Diabetes and Pregnancy
What is diabetes?
Diabetes is a disease where the body doesn’t properly cooperate with the hormone insulin, which is used to regulate blood sugar (the amount of glucose in the blood). Glucose is a sugar that is converted from food which is used to fuel body functions. As a result of a lack of insulin, sugar is trapped in the blood and other organs cannot get enough sugar, and therefore, not enough energy to function. If this disease is not treated, it can lead to amputations or even be deadly. There are a few different types of diabetes, as explained below.
Type 1 diabetes
Type 1 diabetes is an autoimmune disease where people can’t make their own insulin. This is because their immune system keeps attacking the pancreas, the organ where insulin is made. Causes of this disease are unclear, but there is a relationship between certain genetic elements and having type 1 diabetes.
Type 2 diabetes
Type 2 diabetes is mostly developed in adulthood, and there is a strong relationship between being overweight and having this disease. Type 2 diabetes involves the body not being able to properly use the produced insulin, because body cells resist the action of insulin trying to bring sugar to those cells. The pancreas is usually not able to make enough insulin to counter this resistance, and therefore sugar is still trapped in the blood. According to Diabetes Canada, the ratio of type 1 diabetes to type 2 diabetes among diabetics is roughly 1:9.
There is a condition called prediabetes, where people have higher and normal levels of blood sugar. As the name suggests, having this condition increases the risk of developing type 2 diabetes. For people who are prediabetic, the Mayo Clinic recommends eating healthy diets, exercising for around 150 minutes a week and losing weight to help prevent getting diabetes. There are also medications to take to control high blood pressure and cholesterol that can help. Please see this link for more information.
Common symptoms of diabetes can be found at this link.
Effects of diabetes
If diabetes progresses to a serious degree, it could result in the need for lower limb amputation(LLM). Diabetes can lead to something called peripheral artery disease (PAD) and peripheral neuropathy for some people. PAD narrows blood vessels causing decreased blood flow in the lower half of the body, legs and feet. Reduced blood flow makes the legs and feet more prone to infections, take longer time to heal from wounds, or cause tissue in the legs and feet to die (gangrene). Infections that don’t heal in time can also spread to the bones. (osteomyelitis). If this becomes severe enough and the damage done to tissues is beyond repair, amputation would be necessary to prevent further damage. Peripheral neuropathy refers to damaged nerves in the lower half of the body. When nerves are damaged too much, any pain in the feet won’t be felt, and the body would not be aware of any harm being done to it. For example, a person with peripheral neuropathy would keep on putting pressure on a foot that has an ulcer because they don’t feel pain. Overtime, this can cause infections too, which can lead to amputation if it gets bad enough.
But don't fret, diabetes treatment can help reduce the risk of getting PAD and neuropathy, and there is also foot care and wound care to prevent infections. With these in place, the risk of LLA has become very limited to people with diabetes.
Image is courtesy of thediabetescouncil.com.
A gentle example of amputations (medtube.net).
Please search online yourself if you would like to see real life examples of amputations due to diabetes.
Diabetes and Pregnancy
Something that you may not often hear about is Gestational diabetes, which means diabetes that only developed during a woman's pregnancy. This type of diabetes is less harmful, most people can get better simply from eating healthy diets and exercising. Some people also take insulin. Most of the time gestational diabetes is temporary and goes away after pregnancy, but there are some cases where the diabetes does not go away and becomes type 2 diabetes. As well, around half of the people who had gestational diabetes will develop type 2 diabetes later in life. Again, exercise and eat healthy to help lock type 2 diabetes out of the house.
For the baby of a gestational diabetic mother, if her diabetes is not well monitored, the excess sugar in her blood may be passed on to the fetus. This causes the fetus to produce excessive insulin, which is also not good. Complications that the baby would be at risk of include macrosomia (high birth weight), hypoglycemia (low blood sugar), preterm birth, and birth injury.
Macrosomia can occur because when the baby produces too much insulin due to being given excess glucose, they will be able to absorb all the excess glucose resulting in deposits of fat accumulation in its body. This makes the baby larger than normal, which is troublesome during delivery and can lead to a birth injury. Doctors may also recommend preterm deliveries because the baby has grown too big. A way to prevent birth injury for After the baby grows up, they are also more likely to have obesity and diabetes due to their large weight.
Image is courtesy of natural-health-news.com.
Since the baby has been producing more insulin, they may have too much insulin for their body after they are born, resulting in them absorbing too much glucose from their blood. This is low blood sugar, or hypoglycemia. Hypoglycemia is not only caused by gestational diabetes, it can also occur when the body produces too much insulin after a meal, or when someone doesn’t eat for too long. Lighter symptoms of hypoglycemia include dizziness, hunger, and shakiness. For more symptoms, click here. Severe hypoglycemia can lead to a seizure.
There is also another category called pre-gestational diabetes, which is where the mother has type 1 or type 2 diabetes before getting pregnant. If the mother has type 1 diabetes and goes untreated, in severe cases the baby could have birth defects. Please refer to this link to learn more about being pregnant with pre-gestational diabetes (scroll down a bit).
With everything discussed above, although we are still racing towards a cure for diabetes, it is currently treatable and manageable. There are many ways to help people with diabetes reduce the impact of this disease, please follow the links as stated above for more information. R2AC also has an article about insulin therapy that talks about the treatment of diabetes. As mentioned many times in this article, there is one most important way to avoid developing diabetes later in life, and that is eating healthy and exercising. Live healthy, take care of your body, say goodbye to type 2 diabetes.
Article author: Ivy Sun
Article editors: Sherilyn Wen, Edie Whittington