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Ask Dr. Sears: Diabetes and pregnancy

  • Story Highlights
  • Diabetic mothers and their babies at greater risk of having medical problems
  • Women with diabetes can have successful pregnancies if they take precautions
  • These include getting diabetes under control, eating protien and the right carbs
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By Dr. William Sears
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( -- Q: I'm 28 and diabetic. Now my husband and I would like to have a baby. Is there anything I should worry about because of my condition?

A: Millions of women with diabetes have gone through healthy pregnancies and delivered healthy babies. There's no reason why you shouldn't also -- providing you take some precautions.

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Diabetic mothers and their babies are at greater risk of having medical problems. The reason being when the mother's blood sugar goes out of control, excess sugar will cross through the placenta. This will then trigger the baby to release increased insulin, potentially causing a state of hyperinsulinism.

Since insulin is a fat-storage hormone, the resulting biochemical imbalances can cause babies to gain fat, and excessively large babies can cause more risky deliveries. The better you take care of yourself, the greater your chances of having a healthy pregnancy and delivering a healthy baby. Here's what you need to do:

Get your diabetes under good control. When you become pregnant, you suddenly have two important reasons for taking care of yourself -- your and your baby's health. It's important to keep your blood sugar as stable as possible. You can no longer afford those indulgences of high blood sugar one day and needing more insulin, followed by low blood sugar another day and needing less insulin. You will need to follow the blood-sugar-control program your doctor prescribed very closely. The more stable your blood sugar, the less likely your complications during pregnancy and delivery.

Eat the right carbs. Not only do you need a lower carbohydrate diet when you have diabetes, it's equally important to eat the right carbs. You need foods that won't trigger the roller coaster effect of blood sugar swings. Here's Dr. Bill's right-carb lecture in a nutshell. A right carb, or a good carb, food is one that comes packaged with protein, fiber, or fat. The way I explain it to the kids in my practice is, a good carb holds hands with three friends: proteins, fat, and fiber. These "friends" keep the carb from entering the bloodstream too fast. The best carbs, in order, are: vegetables, high fiber fruits, dairy products, and unprocessed whole grains. As a simple guide, a good carb is one that comes right off the plant and doesn't make a stop at any food factories.

Stay away from the wrong carbs. As you might guess, the wrong carbs are those that stand alone. Processed or refined carbs don't hold hands with friends like protein, fat, and fiber. As a result, these carbs enter the bloodstream really fast and cause high blood sugar. Very simply, avoid all processed carbs. You especially want to stay away from the corn syrup or high fructose corn syrup in sweetened beverages, high sugar pastries, and those "packaged bads" like you see at the supermarket checkout. In fact, there's usually an aisle in the supermarket you just don't go down. That's the bad carb aisle.

Have smaller, more frequent meals. Grazing throughout the day rather than binging keeps blood sugar stable. As your uterus grows and pushes on your stomach and intestines, you will find that grazing on mini meals is more comfortable anyway.

Eat more protein. Strive for at least 100 grams a day. Since you will be eating fewer carbs, you'll naturally make that up with extra protein. Protein-rich foods are more filling than carbs, and they satisfy appetite the best. The best protein foods are: nonfat or low-fat dairy products (especially yogurt), tofu, wild salmon, eggs, lean beef and poultry, and beans.

Fill up with fiber. I'm sure you know the effect pregnancy hormones have on your emotions, but you might not know that they also slow down the movement of your intestines. That's why pregnant women need extra fiber to speed the passage of food waste. Fiber is also filling without being fattening. Best fiber foods are: vegetables, fruits, beans, prunes, pears, plums, flaxseed meal, and whole grains.

Change your oils. Avoid any food that has the word "hydrogenated" or "partially hydrogenated" on the label. These are factory-processed oils which can cause biochemical disturbances in your body and contribute to obesity. Replace them with fish oils, especially wild salmon. (But pregnant mothers should avoid fish such as shark and swordfish, that might contain high levels of mercury.) Since farmed salmon contains more pesticides, stick to wild Alaskan salmon. Canned salmon is usually wild. And if you can't stomach seafood during pregnancy, ask your obstetrician to prescribe some high quality fish oil capsules. Take at least one gram a day. Other healthy oils and fats are olive oil, nut-butters, and egg yolk.

Control your weight. The more excess body fat you carry, the more difficult it is to control your blood sugar. Obesity also puts you at risk for having complications during pregnancy and delivery, such as toxemia and premature birth. Get yourself lean (meaning having the right percentage of body fat for your individual body type) before you are pregnant. Exercise right during pregnancy. And as a pregnancy perk, as you exercise it stimulates your body to produce feel-good hormones. So, exercise also improves your sense of well-being.

Just because you have diabetes doesn't mean you have to do anything special during pregnancy. In fact, I recommend all pregnant women follow these health tips. If you have diabetes, you simply have to follow them more meticulously for your own well-being and that of your baby. E-mail to a friend E-mail to a friend

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