In case of:
Type 1 Diabetes and Type 2 Diabetes:
- Preconception Counselling:
- Counseling about preparing the body before conception is needed with strict glycemic control before and during pregnancy.
- Strict weight management should be advised.
- Glycemic control along with BSR/BSI and Hba1c should be explained, before conception to the patient.
- They should be explained about an increased risk of diabetic embryopathy. specifically, encephalopathy, microencephaly, and congenital heart diseases, which increases directly with an increase in HbA1c in the mother’s blood.
- Chances of spontaneous abortion also increase with uncontrolled diabetes.
- Pregnancy-induced Diabetes:
- As there is no prior history, the patient should be assured keeping HbA1c in view.
- Diet management and weight management should be advised and continuously monitoring should be explained.
- They should be counseled for glucose monitoring to avoid fetal anomalies, preeclampsia, macrosomia, intrauterine fetal demise. Neonatal hypoglycemia and neonatal
Myths/Taboos about Pregnancy and Diabetes:
Q: Blood sugars are higher naturally in pregnancy.
Ans: No, the blood sugars are not higher in pregnancy; it needs to be regularly monitored. In the case of family history on high-risk patients, they should be properly screened in the first trimester.
Q: Strict glycemic control is not needed.
Ans: It is a wrong concept, as strict glycemic controls are needed to keep the fetus safe.
Q: Weight management is not important.
Ans: Weight management is very important as an increase in weight can result in a deranged glycemic index. Weight plays an important role in controlling the existing diseases and helps in preventing complications.
Q: Diet has no major effect.
Ans: A well-balanced diet is needed to keep the weight and glycemic index in control.
Q: Diabetic females/healthy mothers will have big babies.
Ans: It is another myth and does not affect all females.
Q: Insulins are needed in all cases.
Ans: It is again a myth that insulin is needed in all cases. No, it’s again not true, insulin is found comparatively safer but few drugs (metformin, glibenclamide) are found safe also.
Courtesy by: Dr. Sonia Bakhtiar