The metabolically well-controlled diabetic women have the same chance of having children that women are not diabetic, but it should be noted that the coincidence of diabetes and pregnancy leads to the emergence of mutual impact between the two interesting situations that we consider.
In its relationship with pregnancy must specify two types of diabetes:
* Pregestational diabetes: diagnosed before pregnancy.
* Gestational diabetes: diagnosis during pregnancy and may persist after delivery or not.
Gestational diabetes typically affect 3-5% of pregnant women, although their frequency depends on the greater or lesser complexity of the diagnostic strategy. The impact of this type of diabetes on the fetal future is less striking as that exercised by pregestational diabetes.
Influence of pregnancy on diabetes
The presence of pregnancy, through mechanisms such as production by the placenta of an action contrainsulínica hormone (placental lactogenic) or the consumption of nutrients (glucose and amino acids) in the fetus, will alter the metabolism of carbohydrates and contribute to worsening of preexisting diabetes (pregestational diabetes) or the unleashing of a hitherto unknown diabetes (gestational diabetes).
On the pregestational diabetes is concerned, although it might slightly reduce insulin needs, from the second half of pregnancy tend to increase, with a consequent tendency to hyperglycemia and ketosis if not set a good metabolic control. It seems that in the course of pregnancy can sometimes assist a certain worsening of specific vascular complications of diabetes (retinopathy and nephropathy), an aspect which should be monitored in all pregnant diabetic.
Gestational diabetes is usually milder in terms of metabolic compared with pregestational diabetes. With the termination of pregnancy is usually corrected this alteration in about three quarters of cases, although over time many of these women, whose metabolic abnormality is corrected, can become permanent diabetic.
Influence of diabetes on pregnancy
Poorly controlled diabetes may reflect negatively on the pregnancy, both as regards the mother and the newborn. This effect, of course, is less evident in the case of gestational diabetes.
Regarding the impact maternal diabetes suggests that favors the existence of a higher frequency of abortions, premature births, hypertension, preeclampsia, urinary tract or vaginal infections, polyhydramnios (increased amniotic fluid, etc.).
With regard to the child, along with an increase in fetal mortality in newborns of diabetic mothers there is an increased frequency of macrosomia (weight gain), congenital malformations, jaundice, hypoglycemia, hypocalcemia, polycythemia, respiratory distress (hyaline membranes) , obstetric trauma, etc..
In the long term, it also seems that these children may be more prone to developing obesity or diabetes than the general population.