“The only time a woman wishes she was a year older is when she is expecting a baby”.
General Measures
Diet – in pre-pregnant diabetics, diet control is critical. Calorie intake is decided by weight gain during pregnancy. The weight gain during pregnancy is ½ kg per week, and about 10-12 kg per term. Patients should consume approximately 35 cal/kg, with 60% CH, 20% Practitioner, 20% fat with less than 10% saturated fatty acids, 10% polyunsaturated fatty acids, and 10% unsaturated fatty acids. Obese patients may be managed on as low as 1600 cal/day dietIf ketonuria develops, calorie intake will have to e increased Gestational diabetics need 35 cals/kg of ideal body weight.
Advice to Patient
The patient needs to be educated on diabetes, and the importance of proper (almost obsesional) control of blood sugar, especially during pregnancy. Home Blood Glucose Monitoring (HBGM) is a ‘must’ for successful management of the pregnant diabetic, and the patient is coached on the technique involved. The relatives have to be taught and trained as well.
Follow Up
Regular checks and many investigations including blood glucose, urinary proteins, Ultrasonography, creatinine estimation, Hb, plus routine tests for all pregnancies, are required throughout pregnancy.
