 |
||||||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||
Our Address:
BRAID / MDSi
University of Alberta
8308 - 114 St.,
Suite 4100
Edmonton, Alberta
T6G 2V2
Phone: (780) 407-1627
Fax: (780) 407-1715
mdsi@ualberta.ca
Go to NEWSLETTERS to read the full newsletter For more information on DIABETES & PREGNANCY, go to:
www.diabetes-pregnancy.caDiabetes & Pregnancy... Not something to be afraid of
Editorial by Dr. Ellen L. TothRecently we have noticed an increase in diabetes complicating pregnancies in Aboriginal and non-Aboriginal women.
Sadly, if not recognized and treated this can lead to problems including C-sections, big babies, or babies with birth defects. Very rarely there can even be still-births.
But there is no reason for alarm. Properly diagnosed, the situation is very manageable.
You need to know: There are 3 kinds of diabetes in pregnancy.
#1a. Pre-pregnancy diabetes (or pre-conception diabetes). This is Type 1 or Type 2 already diagnosed previously.
#1b. Pre-pregnancy diabetes that has been present before conception but has not been diagnosed or recognized.
#2. Gestational diabetes: Diabetes first diagnosed or recognized in pregnancy (usually later in the pregnancy).
What should happen?
#1. For many reasons it is best to plan a pregnancy. Talk to your family doctor about any medical concerns regarding your plans. If you have diabetes of any sort it is really important to be in good control before getting pregnant.Birth defects are preventable with an A1c of less than 7% and less than 6% if
possible. This may mean seeing a specialized diabetes team or going on insulin.#2. Regardless of whether you do or do not have diabetes eating healthy (as if you had diabetes) will be good for the pregnancy, as well as remaining or becoming reasonably physically active. Talk to your doctor, nurse or dietitian if possible.
#3. Sometimes you don’t know if you have diabetes. Perhaps someone told you but you did not believe or did not want to believe it. Perhaps you had gestational diabetes and did not get re-tested after the baby was born. Perhaps you were tested and had diabetes but were not told. Perhaps someone said something about “borderline”, “impaired glucose tolerance” or “pre-diabetes”. In all cases it is best to check this out before getting pregnant since youmay have diabetes and this is a serious risk for the baby in the first 6 weeks.
#4. If you do not already have diabetes and you are pregnant and have any 2 or more risk factors, you should be tested for diabetes as soon as the pregnancy is known. The biggest risk factors are:
- Member of a high risk ethnic group (any group except Caucasian)
- Significantly overweight or obese
- Previous history of gestational diabetes
- Pervious large baby (over 10 lbs) or still birth
- Family history of diabetes#5. Testing in the early part of pregnancy can be a simple blood test (an A1c, or a fasting glucose), if these are normal a glucose tolerance test (the orange drink) will be needed later in the pregnancy, whether you have risk factors or not.
Will my diabetes affect the baby? The baby will not be born with diabetes. You can have a healthy baby if you have diabetes but you do need to plan your pregnancies and work with the diabetes team, at the very least early on in the pregnancy. Most of these pregnancies will need insulin through the pregnancy.
For women with gestational diabetes, the baby can be protected by treatment, including a good diet, moderate activity and insulin if necessary.
This means a lot of doctors appointments! That is true. But many nurses and dietitians can help, and we at www.braiddm.ca are starting to work on providing more resources for communities to help with this issue. If you have questions, wish to make suggestions or offer your help please contact us by phone: (780) 407-1627 or e-mail: mdsi@ualberta.ca. You can also access information at:
www.diabetes-pregnancy.caDiabetes in pregnancy should not be something to fear. It can be managed and have good outcomes for the mother and the baby.
HEADLINES:
