The care of women with diabetes during pregnancy is one health challenge facing our country that needs to be understood. Dr. Lois Jovanovic, of the Sansum Diabetes Research Institute in Santa Barbara, Calif., says 1 in every 10 pregnant women will be affected by diabetes - a condition of abnormally high blood sugar levels. And if not treated effectively during pregnancy, babies could suffer for a lifetime.

Cause of birth defects: For example, women with type 1 or type 2 diabetes can give birth to children with major birth defects if their diabetes is not in good control during the first weeks of pregnancy.

Infants born to women with poorly controlled gestational diabetes (diabetes diagnosed in pregnancy) are at risk for other complications. During pregnancy, Jovanovic explained, if a baby is exposed to extra sugar (glucose) from mom's blood, he or she stores it as fat. One hallmark of uncontrolled diabetes during pregnancy is a big baby - over 9 pounds at birth.

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Diabetes begets diabetes: Additionally, this extra fat is mostly "visceral fat," the type associated with metabolic syndrome and diabetes. Visceral fat doesn't go away, says Jovanovic, making these babies prone to develop obesity and diabetes in their lives. In essence, she says, "diabetes begets diabetes."

"All the problems (from diabetes in pregnancy) are from overnutrition," Jovanovic concludes. And the way to avoid them is to keep blood sugar levels in tight control all the way through pregnancy.

What to do: So what's a mother-to-be-with-diabetes to do? Get thee to a team of certified diabetes educators - registered nurses, registered dietitians and medical doctors - who can help with the challenges of baby shower cake and ice cream. Here's a few initial goals:

1. Limit portions of carbohydrates (sugars and starches). And it's tricky, since carbs are a necessary fuel to propel mommies and grow babies. (That's good.) But too many carbs at a time can spike blood sugars and stress babies. (That's bad.) A careful diet plan is essential.

2. Eat foods high in fiber. Dietary fiber found in vegetables, whole grains, fruit, nuts and legumes help manage large spikes in blood sugar levels after meals. And it relieves constipation, a common discomfort of pregnancy.

3. Check blood sugars frequently. Most pregnant women with diabetes need to check their blood sugar levels four to six times a day (before and after meals) to make sure all is well.

4. Close followup. Gestational diabetes is a serious but very controllable condition. Normal blood sugars "before, during and after all pregnancies complicated by diabetes results in a normal baby," says Jovanovic. "And it's time to turn the tide."

The Monterey County Herald


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