Research Article

Pregnant Woman; Diabeties Complications 
Nikita Saraswat1, Pranay Wal2, Neetu Sachan3, Phool Chandra4
Abstract
This paper gives an insight on how important is the management of diabetes for a pregnant women and
diabetic women who are planning to conceive. According to the Society of Obstetricians and Gynaecologists
of Canada (SOGC) it is extremely significant to create awareness about the complications one can face during
pregnancy and child birth. Even trimester shows variable levels of glucose levels whose management is
very much required to maintain a safe pregnancy. It is well known that India has reported huge number of
pregnancies and complications in diabetics (pre-existing type 1 or type 2 diabetes and gestational diabetes
mellitus [GDM]) and the numbers are increasing progressively. The awareness and management has to
be performed under the expert medical professionals with regular guidance by dialectologists has proved
out to be a significant factor in controlling complication to diabetics during the pregnancies.

Keywords: Pregnancy, Diabetes, Gestation

Counselingprior conception
The management of diabetes should be handled in a careful manner as the women who are in child bearing age,married,
planning to conceive ordiabetes should be basically counseled about the risk of diabetes as well as diabetes mellitus.
As per the observation studies there are high risks of diabetic embryopathy, microcephaly, especially anencephaly
and congenital heart diseases when a reported increase in A1C is reported. Some other major risk in pregnancy is the
frequent abortions which also leads to uncontrolled diabetes. When all the observations were studied the elevated
preconception A1C levels (glucose levels) and poor self-care behaviors were found to be a major cause of diabetes
during conception. Getting A1C checked prior conception has helped in reporting and reducing about 7 % of gestational
diabetes as well as helps prevent complications in diabetes during the trimesters and thus minimize risks.(1,2)

Educating the adolescents as well as people with reproductive age about unplanned pregnancies and about the risks of
diabetes is a great way to manage the diabetes. They must be made aware of the fetal as well as maternal problems.(3)

As in the case of uncontrolled diabetes the fetal abnormalities, neonatal hypoglycemia, intra uterine fetal demise and
neonatal hyperbilirubinemia are reported therefore awareness about diabetes risks must be reported to expecting
mothers. In addition diabetes during pregnancy of mothers has shown risks of obesity and type 2 diabetes in the child
in future years of its life. (4,5)

Classification of diabetes inpregnancy

Correspondence: Nikita Saraswat, Department Pharmacy,Pranveer Singh Institute of Technology, Kanpur - Agra - Delhi National
Highway - 2, Bhauti, Kanpur, Uttar Pradesh 209305, India

E-mail Id: [email protected]

How to cite this article: Saraswat N, Wal P, Sachan N et al. Pregnant Woman; Diabeties Complications. J Durg Dis Dev 2017; 1(1):
37-39.

© ADR Journals 2017. All Rights Reserved.

• Pre gestational Diabetes: Pre-existing condition of gain. A diet schedule must be prior decide in such cases to
Type 1 or 2 or secondary Diabetes prevent postprandial hyperglycemia condition.
• Gestational Diabetes: Diagnosis made post gestational
period Ultrasound scan
• Any other type of Diabetes occurring firstly during
pregnancy An early ultrasound is also required to properly estimate
the age of gestation, risk of preterm delivery or problems
Consequences of fuel metabolism changes during of macrosomia during the second trimester. (11)
diabetic Pregnancy
Management during the second trimester
A lot of research has been done for management of diabetes
during the pregnancy as it altogether disturbs the glucose Monitoring diabetic control
levels in the body and produce complications which disturb The requirement of Insulin is expected to be double by
the body physiology of the mother and the fetus. Therefore the beginning of the second trimester. A major problem
if hyperglycemia condition prevails in first trimester of in the glucose levels arises between the time periods
pregnancy during organogenesis then there is a high risk of breakfast and lunch where the short acting insulin
of congenital malformations to show up. (8) level is raised to maintain a balance between the meals
Management of pre-gestational and gestationaldiabetes and prevent the condition of hypoglycemia. Along with
mellitus glycemic control a check on the ketones levels of the
body has to be maintained further. Approximately 10% of
An important factor which characterizes the outcomes of pregnancies (12) witness diabetic ketoacidosis along with
pre-gestational and gestational diabetes is the glycemic mildhyperglycemia. To keep monitoring such problems a
control during the pregnancy. If the control is achieved proper urine test must be conducted especially in time of
then we can be sure about controlling the problems of uncontrolled glucose levels.
diabetes. Complications arise for mother and the baby
from associated factors like medical, neonatal and obstetric Management during the thirdtrimester
factors. Therefore, a management team consisting of Monitoring diabetic control
obstetrician, pediatrician, diabetologist, nurse and dietician
must be involved during the entire term of pregnancy for Therequirement of insulin will eventually drop at
any expecting mother irrespective of the fact she is diabetic approximately 34-36 weeks of gestation time. Ultrasound
or not.Women suffering from established neuropathies scans must be conducted to keep a check on the fetal
must avoid any kind of pregnancies as it will cause a major growth during the third trimester. The baby weighing
troubleand increased life risk to the offspring as well as greater than 4000g are macrosomic though there may be
the mother.(9) a variation of about +20% from the weight estimated in
ultrasounds. (13)
Patients suffering from proliferative retinopathy must
not risk the pregnancy until they have gone under Management during delivery andpuerperium
photocoagulation treatment.A prior checkup is also crucially
required for people suffering from Ischemic Heart Disease Pregestational diabetes
prior to any decision taken for pregnancy. Cases with
Myocardial Infarction occurring during the pregnancies have The laborinduced spontaneously or induced by medication
shown high rates of mortality of both mother and fetus.(10) can be a problem for management of the glucose levels to
prevent any hint of ketosis. The levels of glucose must be
Management during pregnancy in a range of (3.9 to 6.7 mmol/L) during delivery.Patients
with type 1 diabetes are treated with sub cutaneous doses
Diet of insulin every 3 to 6 h (14)or giving continuous doses at
regular rates of 0.02 to 0.04 IU/kg body weight. Women
The diet of a diabetic during pregnancy must not be altered with type 2 diabetes don’t regularly require insulin regime
very much. Nutrients like carbohydrates, proteins and fat therapies. Summarizing the uptake of diabetic women in
must be taken into proper proportions. It is very important India the pregnancy conditions associated with diabetic
to avoid consumption of dietary proteins excessively if the patients are poor when compared to developed nations.
women is suffering from nephropathy.As the expected
weight gain during pregnancy is 300 – 400 gram per week An effective management plan is essentially required
therefore it ends up giving her a total of 10-12 kg weight to manage diabetes in pregnant women to prevent

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J. Durg. Dis. Dev. 2017; 1(1) Saraswat N et al.

any complications and give them a healthy pregnancy glycemic control, preeclampsia, and gestational
experience. hypertension in women with type 1 diabetes in the
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Conflict of Interest: None ObstetGynecol 1989;161:106-111.
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