Diabetic Embryopathy
I have included this here although the physical damage is to a third party rather than the diabetic themselves, (though the psychological affects on the diabetic may be great) and is certainly a complication of diabetes that all woman of childbearing age need to know about.
This occurs when the uncontrolled diabetes in a pregnant woman causes congenital malformations in her child. See gestational diabetes.
The malformations are usually to the heart and central nervous system, and are potentially fatal.
Malformations of the gastrointestinal, genitourinary, and skeletal systems are also common.
HELP! What can I do to have a healthy child?
It has been suggested that diabetics plan their pregnancies.
The most damage is caused during the first trimester and if unplanned a woman may be unaware that she is pregnant during this period.
Tight control of blood glucose levels at this time substantially reduces the risk to the baby.
As the oral medications are contra-indicated in pregnancy diabetics on them will need to change to insulin during the pregnancy.
Pregnancy also pushes up your insulin resistance so even if you control your diabetes with diet and exercise you may well need insulin during this period.
Don't worry, the IR usually returns to previous levels afterward and you can come off the insulin.
If you are on any other drugs, like ACE inhibitors or cholesterol lowering drugs you need tell your gynaecologist as they can also harm the foetus.
A note here - you need your assorted health practitioners eg. gynaecologist, endocrinologist, general practitioner, diabetic nurse and midwife to work closely together so they all understand your situation and can give the best advise and treatment possible.
With proper care most diabetics produce happy healthy babies.
Pre-pregnancy counselling which gives advise on diet, insulin regimes and BG levels is a good idea, along with tests for HbA1C and kidney function.
A HbA1C of below 8 has been suggested as optimum as this is the level at which least problems occur.