Pregnancy and Diabetes

Pregnancy is a very special time in any woman's life, but it is particularly special for a
diabetic and her unborn child.
Diabetes is not a factor of any magnitude as far as conception is concerned, but
pregnancy affects the diabetic's carbohydrate metabolism dramatically. jri general there is an
increase in blood glucose levels and an ever increasing need for insulin. However, there Fgr715ep-Priodic and unpredictable reductions in insulin need. Therefore, urine glucose and blood
glucose need to be tested more frequently/than under ordinary circumstances.
The urine should he tested three or four times ' a day and the blood glucose at every visit
to the obstetrician.
With good management during a diabetic's pregnancy, her baby has an excellent chance
of being as normal and healthy as that of the nondiabetic mother.

Diabetes in Later Life

The association between aging and diabetes relates largely to a gradual loss of elasticity in
the cells of the blood vessels, kidneys, eyegrounds (the inner sides of the backs of the
eyeballs), and nerve tissues.
These cellular changes may not become apparent for many years after the development of
diabetes... However, occasionally they are present before or appear several years after the
diabetes is recognized. This is particularly apt to be true in older people who develop diabetes.
The nerve-tissue changes can cause a diminished sensation to touch and pain and
sometimes a loss of motor function of the extremities as well as sexual impotence.
The eye-ground changes damage the retina in various ways and can cause varying
degrees of loss of vision. In about eight percent of cases this progresses to blindness.
The changes in the kidneys affect their filtration functions, causing albuminuria, a loss
of protein from the blood serum into the urine and the development of high blood pressure
in roughly 23 percent of diabetics.
The vascular changes, which are rather diffuse, contribute to the specific organ changes
noted above, and frequently cause a reduction in blood supply to the legs and heart muscle.
This ultimately causes heart damage in perhaps 20 percent of diabetics.
Medicine can do much to reduce the effects of these many changes but cannot cure them.
Some degree of prevention is possible, and good diabetic control generally is thought
to contribute to a reduction and delay in the development of these complications. Since the
nerve and vascular changes make the feet particularly vulnerable to infections that can be
serious and even lead to amputation. Gangrene occurs in about three percent of diabetics.
Proper and daily care of the feet is essential to prevent the development of infections. The
older diabetic should be careful to keep his feet clean and dry and cut his toenails
frequently and evenly. Some physicians recommend that diabetics have their toenails cut
only by a podiatrist.

Early Detection
Anyone who does not have diabetes might very well wonder whether he or she is at all
likely to get it, and, if so, what can be done to prevent it. One answer is clear. If you are
obese, whatever your age, try to lose weight. This is especially important if you have
grandparents, parents, brothers, sisters, or children who developed diabetes in middle age
or earlier. It is important also if you are a mother who has had babies weighing, nine or
more pounds at birth.