Diabetes is a medical condition resulting from a malfunction in carbohydrate metabolism, leading to elevated blood sugar levels. It's primarily linked to issues with insulin, a hormone responsible for transporting glucose from the blood to cells, where it's converted into energy.

Inadequate insulin production or an ineffective insulin response results in glucose accumulation in the bloodstream, known as hyperglycemia. Prolonged hyperglycemia can damage various body organs, causing heart disease, vision impairments, and kidney disorders.

Exploring the Different Types of Diabetes

  1. Type 1 Diabetes: characterised by insufficient insulin production, it generally manifests in younger individuals. Management includes insulin injections, dietary adjustments, and regular exercise.
  2. Type 2 Diabetes: Here, the body produces insulin but fails to utilise it effectively, causing glucose buildup in the blood. This type typically appears in older individuals, with obesity and family history as risk factors. Management strategies include weight loss, diet modification, exercise, and possibly insulin therapy.
  3. Other Diabetes Variants: These arise from factors like genetic anomalies, medical treatments, or infections. Regular health checks and blood sugar monitoring are crucial for women with these conditions.
  4. Gestational Diabetes: This form occurs during pregnancy due to hormonal changes leading to insulin resistance. It's particularly common among Asian populations.

Gestational Diabetes Categories

  • Pre-existing diabetes, which refers to a woman who has diabetes before she becomes pregnant or has a fasting blood glucose level higher than 25 milligrams per deciliter, combined with other symptoms of diabetes. Treatment includes managing diet, exercising, and possibly using insulin injections if blood sugar levels cannot be controlled.
  • Diabetes that is discovered during pregnancy, which occurs when a woman develops diabetes during pregnancy despite having normal blood sugar levels before becoming pregnant. In most cases, this condition resolves naturally after giving birth, especially if the blood sugar level is not excessively high.

Risk Factors and Testing for Gestational Diabetes

  • High Risk: Obesity (BMI ≥ 30), family history of type 2 diabetes, past gestational diabetes, sugar in urine. Testing is advised at pregnancy onset and between weeks 24-28.
  • Moderate Risk: Age over 25, overweight pre-pregnancy, history of pregnancy complications. Glucose levels testing is recommended between weeks 24-28.

Glucose Tolerance Testing

It involves consuming 50 grammes of glucose and measuring blood sugar levels after one hour. A reading above 140 mg/dl suggests a risk of gestational diabetes, warranting further testing.

Impact of Diabetes on Pregnancy

  • Maternal Effects: Fluctuations in blood sugar levels, high blood pressure, organ damage, increased infection risk, excessive amniotic fluid, and higher caesarean delivery chances.
  • Foetal Effects: Increased risks of miscarriage, stillbirth, congenital defects, high birth weight, and post-birth complications like low blood sugar or jaundice.

Managing Diabetes During Pregnancy

Maintaining near-normal blood sugar levels is key. This involves a balanced diet, regular exercise, and insulin therapy if necessary. Regular medical appointments are crucial for monitoring and managing the condition.

1. Exercise Recommendations

Pregnant women, particularly those with diabetes, should engage in daily physical activities, such as 30 minutes of exercise, as recommended by their healthcare provider.

2. Monitoring Blood Glucose

Daily blood glucose monitoring is critical for women with gestational diabetes. Adhering to a testing schedule and reporting results to the doctor is essential.

3. Dietary Guidelines

A balanced diet is vital during pregnancy. It's recommended to limit carbohydrates and increase protein and vegetable intake. Caloric needs vary based on weight and should be discussed with a nutritionist.

4. Medication for Diabetes Management

If diet and exercise are insufficient, medication may be necessary. Insulin injections are commonly used, along with oral medications like glyburide and metformin, in some regions. Continuous monitoring and medical consultations are vital for managing diabetes effectively during pregnancy.