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