Reducing Your Risks
To better control your diabetes, you should monitor and record your blood sugar regularly, make necessary changes to your diet, take prescribed medications and/or insulin as directed, and exercise on a regular basis. It is also vital to achieve a healthy weight. Type 2 diabetes is very prevalent among people who are overweight or obese, and achieving a healthy weight often decreases or eliminates blood sugar problems. All these factors can lead to better control of your condition.
It is also important to take a prenatal vitamin that contains 1,000 mcg of folic acid at least one month or more before becoming pregnant. Women with preexisting diabetes are already at a higher risk for having a baby with neural tube defects, so folic acid intake is essential. A registered dietitian can work with you on your dietary intake as well as weight issues, which can both greatly affect not only your blood sugar levels but also the effectiveness of your medication or insulin.
It is important for women with diabetes to continue closely monitoring their blood sugar levels following delivery because these levels might be more difficult to control. This can be especially true for women who breastfeed. Monitoring blood sugar levels frequently can help the doctor to adjust insulin doses back to pre-pregnancy levels.
Treatment Plan
If you have either type of diabetes, you should follow a diet and treatment plan during pregnancy that has been designed specifically for you. You should continue with nutritional counseling as your pregnancy progresses so that diet modifications can be made if necessary, and nutritional education can continue. Calorie needs during pregnancy vary among different women and depend on weight, height, stage of pregnancy, age, and level of activity.
However, most women require the standard 300 extra calories (after the first trimester), diabetic or not. If you are like most pregnant diabetics, following the Food Guide Pyramid and eating small meals throughout the day will help you gain the recommended number of pounds. Again, your meal plan will depend on your individual situation, including the insulin regimen that you are on. A dietitian can help you to plan out a diet that is right for you. Regular exercise, with your doctor’s permission, can help to control blood sugar levels.
If you take oral glycemic medications to control your blood sugar, your doctor will probably switch you to insulin for the time before you conceive and during your pregnancy. The safety of oral glycemic medications during pregnancy has not yet been completely established and may increase the risk of birth defects. Insulin requirements will generally change during pregnancy. In the first half of pregnancy, insulin requirements may decrease because of the baby’s use of glucose. In the second half of pregnancy, around the fifth month, hormone changes can create an increased need for insulin. At this point, some diabetic women may need insulin even if their pre-pregnancy condition was adequately controlled with diet alone.
