limit. Everyone is different — some need to adjust their diets to their lifestyles or their lifestyles to their diets.

Take care of your unborn baby.

Disclaimer
The sole purpose of these blogs is to provide information about the tradition of ayurveda. This information is not intended for use in the diagnosis, prevention or cure of any disease. If you have any serious, acute or chronic health concern, please consult a trained doctor/health professional who can fully assess your needs and address them effectively. If you are seeking the medical advice of a trained Ayurvedic expert, call us or e mail.

Dr Unnati Chavda
(Promoting pregnancy wellness)
www.ayurvedapanchkarma.in

1 comment:

  1. What an wonderful post. Very nice to read. I very much appreciate the way you have provided extremely useful information about the relationship between diabetes and pregnancy. These days people in general are extremely concerned about diabetes and always on the lookout for an effective solution. Recently I came across a book called "The 7 Steps to Health and the Big Diabetes Lie". Trust me the book practically breaks hundreds of myths related to the disease and provides an effective solution. I have found it extremely useful and effective. Maybe you can also read it out at once.

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