Pregnancy and Diabetes

pregnant diabetic, pregnancy and diabetes, gestational diabetes, gestational diabeticWhen I was in graduate school, I completed a paper describing an educational plan to teach pregnant diabetics. My University of Pennsylvania School of Nursing professor encouraged me to submit an abstract to the American Diabetes Association. I was so naïve that I did not realize what I was volunteering to do. I did not realize that if the abstract was accepted, I would be expected to write a paper to go with the abstract and to stand up in front of a group of diabetic educators and healthcare professionals and deliver this talk.

One of my wise professors advised me early in my graduate program to pick a clinical area or topic and to continue to build on it. So I developed educational materials for diabetics, worked in a diabetologist’s clinical practice seeing diabetics for care, and created this teaching plan for pregnant diabetics. One of the most amazing things I saw at the diabetologist’s office was the prototype of the insulin pump. This machine was the size of a washing machine. It is now the size of a syringe.

Pregnancy and diabetes
Pregnant diabetics are at risk for problems. Women with insulin-dependent diabetes have to avoid both high and low blood sugar during pregnancy. Women who are pre-diabetic (early stage before diabetes develops) or take oral medication to control blood sugar may develop resistance to insulin and need to take additional insulin to control blood sugar. The pregnant diabetic increases her chances of having a healthy baby without congenital defects by strictly controlling blood sugar before getting pregnant and during the first three months of pregnancy when critical organ development occurs. Pregnant diabetics are also at increased risk of having a spontaneous abortion because of poorly controlled blood sugar. They are at risk for having large babies with associated delivery risks.

One of the aspects of pregnancy and diabetes that I focused on was gestational diabetics. These are women whose bodies cannot tolerate the changing needs for insulin. There are certain known risk factors for developing gestational diabetes, including obesity, family history of diabetes, sugar in the urine and a prior history of gestational diabetes in a previous pregnancy. After delivery, the vast majority of gestational diabetics return to normal blood sugar levels, but 35 to 75% of these women will again have gestational diabetes during their next pregnancy. Half of them will develop type 2 (oral medication needed) diabetes. My educational plan focused on helping women in this category control her risk factors so they could lessen the risk of developing diabetes.

Funding to present talk at American Diabetes Association Conference
My proposal to teach was accepted. There was one significant problem: I could not afford to go to the conference. Although I did not have to pay registration, I had a flight and hotel bill to think about. My husband had been unemployed for the entire time I was in graduate school. For 1.5 years, we never used a deposit slip, only a withdrawal slip. I accepted a job to head a nursing staff development program of a local hospital immediately after I finished from graduate school, and had not been at the job more than 2 weeks when I got news that the abstract was accepted. My employer said she would give me the time off but would not pay any of the expenses.

Encouraged by one of my professors, I went to see Claire Fagin, the dean of the University of Pennsylvania School of Nursing. I asked this imposing woman for money. I told her I would call alumni in the Los Angeles area as well as guidance counselors at local high schools and would market the benefits of Penn’s School of Nursing. Much to my delight, she agreed and the amount she provided paid for my flight and hotel bill. The presentation to the American Diabetes Association led to a request to publish the paper in their journal. This led to a request to write a column for a publication for diabetics. This was one of the early steps of my writing career, which includes over 125 articles, chapters, books, case studies and online courses.

What you can do
1. If you are diabetic and become pregnant, you will need skilled care to manage your health during your pregnancy.
2. You will need the help of a nutritionist to develop meal plans that work for you.
3. You will need careful monitoring of blood sugar levels during pregnancy.
4. If you are diabetic and thinking of becoming pregnant, start off in the best possible blood sugar and weight control.

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