KARACHI, Feb 8: Speakers at a weekly health-care programme of the Sobraj Maternity Hospital stressed the need for pre-planning, balanced diet, regular exercise and use of insulin as a best remedy for safe pregnancy for diabetic women.

The speakers informed that there were two types of patients: one who already have diabetes before becoming pregnant and the others are those who develop diabetes during pregnancy. The second category is quite rare.

However, pregnant women who gain rapid weight during pregnancy, moving over to more than 90kg, and those who have family history of diabetes and previous history of repeated miscarriages, still birth, or are passing sugar in urine, must be suspected for blood sugar.

The speakers highlighted the need for a strict self-management plan for all diabetic pregnant women, which include following an appropriate meal plan, frequent self-monitoring of blood glucose (SMBG), administering insulin injections and knowing how to adjust the doses depending on results of the SMBG, besides maintaining an appropriate level of physical activity.

When women have maintained strict blood glucose control prior to conceiving and during the first trimester, the incidence of malformations is much lower.

The speakers informed that contrary to general perception, heavier babies with more than 4kg weight at birth can be a symptom of blood sugar problem in mother.

It was stressed that all mothers suffering from diabetes must never take oral medication for lowering blood sugar level. Instead changes in diet and an exercise schedule should be adopted. Insulin usage has also been advised.

Dr Shabeen Naz dispelled the impression of “once on insulin it’s always on insulin”, saying that women having type-2 diabetes could shift to oral medication after the birth. However, controlling sugar level through diet and proper exercise is the best way for it, she added.

Simple dietary message for such pregnant women is the diet minus sugar, rich in underground vegetables except sweet potatoes.

Some common complications of diabetes can be affected by pregnancy or can affect its outcome, including diabetic retinopathy may develop or worsen during pregnancy, she said.

“You should have a dilated eye exam before you become pregnant. Hypertension frequently accompanies diabetes; women who are contemplating pregnancy or are pregnant should not take anti-hypertensive drugs and even kidney disease may be worsened by pregnancy.”

It may be mentioned that according to a survey conducted by Diabetes Association of Pakistan in collaboration with the WHO, there were about 11 to 13 per cent diabetic patients in Sindh and Balochistan. However, no proper survey of women of child-bearing age or mothers having diabetes has been conducted in Karachi, or at provincial and national levels.—PPI