Smart Steps For Diabetics

There was a time in the not-so-distant past when doctors advised their diabetic female patients against pregnancy. Happily, with the advances in insulin and diet management, the prospects for a healthy pregnancy and safe delivery are greatly improved.

It's All In The Planning

A woman who has either Type 1 or Type 2 diabetes can, with planning and adherence to a strict regimen that will keep both mother and baby safe, have the dream of a family fulfilled. The trick is in planning ahead of time. For the baby's well-being a woman must have tight control of blood sugar before she conceives and maintain that control throughout the pregnancy. This is particularly important because the baby's internal organs develop during the first few weeks of pregnancy and out-of-control blood sugar can result in birth defects. Also, if blood sugar is not under control the baby can potentially grow very large, presenting a problem for both mother and child.

Get Control Early, Before Conception

Robert Meloni, MD, Fellow of the American College of Endocrinology recommends that a woman "Plan on achieving excellent blood-sugar control by six months before conception." He goes on to say, "It takes time to get everything together-diet, exercise, insulin-in the proper proportion for continuous, excellent control."

"Diabetes doesn't usually interfere with fertility unless the disease is out of control or in very poor control," Dr. Meloni says. The birth defects that may result from poor preconception blood-sugar control include macrosomia (baby over 9.5 pounds); incomplete lung development; malformations in the central nervous system or cardiovascular system and cleft palate.

And, Here's How To Get The Job Done

Some recommendations to help a woman achieve good control over her blood sugar prior to conception include such things as arriving at a weight that is as close to ideal as possible before conceiving. She should develop a diet that keeps sugar under control and stay balanced with insulin to ensure she becomes neither hypo nor hyperglycemic. By including enough insulin to keep everything stable and also by adding snacks and reducing meal portion sizes, she can maintain a balance that will be beneficial for the long term.

One method that seems to be a bonus for diabetics is carb counting. Because carbohydrates greatly influence blood sugar, by counting carbs a lot of guess-work is removed from managing blood sugar levels. By including carb counting in her insulin regimen, a woman can determine her insulin needs based upon her diet, adjusting the dosage to meet the need.

Managing diabetes well is a lifestyle choice. Keeping healthy foods on hand, eating well and on time, getting adequate exercise and enough rest and relaxation are all components for the kind of lifestyle that will produce excellent control of blood sugar prior to conception.


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