Planning for a pregnancy is important for all women’s wellness, but, according to Rita Forde, an advanced nurse practitioner at the Mater Hospital’s Diabetes Centre in Dublin, when your wellbeing is affected by diabetes, ‘this need to plan has even greater importance’.
Ms Forde noted in the Irish Journal of Clinical Medicine: Modern Medicine that ‘optimal medical care, patient education and training must begin before conception’ in order to prevent early pregnancy loss and congenital malformations in your baby. She added that your diabetes management during pregnancy becomes more intense, on top of coping with the ‘normal emotional and physiological diversity of pregnancy’. Yet some women find it hard to stay motivated with their disease management during pregnancy, and this is where complications arise.
According to Ms Forde, ‘major congenital malformations remain the leading cause of mortality and serious morbidity’ in the babies of women with diabetes, in spite of the fact there have been major advances in the treatment of diabetes, particularly for pregnant women. The evidence suggests that poor glycaemic (blood sugar) control during early pregnancy is the main culprit for this as hyperglycaemia (high blood sugar), can disturb your baby’s normal growth and development if you suffer the condition during the first eight weeks of pregnancy.
Ms Forde works in the Mater’s Diabetes Centre, where a dedicated pre-pregnancy clinic has been established since 2004. The clinic aims to ensure that the women attending ‘are in the best possible general health prior to pregnancy’, as potential malformations often occur before you even realise you’re pregnant. Ms Forde explained, ‘Therefore it is essential for women with diabetes that specialist care commences before pregnancy in order to reduce the rate of these anomalies.’
When women attend the clinic, Ms Forde noted that they deal with issues such as folic acid supplementation and weight, as well as diabetes, throughout regular reviews. ‘Their diabetes management and control are assessed and alterations to treatment made as necessary to achieve their pre-pregnancy targets,’ Ms Forde said, adding that pre-pregnancy care should be considered as part of the management of all women of reproductive age with diabetes. ‘The challenge now is how best to inform all women of reproductive age with diabetes about the importance of obtaining specialist care prior to becoming pregnant,’ she concluded.
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