Pregnancy and the Effects of Diabetes

Maternal health and fetal complications are at a muchplan used by a pregnant woman should include
greater risk in women with diabetes who areadequate calories and nutrients to meet the needs of
pregnant. Even the stress of a pregnancy can bringboth mother and fetus and should be consistent with
about gestational diabetes, which is a form of glucoseestablished maternal blood glucose goals. The impact
intolerance that begins during the pregnancy andof meals and snacks on blood glucose levels must be
resolves itself after the birth of the baby. Whethertracked with self monitoring and should be done a
there is preexisting diabetes or gestational diabetesminimum of four times a day.
there is an increased risk of fetal congenital defectsPlanning and commitment is required for any pregnant
and death from hyperglycemia, or abnormally highwoman with diabetes to have a successful
blood sugar, which must be controlled. Any womanpregnancy. Achieving and maintaining tight blood
with diabetes that is pregnant should get some formglucose 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 awhen most fetal malformation occurs. The best time
pregnancy that can have detrimental effects onfor any woman with diabetes who is attempting to
controlling the diabetes and the use of insulin. Thebecome pregnant is before conception.
placenta produces some hormones and enzymes thatDuring the second and third trimesters the need for
reduce the effectiveness of insulin. Insulin from theinsulin increases because of increased blood glucose
mother does not cross the placenta but bloodlevels caused by the increased production of
glucose will. If too much blood glucose crosses overhormones associated with pregnancy that decrease
to the baby the baby's pancreas will increase insulinthe effectiveness of insulin.
production. This increase in insulin leads to a conditionA 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 withpregnancy. Special considerations need to be made
either form of diabetes can also suffer fromfor 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 individualizedthroughout the pregnancy as insulin and nutritional
based on the mother's weight and height. The dietneeds change.