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VOLUME 8 NUMBER 2 • JUNE 2011
SA JOURNAL OF DIABETES & VASCULAR DISEASE
Keep and Copy Series
We control
QUALITY
through
INVESTIGATION
not
speculation
SOLGAR
Vitamins |
INNOVATION AND QUALITY
Since 1947
CAREFULLY MANUFACTURED
in the USA
BY SOLGAR LABORATORIES
Available from Independent Health stores and Healthcare practitioners
For more information email infosa@solgar.com | www.solgar.com | Tel 011 462 1652
TREATMENT IN PREGNANCY
All established diabetic patients must have their medication reviewed
prior to falling pregnant. Certain oral medication may pose a risk to the
developing baby. Possibly changing your medication to insulin prior to you
conceiving should be discussed with your doctor. Pregnancy may worsen
your blood sugar control due to the hormones that occur naturally during
pregnancy. Your blood sugar levels therefore need to be tightly controlled.
There are certain target blood sugar (glucose) levels that need to be
maintained to minimise risk to you and your growing baby. These are:
•
Before meals: target level should be between 3.5 and 5.5 mmol/l.
•
After meals (2 hours): target level should be
≤
6.5 mmol/l.
ANTENATAL CARE
Pregnancies with diabetes are ‘high-risk pregnancies’. Antenatal visits
need to be more frequent. Monitoring of both you and your baby will be
more frequent than patients with low-risk pregnancies.
DELIVERY
Delivery can be normal (vaginal). Caesarean section should be done only
when indicated, e.g. for a big baby. The timing of the delivery should
be discussed with your doctor and usually occurs between 38 and 40
weeks’ gestation unless otherwise indicated. Patients with diabetes are
at higher risk of having their labour induced. Big babies may be difficult
to diagnose and a complication of ‘stuck shoulders’ (shoulder dystocia)
may occur during delivery.
POST-DELIVERY
Many changes occur after delivery of the baby – both for mum and baby.
Mother: your blood sugar levels usually drop quite drastically after the
baby is born. Patients with established diabetes are usually put back onto
their pre-pregnancy medication.
Baby: babies born to mothers with diabetes are at risk of low blood
sugar, jaundice, electrolyte problems – such as with calcium control,
and lung problems. Babies born to diabetic mothers may have immature
lungs for their gestational age, due to a relative lack of a substance in the
lungs (surfactant) needed to facilitate breathing.
POINTS TO REMEMBER
•
Your pre-pregnancy care is essential.
•
Optimal blood sugar control during your pregnancy minimises risk to
you and your baby.
•
Regular antenatal visits are essential to ensuring a good pregnancy
outcome for you.
•
A delivery plan for you is essential.
•
Close post-delivery monitoring of you and your baby is needed.
