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Diabetes, also known as sugar disease, is a highly significant health issue caused by the pancreas’s insufficient insulin production or complete lack of insulin. Especially in recent years, with the rise of obesity, diabetes has become a global health concern.
In this article, you can find answers to questions such as what the normal postprandial blood sugar levels should be during pregnancy, what the fasting blood sugar levels should be, how diabetes affects pregnancy and the baby.
Gestational diabetes is diabetes that develops during pregnancy or is first diagnosed during pregnancy. A woman who has not previously been diagnosed with diabetes can be diagnosed with diabetes during pregnancy. This condition, defined as “gestational diabetes,” can disappear after pregnancy.
As the placenta (umbilical cord) grows during pregnancy, the hormones it releases increase, rendering insulin ineffective, which leads to an increase in blood sugar levels. This effect generally increases around the 20th to 24th weeks of pregnancy.
However, in women who are overweight, high blood sugar levels can occur from the early months of pregnancy. After birth, when the placenta is expelled, these hormones disappear, and the diabetes may also resolve.
When there is no insulin in our body, the sugar and other nutrients we obtain from food cannot enter the cells that need them. As a result, while the cells cannot access sugar, blood sugar levels rise above normal values.
Diabetes can manifest in two different forms: Type 1 and Type 2. Type 1 diabetes is a form of diabetes diagnosed at a young age, where the pancreas does not produce enough insulin.
Insulin is used in the treatment of Type 1 diabetes. Type 2 diabetes is known as insulin-independent diabetes and can be particularly observed in women with polycystic ovary syndrome.
Gestational diabetes often shows no symptoms, so all pregnant women should be screened. A 50-gram glucose loading test is performed between the 24th and 28th weeks of pregnancy. A glucose solution containing 50 grams is consumed at any time of the day, and blood sugar is measured one hour later. If the result is 140 mg/dl or higher, there is a risk of diabetes, and a 100-gram glucose loading test is performed. If the level is below 140 mg/dl, diabetes is ruled out.
Chronic conditions like hypertension and diabetes may not directly cause infertility, but they can be contributing factors. More importantly, it is essential to monitor how blood sugar and blood pressure will progress after pregnancy.
While blood sugar may be well-controlled in the early months, the need for insulin or medication may decrease, but as the baby grows, this balance may shift. During this process, more insulin, dietitian monitoring, and exercise are necessary. Blood pressure and sugar should be assessed before becoming pregnant.
Individuals at risk for gestational diabetes should undergo a glucose loading test in the early months of pregnancy. Even if diabetes is not diagnosed, the glucose loading test should be repeated between the 20th and 24th weeks of pregnancy.
In women who develop diabetes during pregnancy, blood sugar typically rises by the 24th week, and the baby does not usually experience any abnormalities. However, if this issue is detected in the first three months of pregnancy, extra caution is required.
Women who were diagnosed with diabetes before pregnancy can still have healthy babies, but it is crucial for these women to monitor their blood sugar levels throughout their pregnancies.
Gestational diabetes can lead to the baby being born larger, posing significant risks. Elevated blood sugar levels in the mother cause the baby's pancreas to produce more insulin.
This can lead to increased fat accumulation in the baby and result in a larger size at birth, potentially necessitating a cesarean delivery.
After birth, the baby may experience low blood sugar levels, so regular monitoring of the baby's blood sugar is necessary. Additionally, these babies may have low levels of calcium and magnesium, requiring monitoring in these areas as well.
Monitoring gestational diabetes is two-fold. The first aspect is managing the mother’s blood sugar levels, and the second is monitoring the baby’s development by an obstetrician. The most crucial point in diabetes monitoring is to maintain blood sugar levels within normal ranges.
Regular blood sugar measurements should aim to keep blood sugar levels between 60-120 mg/dl. Blood sugar should be measured at fasting, 1 hour after meals, and 2 hours after meals. Additionally, measurements should be taken before dinner and at 10:30 PM (sometimes at 3-4 AM).
In these measurements, fasting blood sugar should be 95 mg/dl or lower, 1-hour postprandial blood sugar should be 140 mg/dl or lower, and 2-hour postprandial blood sugar should be 120 mg/dl or lower. It is also important to periodically measure ketones in the urine, as urine ketones are a significant indicator for diabetes.
For expectant mothers with a diabetes diagnosis, pre-pregnancy evaluations are essential and facilitate monitoring. If you are overweight or obese, losing weight and stabilizing your blood sugar levels before pregnancy will make your pregnancy easier and can facilitate delivery.
It is crucial to adopt balanced and proper nutrition habits and to exercise during pregnancy. We recommend that pregnant women engage in walking 4-5 days a week. If walking is not possible, aerobic exercises (such as prenatal yoga) should be performed for 30-40 minutes. Regular exercise can lower blood sugar, stabilize blood pressure, and assist in overall management.
Gestational diabetes can be divided into two categories: the first group consists of individuals already diagnosed with diabetes, while the second group includes those identified with gestational diabetes through screening tests performed between the 24th and 28th weeks.
The diagnosis and monitoring of both types of diabetes during pregnancy are crucial. In cases where diabetes was known before pregnancy, failure to control blood sugar levels adequately during the first three months can result in structural anomalies in the child.
The most common issues include structural anomalies in the brain and spinal cord, as well as anomalies in the heart. These are, frankly, irreversible.
Therefore, it is very important for patients known to have diabetes before conception to maintain proper blood sugar levels during the early stages of pregnancy and seek professional help from obstetricians and endocrinologists.
For the second group, those diagnosed with diabetes during pregnancy, monitoring is also critical. Particularly in this group, excessive fetal growth, increased amniotic fluid, and the potential for premature birth are common problems.
Additionally, in known cases of diabetes, we can encounter severe drops in blood sugar levels immediately after birth, which can pose life-threatening challenges for the baby. Therefore, diabetes is a condition that requires significant attention and preventative measures.
Postprandial Blood Sugar: During pregnancy, postprandial blood sugar levels should be less than 120 mg/dl two hours after a meal.
Fasting Blood Sugar: During pregnancy, fasting blood sugar should be:
A weight gain of 9-12 kg during pregnancy is appropriate. If a woman begins her pregnancy overweight, a gain of 7-8 kg is normal, and if she starts underweight, a weight gain of 17-20 kg is acceptable.
Exercise and an active lifestyle are crucial for all diabetics. Exercise not only helps lower blood sugar but also supports blood sugar management.
We recommend pregnant women walk 4-5 days a week. In addition to walking, aerobic exercises can be performed for 45 minutes daily. While nutrition is very important during pregnancy, its significance increases for diabetic patients.
In terms of diet, a greater emphasis should be placed on vegetables, whole grains, legumes, and fiber-rich foods. Care should be taken to consume olive oil, whole grain bread, low-fat yogurt, and low-fat milk.
Margarine should be avoided, and carbohydrate intake should be limited. Carbohydrates should not exceed 40% of total daily caloric intake. Another important point is monitoring blood pressure.
Therefore, regular blood pressure measurements should be taken, and if systolic pressure exceeds 140 or diastolic pressure exceeds 90, you should consult your doctor.
Gestational diabetes occurs in about 3% of pregnancies, but 10% of these mothers may develop diabetes later in life. The baby, however, does not develop diabetes.
However, it is essential to emphasize that the risk of developing diabetes in the mother is high within the first 10-15 years. Therefore, fasting and postprandial blood sugar levels should be checked every six months.
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