Diabetes, whether acquired prior to or only during the pregnancy, affects both the mother and her unborn baby. For instance, it places the mother at higher risk of developing high blood pressure. Babies of mothers with poorly controlled diabetes tend to be macrosomic or large and fat. Macrosomia puts babies at risk for shoulder injuries during delivery, and low blood glucose levels immediately after they are born.
Managing diabetes in- pregnancy entails the concerted effort of a team of health practitioners – endocrinologist, obstetrician, pediatrician/neonatologist (newborn specialist), dietitian/ nutritionist and health educator. The diabetic mother must also participate in her care by following some simple guidelines:

DOs:

Eat a healthy, balanced diet. This point cannot be overemphasized as an expectant mother eats for two –herself and her baby. For diabetic mothers, a special meal plan is designed to lower the. proportion of carbohydrates. Simple sugars or sweets and foods with high glycemic index that cause a rapid rise in blood sugar levels are best avoided. Divide feedings into small,frequent meals. Diabetic mothers are advised to eat three meals and three snacks a day regularly. This ensures that the growing fetus receives a constant supply of nutrients, and that the mother’s blood sugar levels do not fluctuate significantly throughout the day.

Monitor blood sugar levels frequently and record results. Experts recommend that diabetic mothers check their sugar levels up to seven times a day. Your doctor may tailor this according to individual needs. It is very important to record all the results of sugar monitoring and to present these to your doctor during follow-up, so that s/he may make appropriate changes in the diet or medication dose.

Make a food diary. Listing the types and amount of foods eaten alongside blood sugar results gives both the mother and her doctor a feedback of which foods raise sugar levels disproportionately, and which foods don’t.

Exercise. Engage in moderate physical activity, such as walking, low-impact aerobics or swimming. Consult your doctor about the most suitable form of exercise for you.

DON’Ts:

Eat poorly. Crash-dieting, skipping meals, or starving oneself in an effort to lose weight or to lower high sugar levels can have dangerous effects on both the mother and her baby. Both may suffer from hypoglycemia, or dangerously low sugar levels in the body, while the baby may become growth-retarded or smallfor-age. Limiting food intake too much or skipping meals can lead to a state in the mother’s body that is similar to starvation. Some studies suggest that this may adversely affect the baby’s mental development. Work instead with your doctor and dietitian to curb weight gain during pregnancy, by devising a special meal and exercise plan for you.

Start a new strenuous exercise program. If you have not been exercising regularly prior to the pregnancy, now is not the best time to start on high-impact exercises. Engage instead in low-impact aerobic exercises.

Alter medication dosage without doctor’s knowledge. Some mothers may need insulin injections to control blood sugar levels. It is unwise to skip or alter the insulin dose without your doctor’s approval, as doing so may lead to dangerously low or high blood sugar.

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