Diabetes is a condition characterized by higher than normal
sugar levels in the blood. Some women have diabetes before getting pregnant,
this is called pregastational diabetes. In some women, the height of sugar
begins for the first time during pregnancy, this is called gestational
diabetes. It is estimated that one of every 200 pregnancies has pregestational
diabetes, in addition, 5 out of 200 pregnant women develop gestational DM
(diabetes during the course of pregnancy).
If you have diabetes before conception, it may be more
difficult to control your blood sugar level during pregnancy than before. You
may need to change your insulin dose during pregnancy.
Problems
that may occur due to diabetes in pregnancy:
- High levels of sugar in the blood can cause the baby to
become very large. Large babies have a higher risk of developing problems
before and during birth. Large babies are at higher risk of cesarean delivery.
Also, wearing a shoulder during birth, birth trauma and prolonged labor are
risks of the large baby.
- In patients who are diabetic before pregnancy, that is, in
pregestational diabetes patients, the risk of some anomalies in the baby
increases. However, gestational diabetes that starts during pregnancy does not
cause anomalies in the baby or there is a suspicious research that it may be
very mildly related.
- Pregnant women with diabetes have an increased risk of
developing preeclampsia during pregnancy.
- The risk of preterm birth has increased.
- Sudden infant death may occur
- RDS (lung in other words, breathing) may develop after
birth. Lung development is delayed in diabetic mother children.
- After birth, the baby may develop hypoglycaemia (low blood
sugar) and elevated bilirubin, polycythemia (excess of blood cells in the
baby).
- In patients with pregastational (pre-pregnancy) diabetes
disease, placental function deficiency and as a result, IUGR (developmental
retardation) may occur in the baby.
- Polyhydramnios is common in diabetic pregnancies.
Oligohydramnios may also develop in pregestational diabetes.
- Sudden fetal death may occur in the womb.
- Maternal mortality increased due to preeclampsia and
ketoacidosis.
- The risk of urinary tract infections, respiratory tract
infections, postpartum puerperal infections and wound infections are increased
in diabetic pregnants.
- Diabetic ketoacidosis may occur. Excessive nausea,
vomiting, infections, beta mimetic or steroid medications can lead to diabetic
keteoacidosis in diabetic pregnant women.
If you get the right treatment and have regular checks before
and during pregnancy, you have a good chance of giving birth to a healthy baby.
Symptoms:
Many pregnant women do not notice the symptoms of diabetes,
and this is understood by analysis, but there may be symptoms such as feeling
of thirst, weight loss, eating too much, urinating too much, fatigue.
If a woman with diabetes becomes pregnant, she should know
that control of the disease will be difficult and worsen during pregnancy.
Diagnosis:
For the diagnosis, tests called glucose loading tests are
performed. 24-28. 50 g of screening for all pregnant women during gestational
week. glucose test is done. The 50 gram glucose load test is only a screening
test and does not make a diagnosis of diabetes. 100 grams of glucose tolerance
test is performed for those whose glucose test value is higher than 140.
According to the result of the 100 gram glucose test, diabetes can be
diagnosed. These tests are described in detail under a separate title.
Treatment:
Sometimes diet is sufficient to treat gestational diabetes.
When the diet is not enough, insulin treatment is started. Tablet-lowering
drugs cannot be used during pregnancy.
How and
when should birth be?
In diabetic pregnants, if there is no abnormality, there is
no other situation that would require cesarean delivery, delivery is made in
the form of normal delivery and at normal time. In cases such as large baby
(macrosomia) or incompatibility of maternal bone structure, cesarean may be
required. The risk of preterm birth is increased in diabetic pregnancies.
Does
diabetes persist after birth?
In most women, this situation passes after the birth of the
baby. Mothers diagnosed with gestational diabetes during pregnancy are
administered OGTT (sugar loading test) with 75 grams of glucose 6 weeks after
birth. With this test, it is learned whether diabetes continues. Even if this
test is normal, the risk of developing diabetes in the mother's later
pregnancies or later in life is higher than other people. Patients with
diabetes during pregnancy develop apparent diabetes disease in about half of 20
years.
Those with diabetes before pregnancy will return to their
pre-pregnancy state after birth.
The risk of
developing diabetes in the child is high in the following years:
- The risk of developing Type 2 diabetes and GDM increases 20
times larda in children born to diabetic mothers compared to non-diabetic
mothers.
- The risk of developing diabetes in the children of the
mother with diabetes while pregnant is 33%.
- Having a diabetes disease in the father does not cause an
increase in congenital anomaly in the baby. While gestational diabetes in the
mother does not cause an increase in fetal anomaly, pregastational diabetes can
cause an increase in anomaly.
- In pregnant women with pregestational diabetes, the risk of
fetal amomali increases. The most risk-increasing fetal anomaly is caudal
regression and situs inversus. In diabetic pregnants, caudal regression is 250
times more than in non-diabetic pregnants, and situs inversus is 80 times more.
However, the most common fetal anomaly in diabetic pregnancies is cardiac
anomalies as in non-diabetic pregnancies, and neural tube disasters are in
second place.
In the presence of diabetes in the mother, problems such as
hypoglycemia, hypocalcaemia, hyperbiluribinemia, polycythemia, hyperviscosity,
respiratory distress syndrome, and hypertrophic cardiomyopathy may occur in the
postpartum newborn.
- Women with a diagnosis of diabetes during pregnancy have an
increased risk of developing obesity, overt diabetes, hypertension,
hyperlipidemia, and cardiovascular diseases. Therefore, patients with high
pregnancy-related sugar levels should be careful about life-long healthy
nutrition, active lifestyle and regular exercise in the postpartum period.
-CHEMOTHERAPY AND RADIOTHERAPY IN PREGNANCY
-HEADACHE AND MIGRAINE IN PREGNANCY
-MYOMA IN PREGNANCY
-ROMATOID ARTHRITIS IN PREGNANCY
-GALLBLADDER INFLAMMATION IN PREGNANCY
-GALLSTONE IN PREGNANCY
