When women with diabetes became pregnant in the past, their diabetic condition threatened to endanger both their own lives and the life of the fetus in their womb. But nowadays, both mother and child are able to survive the pregnancy because diabetes can be controlled better prior to conception and more thoroughly managed during the term of the pregnancy.
If you are a diabetic, you should take steps to plan your pregnancies. Research indicates that the incidence of maternal complications can be significantly lessened (to the level of the general population) if the blood sugar of the mother has been adequately controlled prior to and at the time of the pregnancy. At the same time, infant mortality, complications, and the potential for birth defects will go down if maternal blood sugar has been managed well.
It is vital that the blood sugar be monitored closely prior to the pregnancy and in the first three months of carrying the child in the womb since this first trimester is when the main fetal organs are being developed. As such, this is the period when the immature fetus is most at risk from the high blood sugar levels of the mother. Women whose diabetes gets out of control during pregnancy risk having their child developing fetal malformations, or suffer from intrauterine death. There is also more incidence of miscarriage in such cases. At the time of gestation, insulin levels may fluctuate with less insulin required in the first trimester. Afterwards, there will be more need for insulin until the pregnancy comes to term and culminates in delivery..
Gestational Diabetes Mellitus (GDM) is the term used to describe mothers who show signs of glucose intolerance at the time of pregnancy, but who showed no symptoms of diabetes before they got pregnant. Such diabetics may have had diabetes even before they became pregnant but only showed indications of glucose intolerance during pregnancy. Such patients, along with women with moderate type 2 diabetes, will most likely not need the strict and intensive management of diabetes that pregnant type 1 diabetics have to undergo unless their diabetes worsens during their pregnancy. Regardless of which type of diabetic you are, you will need to constantly check your glucose levels, and assess your fructosamine or glycohemoglobin levels as well, during the term of pregnancy.
Fasting blood glucose levels are reduced during pregnancy since the mother keeps feeding her child via the placenta, meaning the fetus absorbs glucose steadily. At the same time, there are fluctuations in metabolism and hormonal levels during pregnancy whose physiological effect is to antagonize the function of insulin this results in some insulin resistance. So, blood sugar levels go up, rendering strict control harder to accomplish. GDM shows more similarity to type 2 diabetes rather than to type 1 diabetes since insulin resistance proves to be the main metabolic abnormality.
The blood glucose level of the mother has a direct relationship with the degree of risk faced by the fetus in the womb. To properly manage GDM, maintain proper diet, exercise, and use insulin when needed. But be careful not to overdo your blood sugar control, because the opposite effect may be developing hypoglycemia. Thus, your doctor should customize his management goals to the needs of each patient.