| Maternal health and fetal complications are at a much | | | | plan used by a pregnant woman should include |
| greater risk in women with diabetes who are | | | | adequate calories and nutrients to meet the needs of |
| pregnant. Even the stress of a pregnancy can bring | | | | both mother and fetus and should be consistent with |
| about gestational diabetes, which is a form of glucose | | | | established maternal blood glucose goals. The impact |
| intolerance that begins during the pregnancy and | | | | of meals and snacks on blood glucose levels must be |
| resolves itself after the birth of the baby. Whether | | | | tracked with self monitoring and should be done a |
| there is preexisting diabetes or gestational diabetes | | | | minimum of four times a day. |
| there is an increased risk of fetal congenital defects | | | | Planning and commitment is required for any pregnant |
| and death from hyperglycemia, or abnormally high | | | | woman with diabetes to have a successful |
| blood sugar, which must be controlled. Any woman | | | | pregnancy. Achieving and maintaining tight blood |
| with diabetes that is pregnant should get some form | | | | glucose control before conception and during the first |
| of nutritional counseling from a registered dietician. | | | | trimester is of paramount importance because this is |
| There are many changes that occur during a | | | | when most fetal malformation occurs. The best time |
| pregnancy that can have detrimental effects on | | | | for any woman with diabetes who is attempting to |
| controlling the diabetes and the use of insulin. The | | | | become pregnant is before conception. |
| placenta produces some hormones and enzymes that | | | | During the second and third trimesters the need for |
| reduce the effectiveness of insulin. Insulin from the | | | | insulin increases because of increased blood glucose |
| mother does not cross the placenta but blood | | | | levels caused by the increased production of |
| glucose will. If too much blood glucose crosses over | | | | hormones associated with pregnancy that decrease |
| to the baby the baby's pancreas will increase insulin | | | | the effectiveness of insulin. |
| production. This increase in insulin leads to a condition | | | | A diabetic pregnancy will require a more focused |
| that is typical for women with diabetes, macrosomia, | | | | approach to the diabetic diet plan each day of the |
| or big baby syndrome. Newborns of mother with | | | | pregnancy. Special considerations need to be made |
| either form of diabetes can also suffer from | | | | for food cravings and nausea during the early weeks |
| respiratory problems, hypocalcemia, hypoglycemia, | | | | of a pregnancy. All meal plans need to be |
| hypokalemia, or jaundice. | | | | individualized to each woman and need to evolve |
| Medical nutrition therapy needs to be individualized | | | | throughout the pregnancy as insulin and nutritional |
| based on the mother's weight and height. The diet | | | | needs change. |