FREE ESSAY ON DIABETES AND PREGNANCY

DIABETES AND PREGNANCY

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Daniel Tabarez
Diabetes and Pregnancy
Deciding to have a child is one of the most important decisions of people's lives.
Diabetes is a very serious disease. It attacks million people around the world many of
them women. These women one day may be thinking about having a baby. Numerous precautions
must be taken by women during pregnancy. Special safeguard must be taken by women with
diabetes. These precautions need to be taken due to birth defects. "An estimated 1.5
million women of child-bearing age in the United States have
diabetes. A diabetic pregnancy is one of the leading causes of birth defects." (Henderson
pNA) 
Diabetes can strike at any age and can occur in anyone. Although it is not exactly known
for sure about the what causes it. Diabetes is believed to do with the body's own immune
system attacking and destroying insulin producing cells in the pancreas. There are two
forms of Diabetes, Type I diabetes, also called insulin dependent diabetes. The second
form, Type II diabetes, or non insulin dependent diabetes. 
Before insulin was introduced women with diabetes were told that pregnancy was not for
them. It is true that in the past, pregnancy did present major problems for women with
diabetes. In the pre-insulin era, "Many diabetic women died before the child bearing age
and those that survived were often infertile." (Ellenberg 696) Their babies did not often
survive. When insulin became available in the 1920's, pregnancies became more common with
diabetic women. Yet, the number of successful pregnancies remained far below that of
women who did not have diabetes. Today 
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the news is good, It is now known that the key to a healthy pregnancy for women with
diabetes is tight blood glucose control. The goal of tight control is to keep blood
glucose levels as close to non-diabeteic or normal as possible.
Although the rate of successful pregnancies among women with diabetes has improved, there
are still some problems with to be concerned about. "Pregnant women are who are insulin
dependent Diabetic are more likely to deliver children with birth defects and more likely
to deliver stillborn then the general population. They also have a much higher rate of
miscarriages." (Casson I.F. 275) We now know that many birth defects are related to the
mother's blood glucose control during the first eight weeks of pregnancy. 
What is important to note is that many women may not even know they are pregnant at this
time. For women who have diabetes or with any pregnancy, the solution to this problem is
obvious. You must plan ahead for your pregnancy. If you are a diabetic and don't already
practice good diabetes control regularly, your priority should change. "Patients with pre
existing diabetes require intensive insulin therapy before conception and during
pregnancy. Glucose self monitoring assists in achieving near normal glucose levels during
pregnancy." (Pasui, K. 273) Women should maintain good blood glucose control three to six
months before she plans to become pregnant.
Another problem that rarely occurs is stillbirth. The baby dies before birth, still
births used to occur more frequently among women with diabetes. But now, with care and
good diabetes control the chances for still births are low. 
One more problem , called jaundice, is common among all babies. But increase more so
among those born to women who have diabetes. Jaundice is a yellowing of the skin caused
from a waste 
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product. Before birth the baby needs a large supply of red blood cells. However, at birth
the baby no longer needs this supply. The baby's body will work through the liver to
break down and excrete the old red blood cells. If the baby's liver is not mature enough,
it may have trouble handling this work load.
The broken down red blood cells are called bilirubin. Instead of being excreted,
bilirubin is deposited in the baby's tissues. Bilirubin is what colors the skin yellow. 
Babies with jaundice are sometimes treated by being exposed to special lights. The lights
help break down and get rid of bilirubin. "Treatment of the problem is usually by photo
therapy but exchange transfusions may be necessary." (Hollinssworth, D.R. 266) But high
levels of bilirubin becomes toxic. A baby might need a blood transfusion, but the chance
of this happening is rare.
Finally, as women consider pregnancy, they must realize that managing diabetes during
pregnancy is time-consuming and expensive. There will be more doctor visits, special
tests, more frequent blood glucose testing, and more insulin injections each day. There
will also be more time away from work. Depending on
your condition, your OB may ask you to reduce your hours or stop work by the late weeks
of pregnancy. You and your partner need to be aware of these factors and discuss their
impact on your finances and lifestyle.
Bibliography
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Works Cited
Books:
Ellenberg, Max M. D., et al., eds. Diabetes Mellitus: Theory and Practice. 3rd Ed., New
York:Medical Examination Publishing Co., Inc. 1983
Hollingsworth, Dorothy Reycroft. Pregnancy, Diabetes, and Birth:A Management Guide. 2nd
Ed., Baltimore: Williams & Wilkins.,1992
Periodical:
Casson, I.F. "Outcome of pregnancy in insulin dependent diabetic women:results of a five
year population cohort study." British Medical Journal 2 Aug. 1997: p275
Pasui, Kristine "Management of diabetes in pregnancy." American Family Physician June
1997: p273
Henderson, Charles W. "Study Suggests Promising Treatment for Diabetic Pregnancies."
Transplant Weekly 17 May 1999: pNA