Special Care for Controlling Diabetes

Your diet is an important way to control your glucose levels. The number of calories in our diet will depend on both your weight and the stage of pregnancy. Your doctor may adjust your diet from time to time to improve blood glucose control or to meet the needs of the growing fetus. Usually the diet consists of special meals and snacks spread throughout the day. A bedtime snack helps to maintain blood glucose levels during the night.

Regular exercise also plays an important role in the control of diabetes. It reduces the amount of insulin needed to maintain normal blood glucose levels. The amount of exercise that is right for each woman varies. Among other things, it depends on the stage of pregnancy.

Some diabetics need to take insulin to keep their blood glucose at a normal level. Insulin can be taken by injection only. It does not cross the placenta, so it does not affect the fetus directly. The amount of insulin needed to control blood glucose levels throughout the day varies from woman to woman and depends on many factors. In many cases, insulin must be taken at least twice a day during pregnancy. Usually the need for insulin increases throughout the pregnancy, leveling off near the end. This means that the insulin dose needs to be adjusted from time to time for good control of blood glucose levels. This is where home monitoring of blood glucose levels plays an important role.

If you have diabetes that must be controlled with insulin, you will need to monitor your blood glucose on a day-to-day basis to keep it at a normal level as much of the time as possible. There are a number of ways to do this, all of which are safe and simple to use. You and your doctor will decide together on the best method of combination of methods for you.

Blood glucose meters or colored strips can be used to measure blood glucose levels at home. In either method, a simple device is used to obtain a small drop of blood, usually from the tip of the finger. The blood glucose level is then read with the meter or strip. Both of these methods provide reliable results when used properly.

Because the blood glucose level normally changes throughout the day, it usually mist be checked several times a day. Your doctor will advise you as to how often you will need to check your blood glucose.

When diabetes is not controlled and the body cannot use glucose for energy, it resorts to burning fat. Certain substances called ketones produced as a result of burning the fat may be found in the urine. Ketones in the urine can be a sign of ketoacidosis, a serious complication of uncontrolled diabetes that can cause stillbirth.

Special Care for Diabetics:

A woman with diabetes usually needs to have certain tests done more often in her pregnancy. These tests can help the doctor indentify problems that may occur early and take steps to correct them. One test measures hemoglobin AIC, a substance in the mother’s blood. When levels are higher than normal, they indicate that the control of the body’s glucose use has been poor for a number of weeks. Others tests, such as ultrasound, amniocentesis, and fetal monitoring, are used to assess the present status and growth of the fetus. These tests are especially important if the baby must be delivered early.

Early in your pregnancy, you may need to stay briefly in a hospital so that your blood glucose levels can be controlled and your general health can be assessed. Additional hospital stays may be needed, depending on your blood glucose levels and any other health problems you may be having. The trend has been to reduce the length of these hospital stays.

At one time, almost all women with diabetes had cesarean birth because the potential problems associated with diabetic pregnancy could be made worse by the added stress of labor and vaginal delivery. Today, however, with special tests and monitoring methods, most women with diabetes are able to give birth safely trough the vagina.