The best way to deal with diabetes during pregnancy/gestational diabetes


You are pregnant and you have diabetes. What precautions must be taken during pregnancy if you have diabetes? This guide will help you understand how diet control exercise and rest are some of the ways to manage gestational diabetes or diabetes during pregnancy.

Until a few decades back getting pregnant was considered a risky proposition for women suffering from diabetes. With the risks compounded for the unborn baby. Today, things stand to be different – medical science has made notable advancements and diabetic woman can rely on expert medical care and guidance to have a successful pregnancy, like any other pregnant woman.

However, this is not possible without meticulous self-care, on the part of the diabetic woman. Diabetes is a serious medical condition and doctors can do only so much to help. The most effort, in managing diabetes, must be put by the woman herself.



According to studies the key to effectively managing a diabetic pregnancy (both Type I & Type II), is attaining normal blood glucose levels before conception and sustaining the same healthy levels throughout the gestation period, until the delivery. Life for diabetics is relatively easier today, with modern gadgets like the home monitoring system and advanced split-dose administration of insulin and the high-tech under-the-skin insulin pumps all of which contribute to the better management of the condition.

Whether you were diabetic before you got pregnant or developed gestational diabetes during your pregnancy, the care and precautions that you need to take would be the same. Follow the tips provided below for a safe pregnancy and the birth of a healthy baby.

Choose your obstetrician/gynaecologist with care


Ensure that the doctor you see has enough experience in handling diabetic pregnancies. In case you have a history of diabetes, then it is best that you keep your regular doctor (endocrinologist) informed about your condition as well and follow-up it up with periodic check-ups/consultations.

Watch your diet


Take the help of a nutritionist to chalk a diet plan, especially geared to your individual requirements. A good diet plan for pregnant women with diabetes would be as follows –

  • Be rich in complex carbohydrates, such as beans. Experts in nutrition recommend that roughly half of your caloric intake must be sourced from complex carbs
  • Protein should be consumed in moderation and must make up for about 20% of the daily calories
  • Low-fat meals are ideal and should be low in saturated fats
  • Sugary stuff should be limited to the barest minimum but is best completely avoided
  • Fibre-rich foods come highly recommended as according to studies fibre may decrease the insulin requirements in diabetic pregnancies. A good diet plan must cater for 40-70g of fibre intake, everyday

Note that caloric requirement goes up by around 300, during every pregnancy, and this is considered normal. However, the number of calories you need will depend on your weight. If you are overweight your doctor and nutritionist will probably recommend that you control the number of calories you eat.

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Good diet and diabetes


The intake of carbohydrates will need to be regulated depending on how your body reacts to it. Some women witness a sharp rise in blood sugar levels on consumption of fruits and fruit juices, while many others can handle these foods well. In case, you fall in the former category then you will have to rely on grains, vegetables and legumes for your carbs.

To regulate your blood sugar levels get enough carbohydrates at breakfast. Snack healthily. The perfect snack would be a combination of complex carbs (something made from whole-grain and protein (cheese, or beans or meat).

Do not skip meals, even if eating aggravates the symptoms of morning sickness. Skipping meals can be risky during this time as the blood glucose can drop to dangerously low levels.

Aim at eating between 6-8 small meals/snacks a day. Space them out, so that you are eating every few hours. Plan your meals well, so they are nutritious and made up of the right components of carbs, protein and fibre.

Perfecting diet control can be the key to a safe pregnancy.

Recommended reading : Foods to control diabetes

Weight gain – how much is acceptable


Pregnancy and weight gain complement each other. It is best that you lose weight to reach your 'ideal' weight before you conceive. So, work on your weight, before you plan your pregnancy.

However, if you conceive and find yourself overweight, then do not take drastic measures to bring down your weight. This is not the time to slim down!

Your caloric requirement will go up as you advance through your pregnancy. Regular check-ups are a must and your doctors must monitor your weight. Excess weight gain could be detrimental to you and your baby's health. Babies of diabetic mothers can at times grow to be very large. Your doctor should monitor the baby's growth through ultrasound scans.

Get Moving


Include an exercise plan in your daily regime, nothing strenuous, but something that keeps you active, for a small part of the day. This is especially beneficial for pregnant women with Type II diabetes. Exercise can regulate blood glucose levels and energise.

Any form of exercise must be undertaken after consultation with the doctor. However, if there are no complications and if you have not been advised bed rest then brisk walks can be helpful. If you were out of shape before the pregnancy, then the doctor might advise leisurely strolls. Do take the doctor's advice seriously.

Precautions while exercising


  • Remember, to fuel your body, before you exercise. Take a glass of milk or a healthy snack before you begin your workout regime
  • Avoid workouts that raise your pulse levels to dangerously high levels. It should not cross 70% of the 'safe' heart rate, recommended for your age
  • Do not exercise in a warm environment. Workout in a cool, well-ventilated area, to maintain your comfort levels
  • If you are taking insulin injections then do not inject the same on parts of the body that you will engage in the exercise. Avoid, your legs, if you are intending to walk
  • Lastly, do not reduce the insulin dose before the exercise

Important : How to calculate safe heart rate


There is a simple calculation to determine your safe heart rate.

  • Subtract your age from 220
  • For example, if you are 28, you would calculate it this way: 220 – 32 = 188; then 192 x 0.7 = 131.6
  • This means that your heart rate must not cross 131/minute when you exercise

Rest a while


Rest is essential, particularly, when you reach the third trimester of your pregnancy. Avoid exerting yourself. Take a nap in the afternoon or just your feet up and relax. If you are a working woman then it would be in your interest that you start on your maternity leave, now.

Special care


The levels of pregnancy hormones that interfere with insulin swell as the pregnancy advances. Chances are that you will not be able to maintain blood sugar levels through diet and exercise.

If diabetes preceded the pregnancy then doctors might switch oral medication to insulin injection. If it is gestational diabetes then the doctors might choose to hospitalise you, so your blood glucose levels could be monitored.

You may also be subject to more episodes of low blood glucose levels (hypoglycaemia) than before you became pregnant, more so in the first trimester.

The insulin dose will also need to be recalculated as your pregnancy advances, as both you and the baby will be gaining weight.

Recommended reading : Everything you need to know about diabetes

Additionally,

  • Do not take over the counter medication as it can have an adverse effect on insulin levels
  • Test your blood sugar levels before and after meals – even if it means pricking your finger 10 times a day
  • The doctor might advise hospitalisation or run a few tests during the third trimester. Don't be alarmed, it is just to ensure that you and your baby are fine
  • The doctor will also advise you on eye check-ups, which is normal, in this condition

In conclusion, you are pregnant, so enjoy the experience. Don't get worked up. Follow your doctor's advice and remember you are in good hands. If the diabetes is gestational, you will be normal once your bundle of joy arrives.



Good luck!

Note: This piece is written after much research. The information provided here is sourced from a medical encyclopaedia and a book written in consultation with a Professor of Obstetrics & Gynaecology.


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