It is generally associated with a deficiency of insulin or resistance of body cells towards insulin.
A number of complications are associated with diabetes resulting from the increased levels of blood glucose and ketones; depleting reserves of glucose such as glycogen, and muscle proteins; and a reduction or loss of insulin.
Types of Diabetes in pregnancy Diabetes during pregnancy can be categorized under two heads; Type I Diabetes: Diabetes that a woman already has before pregnancy, and needs to take insulin to control her glucose and insulin levels.
Gestational Diabetes: A woman develops gestational diabetes during pregnancy, which goes away after child birth.
Gestational Diabetes increases the risk of developing Type II Diabetes later in life.
Either type of Diabetes raises the risk of further complications in both the mother and the baby.
The Diabetes in pregnancy has to be controlled with proper meals, carefully planned exercise regimen, regular monitoring of blood glucose levels, and medicines.
High blood glucose in mother If the mother's blood glucose is high, there is a risk that the unborn baby will be affected.
A high blood level of glucose early in pregnancy (during the first 8 weeks) gives rise to an increased risk of birth defects.
In a number of cases, the defect is so high, that the baby cannot survive.
The risk of birth defects and difficulties during pregnancy is equivalent in both Type I Diabetes and gestational Diabetes.
There is an increased need for insulin during pregnancy.
This is due to the increased body weight and an increased level of hormones secreted from the placenta which counteract the glucose lowering effect of insulin.
Eye and kidney damage is also accelerated in Diabetes during pregnancy.
If the mother's kidneys have been damaged because of Diabetes, then the risk of fetal growth retardation and premature delivery also increases considerably.
A high blood glucose level for a considerable period during pregnancy will be easily absorbed by the baby and be acted upon by the insulin produced in the baby's pancreas.
There is an increased production of insulin comparable to increased level of glucose in blood.
In this case the baby will grow faster than it should and will gain an excess weight before birth.
This will cause problems in normal delivery.
Hypoglycemic episodes in pregnancy Severe hypoglycemia with convulsions or unconsciousness is dangerous.
Low blood glucose levels give rise to the problem of morning sickness.
Simultaneously, feeling very sick reduces food intake and this causes low blood sugar.
Thus, a vicious cycle develops during pregnancy.
The glucose from the mother's blood easily passes off through the placenta into the baby's blood.
The baby has his own supply of insulin to take care of this glucose.
Hence, mother becomes hypoglycemic, and there may be an increased risk of night attacks of hypoglycemia.
Low levels of blood glucose will cause the baby to have a low growth rate and will show a retarded growth before being born.
Risks for the unborn baby Early in pregnancy, there is an increased risk of congenital malformations if the blood glucose level is increased.
Due to high blood glucose level, there is an accelerated growth of baby and the high birth weight poses problems during delivery.
Also, immediately after birth, the infant will develop hypoglycemia (low blood sugar level), as its body continues to produce large amounts of insulin.
This makes the baby less capable of coping with lack of oxygen during delivery.
Levels of blood glucose if maintained at normal levels throughout the pregnancy, then Diabetes associated complications can be eliminated to a large extent.
If the woman has good control of blood glucose levels and HbA1C similar to that of a person without Diabetes, while conceiving and during early pregnancy, then the risk of birth defects or miscarriage is no greater than average.
HbA1C: It is the name for the test used to measure average glucose control over a longer period of time, and is named after a subgroup of adult hemoglobin, a pigment present in red blood cells which binds to glucose.