Diabetes

Diabetes

Diabetes mellitus (MEL-ih-tus), often referred to as diabetes, is characterized by high blood glucose (sugar) levels that result from the body’s inability to produce enough insulin and/or effectively utilize the insulin. Diabetes is a serious, life-long condition and the sixth leading cause of death in the United States. Diabetes is a disorder of metabolism (the body's way of digesting food and converting it into energy). There are three forms of diabetes. Type 1 diabetes is an autoimmune disease that accounts for five- to 10-percent of all diagnosed cases of diabetes. Type 2 diabetes may account for 90- to 95-percent of all diagnosed cases. The third type of diabetes occurs in pregnancy and is referred to as gestational diabetes. Left untreated, gestational diabetes can cause health issues for pregnant women and their babies. People with diabetes can take preventive steps to control this disease and decrease the risk of further complications.

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    A , Pharmacy, answered
    If you have diabetes, your doctor may treat your pregnancy a little differently. For example, if a woman has diabetes, some doctors would prefer to deliver her baby a week or two before the due date to lower the risk of certain problems at birth. After you deliver, you should breastfeed your baby. But because breastfeeding can lower the amount of insulin your body needs, you'll need to check your blood sugar and adjust any medications accordingly. You'll also want to plan your meals and snacks carefully around breastfeeding so you don't experience very low blood sugar.
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    For women who have type 1 or type 2 diabetes before becoming pregnant, keeping blood glucose levels low even before pregnancy decreases the risk of birth defects. Birth defects occur early in pregnancy as the baby’s organs are being formed. But gestational diabetes does not usually occur until more than halfway through the pregnancy. By the halfway mark, the baby’s organs are already formed.
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    Although women with diabetes and their unborn children face additional risks because of diabetes, these can be kept to a minimum through careful blood glucose management, before and during pregnancy, and intensive obstetrical care. For this reason, all women with diabetes need to plan ahead before becoming pregnant. 

    The first step is to meet with your health care team to consider the specific challenges you may face during your pregnancy. You need a complete evaluation of your overall health and any diabetes complications. It’s important to get a good idea of how much extra work and expense may be involved before you become pregnant.

    You may have specific questions for your health care provider. You may be concerned that your baby could develop diabetes. You may be worried for your own health. Your glucose levels may also be an issue.

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    Most women use intensive diabetes management during pregnancy to keep blood glucose levels close to normal. If that is your goal, you’ll need to be extra watchful for low blood glucose levels caused by exercise. Your glucose level can go very low very quickly. Monitoring is your way to watch out for hypoglycemia. Chances are that you’ll already be monitoring frequently during pregnancy. This can help you figure out how exercise affects your blood glucose and when your levels are starting to drop.

    • Monitor your blood glucose levels often—before, during, and after
             exercise.
    • Drink plenty of fluids before, during, and after exercise.
    • Warm up before and cool down after exercise.
    • Keep the strenuous part of your workout to no longer than 15
             minutes.
    • Keep your heart rate under 140 beats per minute while you
             exercise (about 23 beats per 10-second pulse count).
    • Keep your body temperature under 100°F. Ask your provider if hot
             tubs or steam rooms are safe.
    • Avoid exercises that involve lying on your back after your fourth
             month of pregnancy, straining or holding your breath, jerky
             movements, or quick changes in direction.
    • Stop exercising if you feel lightheaded, weak, or very out of
             breath.
    • Ask your obstetrician to show you how to feel your uterus for
             contractions during exercise. These contractions could be a
             sign you’re overdoing it.
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    The ideal pregnancy health care team for people with diabetes includes:

    • Diabetes care provider
    • Obstetrician experienced in treating pregnancy complicated by diabetes
    • Pediatrician experienced in the care of infants of mothers with diabetes
    • Registered dietitian
    • Diabetes nurse educator experienced in teaching women how to intensively manage their diabetes
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    Breastfeeding is good for women with diabetes, but it may make your blood glucose a little harder to predict. To help prevent low blood glucose levels due to breastfeeding, try these tips:
    • Plan to have a snack before or during nursing
    • Drink enough fluids (plan to sip a glass of water or a caffeine-free drink while nursing)
    • Keep something to treat low blood glucose nearby when you nurse, so you don't have to stop a feeding to treat low blood glucose levels.
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    Be aware that your blood sugar can change very quickly, becoming too high or too low. What you eat, how physically active you are, and your growing baby will change your blood sugar many times during the day. Check your blood sugar often—as directed by your doctor and any time you have symptoms. Know what blood sugar levels mean. Learn how to adjust what and when you eat, how physically active you are, and, if prescribed, how much insulin to take depending on your blood sugar tests. Check your blood sugar right away if you have symptoms. Treat low blood sugar quickly. Always carry with you a quick source of sugar, like hard candy or glucose tablets. Wear a medical alert diabetes bracelet.

    The presence of the CDC logo and CDC content on this page should not be construed to imply endorsement by the US Government of any commercial products or services, or to replace the advice of a medical professional. The mark “CDC” is licensed under authority of the PHS.
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    It is important to maintain physical activity during pregnancy, as long as your overall health permits it. Being fit prepares you for the physical stress of labor and delivery and the busy days that follow. It is usually safe to continue with any exercise you were doing regularly before pregnancy. But pregnancy is not the time to take up any new, strenuous activities.

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    Ask your dietitian and doctor about the use of caffeine, alcohol, and artificial sweeteners during pregnancy. Unless you have special needs, it is safe to use the artificial sweeteners aspartame and acesulfame-K during pregnancy. You need to avoid saccharin during pregnancy and when breast-feeding. Alcohol is generally not recommended for anyone during pregnancy and can increase the risk of hypoglycemia among women with diabetes.

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    Your baby will be closely watched after birth. He or she is at risk for hypoglycemia and will have frequent blood glucose monitoring during the first 24 hours after birth. Hypoglycemia occurs because the baby has been producing enough insulin to cover the high glucose levels in the uterus. This does not mean your baby has diabetes.

    Jaundice is also common and may require therapy with lights. If your baby was delivered early or is very large for his or her age, your baby will also be evaluated for respiratory problems. It is not unusual for these babies to be in an intensive care nursery for a short time so that they can be watched very closely.