Diabetic patients have genetic risks, but in outpatient clinics, diabetic patients often come to consult on how to reduce genetic risks. In fact, research shows that the incidence of diabetes in China is now as high as 11.6%, including many people of childbearing age. Every couple of childbearing age desires to have a healthy baby, but for diabetics, whether they can get pregnant is an issue that needs to be carefully considered. The effects of diabetes on the fetus include: polyhydramnios leading to intrauterine fetal death, macrosomia, immature infants, deformed infants, neonatal hypoglycemia, hypocalcemia, etc., as well as miscarriage, premature birth, neonatal death, and deformed infants. wait.
But this does not mean that people with diabetes cannot give birth to a healthy baby. Research shows that if diabetics have a doctor to guide them, their chances of giving birth to a baby with birth defects are significantly reduced.
People with diabetes can get married and have children. Although diabetes may affect offspring, it is difficult to determine which children will develop the disease. If both parents have diabetes, their children are at a higher risk of developing diabetes. Preventing two diabetics from getting married can reduce the risk of their children developing diabetes.
Type 1 diabetes can be inherited from both parents, and the father is more likely to be hereditary than the mother. Antibodies to islet cells, insulin autoantibodies, and glutamic acid decarboxylase antibodies can be detected in the blood of patients with type 1 diabetes; the positive rate of these antibodies in the siblings of patients is also higher than that of brothers and sisters without type 1 diabetes, and the positive rate of these antibodies is also higher. Siblings are more likely to develop type 1 diabetes, and the higher the antibody titer, the greater the likelihood of developing type 1 diabetes. Therefore, we may be able to use these antibodies to predict the risk of type 1 diabetes.
Type 2 diabetes is a polygenic disease that is often accompanied by obesity, dyslipidemia, hypertension, coronary heart disease, and cerebrovascular disease. Mothers play a greater role than fathers in the inheritance of type 2 diabetes. Women with type 2 diabetes, especially those who are obese, may be accompanied by polycystic ovary syndrome, which makes it difficult to become pregnant.
Three months before deciding to get pregnant, diabetic women should try their best to control blood sugar, blood pressure, and weight within normal ranges, check for complications, understand their condition, and know how to protect themselves and their fetus. Women who are taking oral hypoglycemic drugs should switch to insulin treatment under the guidance of a doctor. Relatively speaking, if the expectant father has diabetes, the problem is much simpler. They only need to control blood sugar to the target. There is no research showing that the man\’s oral hypoglycemic drugs will have an impact on the fetus.
Women of childbearing age with diabetes who are determined to have a child are advised to use contraception before becoming pregnant.Use contraception for 3 months, strictly control metabolic disorders, and keep blood sugar normal or close to normal before considering pregnancy. Control blood sugar as much as possible from 2 to 10 weeks after pregnancy to help reduce the possibility of teratogenesis. However, if diabetic cardiovascular disease, diabetic nephropathy, proliferative retinopathy or vitreous hemorrhage are combined, the patient is advised to use contraception as much as possible, and pregnant women should terminate the pregnancy and be sterilized at the same time.
Women with diabetes should be fully prepared before pregnancy and undergo a comprehensive physical examination, focusing on blood sugar (24 hours), glycated hemoglobin, blood lipids, urine protein, routine urine (ketone bodies, sugar, infection), blood pressure, fundus, Nervous system and electrocardiogram. You should master blood sugar monitoring before pregnancy, pay attention to dietary adjustments and exercise during pregnancy, and have diabetes-related knowledge and skills such as insulin injections, recognition and treatment of hypoglycemia, and pregnancy-related knowledge.
Female diabetic patients can become pregnant if their blood sugar is well controlled and they have no serious heart, brain, kidney, eye or other serious complications. Ideal blood sugar control includes normalization of blood sugar within 24 hours, no abnormal blood sugar fluctuations, and glycated hemoglobin between 4.0% and 6.0%. Background diabetic retinopathy will worsen during pregnancy, so fundus examination and appropriate treatment should be performed before pregnancy. Postpartum retinopathy in most diabetic patients can return to prenatal levels. Diabetic nephropathy requires appropriate treatment before pregnancy. Before pregnancy, urine protein should be less than 1 g/day, and plasma protein and blood pressure should be normal.
Poor blood sugar control is not only harmful to pregnant women, but can also lead to fetal malformation and stillbirth. Pregnancy can aggravate proliferative retinopathy, which may lead to retinal detachment and blindness in severe cases. Pregnant women with severe diabetic kidney disease, urinary protein exceeding 1 g/day, creatinine clearance less than 70 ml/min, or severe hypertension are prone to intrauterine growth retardation, intrauterine distress, and eclampsia. Therefore, it is not advisable to become pregnant if you have the above conditions.
If pregnancy is possible, expectant mothers should do the following.
If the patient is taking sulfonylurea drugs, the drug must be stopped:This This medicine may cause birth defects in babies, and insulin can be used instead. In addition, if you are taking other drugs, you should use them under the guidance of a doctor. Drugs that are harmful to the fetus should be stopped or replaced.
A comprehensive examination should be carried out before pregnancy: including various biochemical indicators, blood pressure, electrocardiogram, Abdominal B-ultrasound, cardiac color ultrasound, and ophthalmological examination are performed to evaluate the patient for signs of hypertension, heart disease, kidney disease, neurological disease, and ophthalmic disease. If there are some signs of these disorders, treatment should be given before the patient considers pregnancy.
Good eating habits: Develop a diet plan based on the patient\’s weight, weight gain during pregnancy and blood sugar target value according to the physician\’s guidance. Try to eat smaller meals more frequently and control sugar and fat diets to keep blood sugar levels stable.
Exercise: It is very important to maintain physical activity while preparing for pregnancy. This not only helps to better control blood sugar levels, but also helps to cope with the physical demands during childbirth and physical recovery after giving birth. After exercise, you can appropriately increase the amount of food or reduce the amount of insulin. People who have had hypertension or pregnancy-induced hypertension in the past can Blood pressure, cardiovascular and cerebrovascular complications, proliferative retinopathy, diabetic nephropathy, orthostatic hypotension, etc. cannot be treated with exercise.
In fact, if diabetic women want a healthy baby, it is not enough to do this. They must be vigilant throughout their pregnancy. The baby\’s major organs are formed during the first 8 weeks of pregnancy. At this point many patients don’t even know they are pregnant. If the patient\’s blood sugar level is not well controlled during this period, it will seriously affect the fetus.
Patients with post-gestational diabetes must state their medical history to the doctor, and conduct investigations and medication under the guidance of the doctor, because an accident during pregnancy may cause all previous efforts to be in vain.
This article is provided by Baidu Reading. It is excerpted from \”Very Good Pregnancy: You Can Get Pregnant by Doing This\” Author: Yu Yue\’e