Pregnancy, Diabetes and You, Part IV

ANSWERS TO YOUR QUESTIONS ABOUT THE PREGNANCY

I'm gonna get a healthy baby;QUESTION: I want to do family, my diabetes is well regulated and I know that during pregnancy the regulation of my diabetes should be flawless. I would like to know how many hazards there to get a healthy baby.ANSWER: The first thing to say is that unfortunately there is no guarantee that everything will go well with your baby, whether you have diabetes or not.There is always a small risk of problems occur in every pregnancy.When a diabetic woman carries, the period of most risk to the baby is when the body and organs are formed, ie the first 12 weeks of gestation. However, it is known that if diabetes receives excellent control during this period, then the risk of defects is reduced dramatically.This means that if you plan your pregnancy and get tips on how to achieve good diabetic control before pregnancy, your baby will be at greater risk than any other baby.However, the need for good control does not stop at 12 weeks of pregnancy, because good control helps to ensure that the baby does not grow too much or does not have breathing problems or hypoglycemia when born.Diabetes will affect the health of my baby;QUESTION: My baby is 6 months and although the health visitor says that behaves normally, I wonder whether the development will be affected because of my diabetes.ANSWER: The shortest answer to this question is: No! A more extensive answer is that a megalx survey conducted in Belfast in 1989 compared to the physical, synaisthimtiki and academic development among children of diabetic mothers and children from non-diabetic women. The results showed that there were no differences between the 2 groups.There are, of course, many factors can influence the development of a child. Hope you are kathysichastiko know that diabetes is not included in these factors.The baby will inherit my diabetes;QUESTION: What are the risks to your child develop diabetes; I diabetes for 12 years.ANSWER: It is very natural to worry about this, and indeed, there is increased likelihood of a child to develop diabetes mellitus.If there is a strong family history of diabetes, the risk is greater. Overall, however, when the mother has diabetes, the likelihood that occur and the child is 2% and if the father has the frequency is 5%. However, what is inherited is the tendency toward diabetes, so there is no way of knowing whether, when and what type of diabetes can develop a child ..Diabetes is a relatively common disorder of glucose (more than 1,000,000 people in the UK have diabetes) that may occur as a result of many factors. Diabetes of parents is only one of them.What is diabetes during pregnancy;QUESTION: I have been told I have diabetes of pregnancy. I am 32 weeks pregnant and treated diet. Can you tell me more about this issue;ANSWER: Diabetes in pregnancy is the term for diabetes that first appears during pregnancy. In most cases (over 90%), disappears after childbirth.Diabetes in pregnancy is usually diagnosed in late pregnancy because this is when the hormone levels of pregnancy is very high. The hormones of pregnancy have the opposite effect than insulin and if not enough insulin is produced, then the levels of sugar in your blood will increase. Then it is shown diabetes. The first sign is usually sugar synithismeni urinalysis during your appointment at the clinic. Some women may be a specific analysis for diabetes because they have symptoms of high blood sugar (eg thirst or large amounts of urine), or because they are particularly at risk because they had developed diabetes in previous pregnancies or because family members have diabetes.Because the existence of sugar in the urine of pregnant is not always indicative of diabetes, a special test is often used for diagnosis of diabetes is known as "endurance test". Treatment of diabetes in pregnancy initially done by diet, but eventually need insulin injections.It is important to carefully check the sugar levels in diabetic pregnancy to prevent weight problems and health of the baby at birth. Therefore, examination of blood sugar at home is an important part of treatment and this technique should be taught when diagnosed with diabetes, so you can check the results of your treatment.Although diabetes usually disappears after pregnancy, childbirth, are likely to recur in later pregnancies. There is also risk of developing diabetes in the future.The levels of blood sugarQUESTION: What should be in my blood sugar during pregnancy;ANSWER: The doctor treating you will tell at what levels should be targeted because these differ from person to person.The main objective is to try to maintain levels of blood glucose as close as possible to normal, which could mean stricter controls blood glucose levels than usual. Your doctor can set acceptable levels should be looking to you before each meal, and 2 to 3 hours after a meal. The pregnancy will almost certainly require more frequent measurements of glucose in the blood.

Feeding bottleQUESTION: I prefer to feed the baby from a bottle instead of breastfeed. How will this affect my diabetes;ANSWER: Sure, use the bottle, unlike with breastfeeding, it affects you physically: no need, for example, eat or drink extra amounts if you feed your baby. This is, perhaps, why give more attention to breastfeeding in the case of diabetes. However, there is no reason not to use the bottle if desired.You may need to check the sugar level in your blood at night when feeding your baby, because the new way of life may mean changes to control your diabetes. It is also good to have lunch with you while you are breastfeeding if your lunch or snack is delayed.Incidentally there is no need for any special care, except to enjoy feeding your baby.Can I conceive normally;QUESTION: Because of my diabetes will be more difficult for me to grasp;ANSWER: When diabetes is properly controlled there is no difference in fertility between diabetic and non diabetic women.This means that if you keep the sugar levels within acceptable frameworks (below 180 mg / dl and 10 mmol / l), then it will not affect the chances of conception.If you do not get pregnant despite the fact that your diabetes is controlled, it is advisable to consult your gynecologist to investigate other possible causes.Diabetic fatherQUESTION: My husband has diabetes and I have just become pregnant. What effect this will have diabetes in my pregnancy;ANSWER: Sometimes. The pregnancy is difficult because of maternal diabetes, but not affected by diabetes father.EVERYTHING RELATING TO YOUR CHILDBIRTHWe have concluded, so reading these texts and talking with other women, that the experiences of childbirth vary. It is not possible to predict how it evolved to give birth and care will need that day.But this should not stop you from examining the different options and of course, like all pregnant women, nearer the time of childbirth, you are employing more and more what you prefer to relieve the pain or the various attitudes of childbirth . Discuss these preferences with the obstetrician and midwife, so be aware.Another reason for discussing the birth with your midwife or obstetrician is to give them the opportunity to explain any special procedures have to do with diabetes. Both research and experience have shown that certain types of birth and procedures are more likely to be needed in diabetes for the mother and her baby to have as few problems. For example:

• Your baby will definitely born in a hospital or clinic. The experts, both in diabetes and for childbirth agree that minimizing any problems to a minimum, the hospital or clinic is the safest place for diabetic mothers and their babies. The home birth is relatively minimal.
• There is an increased likelihood of birth by Caesarean section, either scheduled or as an emergency and what can be done using epidural anesthesia (anesthesia, which is in the area around the spine and temporarily stun the bottom of the body). The epidural anesthesia has the great advantage of leaving the mother awake and gives joy to hear the first cry of the baby.
• It is very likely that the birth will occur around 38 weeks. This is to avoid any problems that occur sometime in late pregnancy, although it rarely happens.

All sounds very medical and, in fact. But when you know as much as possible about what to expect will help you cope better your big day. Of course, not everything is terrible: you will have the choice to relieve pain, such as inhalation, elaafras form of anesthetic injections or epidural anesthesia, and continuous care by the midwife - often by the midwife - and more importantly, the satisfaction Know that you are the last round of the difficult journey during your pregnancy.Despite all the serums and monitoring devices, you can still decide to stop delivery you choose - a sitting position, for example - but it would be better as discuss in advance with your midwife.Provided that everything is okay, some meaiytires allow "diabetic" deliveries to start their own, though rarely allow you to spend more than 1 to 2 days beyond the expected result before the birth. Of course, some women begin to have pain before the specified date which is expected to give birth. When labor begins on its own, can give birth naturally, although this depends on your health status and time of day, amount of insulin received, how long before you received your last meal, etc. You need to check regular sugar in your blood, but after a vaginal birth the serum can be removed immediately, unless of course the mother vomits, which is very unusual. After that you can return atis insulin doses received prior to pregnancy (if you remember, of course) with necessary adaptations for feeding or for any changes in your activities.And the baby; 2 There are often reasonable questions which are:

1. My baby has diabetes; and
2. Will be transferred directly into the chamber for special care; Firstly it is very unlikely to have diabetes, your baby and in fact, has only a modestly increased likelihood to develop later. The sugar in the blood of your baby will be checked one hour after birth and a few more times later during the first 24 hours. This is done with 1 heel prick before feeding the baby, to confirm that it maintains a normal blood sugar level. It may take some time for your baby's pancreas stops producing insulin can cause hypoglycemia in the baby. May in this case to recommend you to feed often.

Regarding transfer to ward care, some babies always need either mothers are diabetic or not, and indeed, some hospitals are applying as a routine in cases of diabetes. However, this is becoming less frequent, as reduce the occurrence of problems in babies of diabetic women. But if your baby is premature or too long or you have hypoglycemia, special care unit is the best place for it. But this usually does not last too long and - of course - you can visit anytime.However, other aspects of childbirth, a good idea to ask in advance for these procedures in the hospital so you know what to expect for themselves.All four parts of this text is a reprint from homonymous form of Cyprus Diabetic Association.

Pregnancy, Diabetes and You, Part III

WHAT WILL HAPPEN MY IF INJURED HYPOGLUCEMIA?

When Mary found out she was pregnant, literally flying in seventh heaven. Both she and her husband John really wanted this baby and Mary had done everything they could to ensure that the control of diabetes was good before you even conceive. He had read much about her pregnancy and felt that he was well prepared. The only thing that was still worried what might happen if you suffer from hypoglycemia.

Will I have hypoglycemia?

The doctor Maria did everything it could to encourage the expectant mom. The doctor knew that only 40% of diabetic pregnant women suffering from severe hypoglycemia. The doctor knew also that the term "severe hypoglycemia" meant hypoglycemia requiring assistance from another person to give glucose or other sugars or inject intravenous glucose or glycogen. Although this means that pregnant women are more prone to hypoglycemia, 60% will pass the pregnancy with little or no problems from severe hypoglycemia.

When there are more likely to happen to me hypoglycemia?

Mary and John decided that it would be better to prepare for these hypos if that would happened, but wondered if there was a way to know in advance if we would get hypoglycemia Mary. Informed that the doctors believe that severe hypoglycemia is more common in women who had many hypos before conceiving and women who have had diabetes for a long time. Addition, if a problem of severe hypoglycemia in pregnancy tend to appear in later pregnancy, although there are many exceptions to these generalizations:

• In the very early stages, usually a few days after conception until approximately 16 weeks.
• In the last few weeks of pregnancy, so that usually occur during the night.
• When it comes to birth, during birth or shortly thereafter.

Why is severe hypoglycemia?

John wanted to know why there are serious hypoglycemia. The answer to this was direct: nobody knows yet. One reason is that during pregnancy, women try to maintain the level of glucose in their blood as close as possible to normal. Other reasons are:

• The rate of insulin absorption varies with the part to inject the insulin.
• The blood sugar drops low when pregnant exercised vigorously or too tired.
• It is difficult to calculate exactly how many carbohydrates you consume because even conventional forms such as sliced bread containing different carbohydrate per type of bread.

Women also sometimes get hypoglycemia because the morning vomiting and nausea do not allow them to eat they need. In such a case may, instead of solid food to get wet (like fresh orange juice) which are tolerated by the stomach more easily.

Finally, the doctor explained that there are some cases where it can find no reason for hypoglycemia. He had met very well adjusted women who before pregnancy had some slight hypoglycemia, but hypoglycemia was significantly worse during pregnancy. It is known that levels of many hormones change during pregnancy, but whether any and what hormones cause unpredictable fluctuations in blood sugar and why this happens to some women is still unknown.

What will happen to me in the last stages of pregnancy?

When Mary asked the question was explained that many women's insulin requirements begin to increase around the 20th week of pregnancy, although some women are still a few weeks before birth. This decline is often more pronounced in the evening. The placenta produces hormones that have an effect opposite to the action of insulin on glucose blood.

It is believed that the increase of these hormones causes an increase in demand for insulin at this stage. Once, however, women do not require insulin during pregnancy and placental hormones are normal. He has conducted research on this subject, but has not yet become a understandable why changing the requirements for insulin.

What happens to the sugar levels in my blood during childbirth?

This is an area of pregnancy, which is understandable. As the birth progresses, the amount of insulin used is reduced, probably because of the required energy needed for contractions of the uterus. Immediately after birth the amount of insulin required falls quickly because the placenta, which produces hormones competitive insulin is removed.

We change the warning symptoms of hypoglycemia?

Mary and John were concerned that it may not be able to recognize when it was Mary on the verge of hypoglycemia. The doctor Maria tried to reassure them. They said however that only some women have no or very few warning symptoms of hypoglycemia when pregnant. Once the hypoglycemia may occur very suddenly, which can be alarming.

Another problem may be that once the hypoglycemia caused vomiting in pregnancy, even in women who had this problem before.

The hypoglycemia will impair either the baby or me;

Mary believed that this was the most important question about hypos. The doctor was able to reassure about this and said it was rare serious effects of hypoglycaemia. There are potential risks to the mother if dropped for example, but the very low blood sugar will not hurt the. Nevertheless, the future mother should continue to take every precaution to ensure that they will get hypoglycemia.

Fortunately, babies do not seem to suffer serious damage from hypoglycaemia. Mothers who suffer from frequent and severe hypoglycemia usually have completely normal babies.Very rarely hypoglycemia in the final stages of pregnancy can cause a slower pace in the heart of the baby, but this remedy when treated hypoglycemia and does not seem to have any negative impact on delivery.

All data indicate that hypoglycemia in early pregnancy does not have bad consequences.In fact, the renowned "father of the handling of diabetic pregnancy," Jorgen Pedersen from Copenhagen, said by the great experience of women who have hypoglycemia in early pregnancy are least likely to have "abnormal" children.

Additionally, many centers around the world have shown that the higher the blood glucose in early pregnancy, the more likely it is to have an abnormal baby. This also implies that hypoglycemia does not cause problems. A large multicenter study in America, examined the levels of blood glucose levels in the first pregnancy, showed no association between hypoglycemia in early pregnancy and congenital abnormalities.

What can I do to avoid the hypoglycemia;

The doctor gave Mary a list of what should be done to avoid hypoglycemia:

• Frequent measurements of blood glucose

Although levels of glucose in blood is around 30 mg / d and 2 mmol / l, insulin should be reduced, even though there are warning symptoms of hypoglycemia. Whenever that happens an unexplained hypoglycemia, insulin should be reduced, but often must be increased again later, because of fluctuating levels of glucose in blood. If you suffer from nocturnal hypoglycemia, try to reduce the evening insulin. For more specific advice, you might talk to your doctor or qualified nurse glucose levels which should target.

• Educate your friends, relatives and your children for your hypo

Make sure you are almost always with friends who have been trained to recognize and deal with hypoglycemia. This certainly includes your partner, but consider include your colleagues. Teach your partner (and other friends and relatives if you have bad hypos) how to use glucagon.

• Do not be alone for long

Recognize that others can help you because you're vulnerable. It is very important to have someone with you at night. Those not working the day must arrange to communicate with them a friend or relative at midday or early afternoon to make sure everything is okay.

• Keep in mind the dangers that exist if you fall asleep

Pregnancy can often make you feel tired and although it is reasonable to sleep if necessary, make sure that you will not fall asleep while you should eat. Put your alarm or arrange someone to wake you up.

• Avoid driving

Driving can be dangerous for pregnant women with diabetes, although we can exclude those who do not seem to have problems with hypoglycemia, but have levels of blood sugar checked before driving. Make sure you have glucose tablets or some other form of glucose that acts quickly and do not drive ever before a meal.

• Make sure you eat your food time to

One of the main causes of hypoglycemia are not eating at all or delay to eat, so make sure you eat your food while it should.

BREASTFEEDING AND DIABETES

The idea to monitor and balance diabetes and additionally learns the art of breastfeeding can cause fear in a mother. Below are ways of making life easier for mothers who decided to breastfeed their babies.

Why breastfeeding;

For many new mothers the idea of feeding can be very attractive, but for those who have the will to achieve the rewards of breastfeeding are enormous. In addition to the sense of integration that gives breast milk is no immunity against infections and is a good way to regain your silhouette because the hormones produced help to stimulate the muscles.When now established breastfeeding, is among other convenient inexpensive and healthy.

You should have no worries about breastfeeding. Breastfeeding is an art learned - that you are diabetic does not change anything. Knowing as much as possible about your diabetes will help you to balance your state requirements of lactation.

Three points to remember

To get the most benefit from breastfeeding should remember three main points:

• Refill the extra carbohydrates used during breastfeeding to avoid a hypo.

Breast milk contains carbohydrates in the form of lactose (milk sugar), so every time you are breastfeeding your child lose carbohydrates. This means that the level of blood sugar will drop.

During one day the "average" mother loses about 50 gr carbs (5 servings) through milk.This loss should be compensated to avoid hypoglycaemia. The exact amount of additional carbohydrates you need in your diet depends on your blood sugar and your baby, especially tends to be very hungry.

Together with the dietitian can not find the right amount of extra carbohydrate that suits your personal needs. Allocate these extra carbs during the day, but remember to increase the amount of evening snacks to meet and nocturnal feeding.

Also make sure you eat everything before breastfeeding to avoid hypoglycemia, especially if you're alone with your baby, which is why some mothers find that they need to get a snack before the night feeding.

During rapid growth, a hungry baby can drink more milk and therefore getting more carbohydrates than you. In these cases you should watch more often the level of blood sugar. If needed, the dietitian will advise you on how to increase the food you take.

Do not reduce your insulin dose to avoid hypoglycemia. You need the extra energy (calories) from increased nutrition to produce milk. It is very likely to happen in hypoglycemia if you start feeding a reduced-sugar in your blood or if your baby eats slowly.Discuss with your doctor what level should you keep your blood sugar. On the advice you can adjust your insulin to suit your needs and the needs of your child.

Be careful not to fall asleep at the evening feeding to not miss the first signs warning signs of a hypo ..

• Do not try to lose weight while breastfeeding

Breastfeeding requires more calories than pregnancy - milk production requires energy.Some mothers find that losing weight even with increased consumption, but certainly is not the time to actively try to lose weight. If you lose weight while nursing talk to the dietitian.Can you recommend to eat more often during the day and give you ideas for nutritious meals and snacks that contain many calories.

• Watch for any hypos!

While breastfeeding may feel thirsty: it is perfectly natural and not necessarily a sign of high blood sugar. Will generate and lose a lot of fluid through breast milk, so I should remember to drink enough fluids during the day to not feel tired and in particular to avoid dehydration. However it is a good idea to keep track of your blood sugar regularly, you can tell the difference between high blood sugar from low fluid intake.

Export of milk

The sooner you start to breastfeed, the more likely you are to succeed. You can export your milk to give to your baby if you can not breastfeed your chest. The export of milk must be patient until you get used to the special pump and the strange feeling it causes. If your baby has to stay in the hospital after your return home and you can not visit every day, your milk can be frozen and given where you will not be there. The exports and freezing the milk is an ideal solution if you return to work or miss from home in general.

Adjusting the diet to the growing needs of the developing baby

As your baby grows, and therefore hungrier, more and more it is time to provide solid food and reduce their breast. This usually happens when your baby is about 4 to 6 months. As you reduce the number of feeds, the fewer carbs you lose through milk. Therefore you have to adjust your diet so you eat fewer carbohydrates. During this period the level of sugar in your blood the more likely you will have many more variations, so a good idea to check the sugar in your blood.

While breast-feeding your baby, you're used to eating larger quantities of food. Maybe hard to adjust your diet to lower energy requirements (calories) of weaning without feeling hungry. If you're not careful, your weight will increase gradually. If this happens, then it is better to discuss with the dietitian.

Tips for Success

The above were the technical side of nursing. Equally important is the support from family and friends. Sharing experience with other people you'll be happy to learn more about your diabetes and the demands of breastfeeding. The following are hints for success, based on the experiences of other mothers:

• Always eat before breastfeeding, if necessary get a special snack, especially at night.
• Have a casual drink and biscuits while breastfeeding - will be very useful if your baby eats very slowly.
• Drink plenty of fluids, at least 1 to 2 liters per day.
• Regularly check your blood sugar: low blood sugar can cause problems and leave hungry baby.
• There are no specific foods that you should avoid. If some foods upset your baby, avoid for a few days and then try again the process of introducing.
• Drink at least half a liter of milk a day to ensure adequate amounts of calcium for healthy bones.
• Try to plan your day and prepare meals in advance. This way your family life will be flowing without disruption.
• Relax and enjoy breastfeeding.