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Pregnancy and Diabetes

Pregnancy is a very special time in any woman's life, but it is particularly special for a

diabetic and her unborn child.

Diabetes is not a factor of any magnitude as far as conception is concerned, but

pregnancy affects the diabetic's carbohydrate metabolism dramatically. jri general there is an

increase in blood glucose levels and an ever increasing need for insulin. However, thereFgr7!"

e#p"Priodic and unpredictable reductions in insulin need. $herefore, urine glucose and blood

glucose need to be tested more fre%uently&than under ordinary circumstances.

$he urine should he tested three or four times 'a day and the blood glucose at every visit

to the obstetrician.

ith good management during a diabetic's pregnancy, her baby has an e(cellent chance

of being as normal and healthy as that of the nondiabetic mother.

Diabetes in Later Life

$he association between aging and diabetes relates largely to a gradual loss of elasticity in

the cells of the blood vessels, )idneys, eyegrounds *the inner sides of the bac)s of the

eyeballs+, and nerve tissues.

$hese cellular changes may not become apparent for many years after the development of

diabetes... However, occasionally they are present before or appear several years after the

diabetes is recognied. $his is particularly apt to be true in older people who develop diabetes.

$he nerve"tissue changes can cause a diminished sensation to touch and pain and

sometimes a loss of motor function of the e(tremities as well as se(ual impotence.

$he eye"ground changes damage the retina in various ways and can cause varying

degrees of loss of vision. -n about eight percent of cases this progresses to blindness.

$he changes in the )idneys affect their filtration functions, causing albuminuria, a loss

of protein from the blood serum into the urine and the development of high blood pressure

in roughly / percent of diabetics.$he vascular changes, which are rather diffuse, contribute to the specific organ changes

noted above, and fre%uently cause a reduction in blood supply to the legs and heart muscle.

$his ultimately causes heart damage in perhaps 0 percent of diabetics.

1edicine can do much to reduce the effects of these many changes but cannot cure them.

2ome degree of prevention is possible, and good diabetic control generally is thought

to contribute to a reduction and delay in the development of these complications. 2ince the

nerve and vascular changes ma)e the feet particularly vulnerable to infections that can be

serious and even lead to amputation. 3angrene occurs in about three percent of diabetics.

Proper and daily care of the feet is essential to prevent the development of infections. $heolder diabetic should be careful to )eep his feet clean and dry and cut his toenails

fre%uently and evenly. 2ome physicians recommend that diabetics have their toenails cut

only by a podiatrist.

Early Detection

4nyone who does not have diabetes might very well wonder whether he or she is at all

li)ely to get it, and, if so, what can be done to prevent it. 5ne answer is clear. -f you are

obese, whatever your age, try to lose weight. $his is especially important if you have

grandparents, parents, brothers, sisters, or children who developed diabetes in middle ageor earlier. -t is important also if you are a mother who has had babies weighing, nine or

more pounds at birth.