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If you have uncontrolled diabetes, your child could pay a price

November 6, 2021 at 10:00 p.m.

Type 2 diabetes and prediabetes can be controlled -- even reversed -- and you can do it with lifestyle changes and supporting medications, if needed. That is great news. And something that the millions of women under age 50 should take to heart if they have either condition and are planning to start or increase their family.

There are two types of diabetes that may affect your pregnancy and your fetus: Gestational diabetes that starts, or is first detected, during pregnancy, and pregestational diabetes, which is diabetes that existed before you became pregnant. From 2000 to 2010, the percentage of pregnant women with gestational diabetes increased 56% -- and continues to increase -- and the percentage of women with Type 1 or Type 2 diabetes before pregnancy increased 37% (mostly from Type 2; the incidence is now increasing by about 5% a year).

Gestational diabetes. Gestational diabetes usually happens to women who have some (undetected) degree of insulin resistance before becoming pregnant -- perhaps they have prediabetes. Then the hormone fluctuations in pregnancy make it more severe, so they experience critically elevated blood glucose. Elevated blood pressure is another symptom.

It's important to be tested for gestational diabetes once you are pregnant so you can begin treatment to protect your baby's health -- and yours. Talk with your doctor about how early in the pregnancy you should be checked. Risk factors for developing gestational diabetes include a family history of diabetes, being overweight or sedentary, being age 35 or older, having polycystic ovarian syndrome and having elevated glucose levels before getting pregnant.

If you have gestational diabetes, your baby is at risk of:

n Being very large (9-plus pounds), which can make delivery more difficult and may require a C-section.

n Being born early, which can cause breathing and heart problems and developmental delays.

n Having low blood sugar.

n Developing Type 2 diabetes at an early age.

Your best move: Take steps to prevent gestational diabetes by losing weight before pregnancy and getting regular physical activity 30 to 60 minutes most days both before and during pregnancy. If you do all that and your glucose levels are still high while you are pregnant, insulin or metformin (an oral diabetes medication) may be suggested.

Post pregnancy: Your blood sugar levels may return to normal after your baby is born, but about 50% of women who have gestational diabetes subsequently develop Type 2 diabetes. You can lower your risk by reaching a healthy body weight, getting daily exercise and managing your stress response after delivery. Also, have your blood sugar tested six to 12 weeks after you give birth and then every one to three years to make sure your glucose levels are OK.

Pregestational diabetes. Becoming pregnant when you have full-blown Type 2 diabetes can cause trouble for you and your fetus. It increases your risk of having a stillbirth, preterm birth or giving birth to a child with birth defects, such as heart problems or defects of the brain, spine, kidney and gastrointestinal tract, or malformation of arms and legs. It also ups your child's risk for obesity and diabetes.

Preconception care can put your diabetes (both Type 1 and 2) into lockdown, if you adopt:

n A plant-based diet and eliminate red and processed meats, foods with added sugars and syrups, and highly processed foods.

n Achieve a healthy weight and a waist circumference less than 34 inches.

n Consistently do moderate-intensity aerobic exercise and strength training.

n Identify and treat other health problems, such as high blood pressure or chronic stress.

n In addition, monitor your blood sugar at home regularly, take diabetes medications as recommended with a goal of A1C of 6.4% or lower.

Before you become pregnant, if you make sure your health is as good as possible, you will be able to slash your risk of gestational diabetes, to tightly control or even reverse Type 2 diabetes, and stabilize your Type 1 diabetes. Then you and your child will be able to enjoy a longer, healthier life together.

Mehmet Oz, M.D. is host of "The Dr. Oz Show," and Mike Roizen, M.D. is Chief Wellness Officer Emeritus at Cleveland Clinic. To live your healthiest, tune into "The Dr. Oz Show" or visit sharecare.com.

(c)2021 Michael Roizen, M.D.

and Mehmet Oz, M.D.

King Features Syndicate

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