Diabetes In Pregnancy And In Later Life - Facts and Prevention

Pregnancy is not an easy time for the diabetic patient. It puts greater stress on the prospective mother's diabetic condition and increases risk for the baby. Fortunately, these facts are now well recognized by obstetrician and by physicians who care for diabetics. The key to prevention of many complications during pregnancy lies in close co-operation between obstetrician and other physician and the pregnant woman. She may need very frequent visits to the doctors to regulate insulin dosage. Insulin requirements change during pregnancy.

Babies of diabetic mothers are at higher risk than other babies are. Usually, a pregnant diabetic will have to be admitted to the hospital several weeks before the expected delivery time so her diabetes can be kept under rigid control before delivery and the decision can be made about possible need for delivery by cesarean section. After delivery, the mother needs to be watched carefully for changing insulin requirement. Babies born of diabetic mothers have tended to have more congenital defects than those of non-diabetic mothers. This may be the result of inadequate control of the diabetes in the early months of pregnancy. It is another reason why a prospective diabetic mother should notify her doctor the mother suspects she may be pregnant. Then she should work out a clear arrangement: will he or the obstetrician take the responsibility for control of the diabetes throughout the pregnancy?

Later life diabetes
Maturity-onset diabetes, which most commonly sets in at age 50 or later, though it may occur earlier, is generally less severe than juvenile diabetes, and rarely leads to acidosis. The symptoms are the same for both types. Maturity-onset diabetes often controlled without medication. The doctor usually will try, unless the case is very severe, to treat the patient with low-sugar diet. He will also try to bring weight down to normal or even somewhat below the accepted normal. If diet and weight reduction do not have the desired effect on symptoms and blood and urinary sugar, the doctor then will generally prescribe one of the oral hypoglycemic medicines rather than insulin.

Medicines taken by mouth are not usually effective in replacing insulin in younger diabetics but do work well in maturity- onset diabetes. Sometimes oral agents supplemented with small amounts of insulin. As the population lives longer, more and more people develop maturity-onset diabetes, from which the main threat is atherosclerosis. For the prevention, the diabetic, we think, would do well to keep his weight down to normal levels, get regular exercise, and emphasize foods containing unsaturated fatty acids and low in cholesterol, avoid cigarette smoking, reduce emotional tensions, and make sure blood pressure is normal.