Diabetic and Pregnant, What Now?

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By Dr. Victor Dumaguing

To Your Health

Friday, April 19, 2013

GESTATION diabetes is a type of diabetes that only pregnant women get. It occurs in 2-5 percent of pregnancies. Normally, the stomach and the intestines digest the carbohydrates - rice, bread, potato, camote, noodles, etc- into a simple sugar glucose, which is our body's main source of energy. After digestion and its eventual absorption into the blood, glucose-also called blood or plasma sugar, is distributed to all cells to provide life-giving energy, in the form of ATP or adenosine triphosphate.

To get the glucose out of your blood and into the cells of our body, the pancreas produce a hormone called insulin. A person who is diabetic does not produce enough insulin or for some reasons, the cells in our body, especially our skeletal muscles, which form the bulk of our body, cannot use the insulin available in the way, insulin should be used.

Pregnancy, as we all know by now, creates a lot of metabolic changes in the body. Aside from the obvious increase in abdominal girth and the increase in weight of the woman, it has been shown that the insulin the non-pregnant woman was producing is now unable to carry out its function adequately, therefore, the body of the pregnant woman is now having difficulty converting the sugar glucose into energy.


The hormones especially, the ones from the placenta aggravate the situation by inducing insulin resistance-a phenomenon in which, the receptors found in the cell membrane of cells, which used to be sensitive to insulin, are now insensitive or refractory to the effects of insulin-that is, the sugar glucose is now not transported into the cell, therefore the sugar in excessive amounts stay in the blood (hyperglycemia) and later on filtered into the kidneys (glycosuria- glucose in the urine).

Most women with gestational diabetes give birth to healthy babies if they have good control of their blood sugar. In some cases though, there are potential risks. It is now a well-known fact that the babies of diabetic women are much larger than normal. These big babies or may be injured by NSD (normal spontaneous delivery) or natural delivery through the vagina and may need to be delivered by caesarian section. Hypoglycemia or very low sugar in the baby's blood is another scary reality, so feedings may have to be initiated through a thin plastic tube in the arm of the newborn. Another common risk is jaundice, in which the skin and the white parts of the eyes of the baby turn yellowish. Of course, there is always the possibility of baby going into respiratory distress syndrome which would require oxygen and other breathing aids. At times, the baby of a diabetic mother may manifest twitching and cramping of muscles indicative of very low calcium and magnesium.

Published in the Sun.Star Baguio newspaper on April 20, 2013.


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