Three categories of diabetes can affect pregnant women: type 1 diabetes, type 2 diabetes and gestational diabetes. Type 1 diabetes, which often starts in childhood or young adulthood and destroys the insulin-producing cells in the pancreas, requires insulin injections. Type 2 diabetes, which often occurs in overweight or obese people, can often be managed by diet or oral medications. Gestational diabetes develops during pregnancy and disappears after delivery, although women with gestational diabetes have a higher risk of developing type 2 diabetes in the future. Dietary measures help control diabetes in pregnancy in all three types.
Keep Blood Glucose Controlled
The purpose of following a diabetic diet during pregnancy is to keep blood glucose levels under control so that the fetus gets enough nutrition but not excess amounts of sugar through the placenta. Both hyperglycemia, or high blood sugar, and hypoglycemia, or low blood sugar, can cause problems in a diabetic pregnancy.
Striking a Balance
Diabetes initially decreases and then increases insulin needs in pregnancy, no matter which type of diabetes a person has, GYNOB.com states. Decreasing the amount of sugar, especially empty calories with no nutritional value, and carbohydrates eaten in pregnancy, lowers insulin demand. Lower blood sugar levels means less insulin requirements. That doesn't mean no carbohydrates should be eaten; carbohydrates are a necessary part of a pregnancy diet for diabetics. A balance between carbohydrates, proteins and fats is essential.
Types of Diet
Every pregnant diabetic woman needs to discuss a plan specifically for her with her doctor or nutritionist. Insulin requirements prior to pregnancy, activity level and height and weight all influence the type and amount of food required. In general, carbohydrate levels may be lower than normal to keep insulin requirements under control, Julie Redfern, registered dietician states on Baby Center. Since blood glucose levels may be most affected in the morning, eating a healthy breakfast with extra protein and decreased carbohydrates helps stabilize blood sugar. Eating two to three small meals a days with two to four snacks between meals, including one at bedtime, helps stabilize blood sugars, Redfern advises.
Benefits to Fetus
Keeping blood sugars as close to normal as possible helps keep the fetal weight close to a normal level. Elevated blood sugar levels raise the baby's blood sugar levels, so he gains extra weight. Babies born to diabetic mothers often have macrosomia, which means that they're larger than normal for their gestational age. A full-term baby with macrosomia, for example, will weigh over 9.9 lbs. and may experience trauma during the delivery or hypoglycemia after delivery. Keeping blood sugar under control with diet and adjusted insulin injections decreases the chance of fetal malformation, which occurs more often if hemoglobin A1c levels, which assess blood sugar control over several months, are over 8.5 percent in the first three months of pregnancy, according to The Merck Manuals Online Medical Library.
Risks
Skipping meals or taking insulin without taking in adequate calories in pregnancy may cause hypoglycemia, or low blood glucose levels. If left untreated, hypoglycemia can cause shakiness, sweatiness, anxiety, confusion, lightheadedness, passing out, coma, seizures and, in rare cases, death. Diabetic pregnant women should always carry glucose tablets to take as soon as they feel symptoms of hypoglycemia. Type 1 diabetic may not experience typical hypoglycemia symptoms before passing out, Merck warns. A MedicAlert bracelet, along with making sure family members know what to do if this happens, helps prevent serious complications.
