Diabetes in Childhood and Pregnancy

Everything you need to know about diabetes in children and during pregnancy.

diabetes in childhood pregnanct

Diabetes in Children

Most children and adolescents diagnosed with diabetes usually have type 1 or insulin-dependent diabetes. They need insulin, dietary management and exercise to control their diabetes.

Parent’s Role

If your child is diagnosed with diabetes, learn more about your child’s diabetes, and how to administer his insulin, as well as how to plan his meals and exercise programmes — you will have to take an active role in diabetes management tasks, whatever his age. As your child grows, he should learn how to manage and control his diabetes from you. In this way, as he gets older, he can gradually assume responsibility in managing his diabetes.

Psychological and Social Issues

Once your child starts schooling, he will interact even more with other children which might result in him looking for their approval so as to fit in. He may then consider diabetes a stigma and as a result, be unwilling to tell other children about it. If this happens, a treatment plan that interferes with school and friendships may be unwelcome. You may have to consider some psychological and social adjustments in order to help your child adopt a positive and healthy attitude towards his diabetes. One way to do this is by encouraging early self-care in the activities and sports that he can participate in, as well as in the types of foods and drinks he can or cannot consume.

Hypoglycaemia

When parents tighten the control of the level of glucose in their child’s blood, low blood glucose or hypoglycaemia becomes a real risk. Very active, young children are also prone to hypoglycaemia. It is important to ensure that good meal planning and regular monitoring take place. It is also crucial that your child has his meals on time and snacks between meals. Do teach him to recognise the signs and symptoms of low blood glucose reaction and how to manage it.

Managing Your Child’s Diabetes in School

The school should be told of your child’s diabetes. By understanding that your child has diabetes, special privileges may be allowed to ensure your child has his meals and snacks on time, even during class. The school will also understand if your child needs to use the restroom more often or go for medical appointments during school hours. A friendly schoolmate should also be taught how to recognise and treat low blood glucose reaction. As far as possible, allow your child to participate fully in all school and after-school activities. Teach your child to have healthy and regular meals and stick to the medication schedule. If the activity your child participates in is strenuous and tiring, he should take a small snack before starting on the activity.

Growing Up with Diabetes

As your child enters adolescence, encourage him to assume more responsibility for his diabetes — he should be able to give himself insulin injections, make wise decisions on his diet, as well as monitor his own blood glucose levels frequently. Your child must also know the possible complications resulting from an unhealthy lifestyle. Therefore, he should learn why he should not start smoking or consuming drugs or alcohol as such habits could increase the risk of complications from diabetes.

Diabetes in Pregnancy

Types of Diabetes in Pregnancy

There are three main types of diabetic pregnancies:
A woman with type 1 (insulin dependent) diabetes who becomes pregnant.
A woman with type 2 (non-insulin dependent) diabetes who becomes pregnant.
A woman with gestational diabetes who is diagnosed with diabetes during her pregnancy. This form of diabetes usually "disappears" upon delivery of the baby, but there is a higher risk of it occurring in subsequent pregnancies or later in life.

A high blood glucose level left untreated has major consequences for the mother and the foetus. If present early in the pregnancy, the result may be physical abnormalities in the foetus. In the later part of the pregnancy, the growing foetus may have macrosomia, a condition where your baby grows abnormally large which can lead to a premature birth. A large baby also increases the risk of injury to the baby or mother during delivery.

Planning for a Baby When You Have Diabetes

Whatever the type of diabetes you have, it is very important to achieve good diabetes control before you plan to have a baby. If you have diabetes and want to become pregnant, you need to check with your doctor or diabetic care team before you plan to conceive. If you are taking oral medication for diabetes, it is likely that your doctor will consider switching you to insulin in order to allow your diabetes to stabilise before you conceive.


Treating Diabetes in Pregnancy

​Types of Diabetes
Type 1 (Insulin Dependent Diabetes)​ ​Type 2 (Non-insulin Dependent Diabetes)
Gestational Diabetes​
Treatment
​Diet and insulin doses up to four times daily. The dose in pregnancy may be more than the dose in non-pregnant state.
Diet and insulin​Diet alone, or diet and insulin​


What to Do When You Have Diabetes During Pregnancy


• Measure your blood glucose before meals, at bedtime, and two hours after eating, according to your doctor or diabetes care team's instructions.
• Control your diet. It may be helpful if you take frequent but small meals e.g. breakfast, mid-morning snack, lunch, mid-afternoon snack, dinner, and bedtime snack.
• Inject your insulin as prescribed by your doctor.
• Exercise regularly e.g. swimming or walking.
• Learn to balance your meals, know how to administer your own insulin injections and understand which exercises are suitable during your pregnancy.

Managing Diabetes After Pregnancy

If you have type 1 diabetes, you will usually be able to return to your pre-pregnancy dosage very soon after delivery. The doctor will advise accordingly. 

If you have type 2 diabetes and intend to breastfeed your baby, you may have to continue to be on insulin. The doctor may change the treatment back to oral medication after you stop breastfeeding. 

If you have gestational diabetes, the doctor will advise when and how to slowly stop your insulin should you no longer need it. You will need to be go for the glucose tolerance test six weeks after delivery. This will enable the doctors to confirm whether you have diabetes and give you appropriate advice accordingly.

Postnatal Visits

Do not miss postnatal visits to your doctor. It is important, as he will advise you on your type of diabetes and how to manage it well. He will also discuss your future family plans as well as caring for yourself and your child.


Breastfeeding 

You should be able to breastfeed if you are not taking oral medication for the control of diabetes. However, you need to be careful with the following:  
Cracked nipples and breast infections — check with your doctor if you are not sure. 
Very low blood glucose (hypoglycaemia) — there will be a need to increase the carbohydrate content in your diet. Consult your dietitian for help. You could also time your meals and snacks about half an hour to one hour before you breastfeed.
Frequent high blood glucose (hyperglycaemia) due to poor control of your diabetes will result in high sugar content in your breast milk. 

Diabetes During Pregnancy — Effects on Baby

Your baby’s blood glucose level is affected by your blood glucose level before delivery. However, this does not mean that your baby will have diabetes later in life. Your doctor will observe your baby, who may be placed in a special-care unit so that his breathing and blood glucose can be monitored carefully.

Insulin injections given during pregnancy to control your diabetes do not affect the health of your baby.

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