Correct management and control of blood sugar levels for type 1 diabetics, is a constant and sometimes difficult process at the best of times. However, when a fetus is involved, stabilized blood glucose levels becomes critical for a healthy pregnancy.
Type 1 diabetes is a chronic autoimmune, insulin-dependent illness, that demands a lot of extra insulin during pregnancy.
Preparing for Pregnancy
Preparation for pregnancy should ensure that you are maintaining good blood glucose levels, exercising regularly and have a healthy diet and body weight.
Studies have shown that women who avail themselves of and follow the advice of a diabetic educator before conception, are less likely to encounter problems during pregnancy.
Hormones and metabolism play an important role during pregnancy, but also cause changes and fluctuations in insulin requirements. It can be challenging and stressful trying to keep glucose levels within the target range for a safe pregnancy.
It is possible that early in the pregnancy the more effective use of insulin by the body could result in a lesser dose of insulin being required, resulting in lowered blood glucose levels.
The indications – the sweating and shaking, which are the usual warning to diabetics of low blood sugar levels (hypoglycemia) could also undergo changes or disappear at this time.
The lifeline between the baby and the mother’s blood supply is the placenta. The placenta provides air and nourishment to the baby. A variety of hormones are made by the placenta.
Decreased glucose production and increased insulin secretion in early pregnancy are caused by these hormones.
As the pregnancy progresses hormones produced by the placenta can have a blocking effect on insulin. The interference of the hormones prevents the conversion of glucose from food, into energy.
This directs the energy to the baby, resulting in the requirement of the mother to rapidly increase her intake of insulin to a level much higher than pre-pregnancy levels.
During the last month of pregnancy there is the possibility of change in insulin dosage occurring again, with lower pre-pregnancy doses required after birth.
Complications Associated with Diabetes Type 1 In Pregnancy
Three reviews involving the study of 223 pregnant women with pre-existing diabetes were compared. The comparison found that the women with poorly controlled blood sugar levels throughout their pregnancy had a much higher risk for complications than expectant mothers who had good to moderate control of blood sugar levels.
Possible complications include high blood pressure, miscarriage, and pre-eclampsia. Any existing medical problems, including kidney problems can also get worse during pregnancy.
Risks for Babies Of Diabetes Type 1 Mothers
Poorly managed blood glucose levels in early pregnancy can have adverse effects on the health of the baby. These include birth defects, premature delivery and the possibility of a miscarriage.
Low blood sugar puts the baby at risk for long-term conditions relating to the development of abnormalities and hypertension. Conversely, high glucose levels can subject the baby to congenital malformations such as spina bifida.
The baby’s kidneys, and heart are also at risk of being damaged if the mother’s blood sugar is high during the early months of pregnancy.
At times during pregnancy when the mother has high levels of blood sugar the excess passes to the fetus, causing it to produce raised levels of insulin. When this extra glucose is turned into energy the result is a baby that grows faster and larger than normal.
All pregnant woman with diabetes is at increased risk for fetal death during the late stage of pregnancy. However, the risk is higher for women with pre-existing diabetes than for mothers diagnosed with gestational diabetes.
It is common for type 1 diabetics to have a pre-term delivery. This often occurs, from the 32nd and prior to the 37th week of pregnancy. Statistics show that an induced birth, is required by one in five women, and delivery by cesarean section is a common occurrence for diabetic type 1 mothers.
