Why diabetic women should visit their doctors at least six months before planning a pregnancy – The Indian Express

The human body has a sophisticated mechanism with complex relationships among all its parts. The failure of one mechanism to function properly might also result in the malfunction of another. In a similar vein, diabetes — a metabolic condition — can also have an impact on both male and female fertility, said Dr Kshitiz Murdia, CEO and co-founder, Indira IVF.
For the unversed, diabetes is an endocrine disorder where the body struggles to keep blood sugar levels in the normal range. “People with diabetes are often asked to monitor their blood sugar levels closely. They are fully aware of the potential negative consequences that diabetes could have on their blood vessels, nerves, and kidneys,” Dr Murdia told indianexpress.com.
But how does the condition affect pregnancy?
Planned vs unplanned pregnancy
If a woman has diabetes, she should visit her doctor as early as possible. “It should ideally be at least six months before they decide to start trying for conception. One will receive advice and direction on how to closely regulate their blood sugar levels. They also need to include certain required nutrients in their food chart, and supplements such as folate. The doctors may also suggest changes in their drug prescription,” Dr Murdia told indianexpress.com.
Pregnancy cannot always be planned. In cases of unplanned pregnancy, where the patients have diabetes, one should consult their doctor as soon as they suspect for proper guidance and care. “The blood sugar levels must be kept steady, for the mother’s and that of the unborn child’s health,” Dr Murdia said.
The link between fertility and diabetes
Fertility can be impacted by uncontrolled diabetes, thus impacting the likelihood of becoming pregnant. All pregnancies include some risk, but the danger is increased for the mother and the baby in case of type 1 or type 2 diabetes.
Diabetes can induce irregular or absent menstrual cycles in women. “It may also raise the possibility of stillbirth, miscarriage, C-sections, and the requirement for critical care for the newborn. In men, it can affect testosterone levels and interfere with erection maintenance,” mentioned Dr Murdia, adding that although one can’t totally eliminate some problems, there are several things one can do to lessen them.
Tips to plan pregnancy
“The patient should try to get their HbA1C to the recommended level. The haemoglobin A1c (HbA1c) test calculates how much glucose (blood sugar) is bound to haemoglobin. It is a crucial blood test providing assessment of how effectively diabetes is being managed,” Dr Murdia said.
Secondly, the first eight weeks of pregnancy are particularly crucial for the development of the unborn child. “So, it’s critical to keep their blood sugar under control before getting pregnant. Testing their levels before and after meals is part of this. One’s doctor may advise on their blood glucose goals and how to maintain them while being pregnant,” the expert said.
Consumption of folic acid is another important thing. If ingested before and during early pregnancy, folic acid can prevent up to 70 per cent of significant brain and spine birth abnormalities known as neural tube defects (NTDs). One runs an increased risk of having children with these diseases if they have diabetes, and thus should consume folic acid at regular intervals as advised by their doctors.
Other than these, lifestyle changes like ensuring proper nutrition, staying active, being in healthy weight, quitting habits like alcohol consumption and smoking goes a long way in ensuring a healthy pregnancy.
While trying to inculcate these healthy diabetes management strategies, it can take some time for the patient to get acclimated to them. Sometimes even after adopting all measures there maybe situations where a couple is still dealing with infertility issues. When the natural course of action is unsuccessful, fertility treatments become crucial. With the help of advance technology, there are methods like in-vitro fertilisation (IVF) in Assisted Reproductive Technology (ART) that makes the dream of parenthood successful for many couples.
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