Patient's question:
Polydipsia, polyphagia, polyuria, weight remains normal. Type 1 diabetes diagnosed at 18, father has diabetesDoctor's answer:
I consulted my internal medicine book: Whether it is gestational diabetes or diabetes already present before pregnancy, pregnancy has complex mutual effects on diabetes, as well as diabetes on the pregnant woman and fetus. The fetus relies on maternal glucose for energy, causing the pregnant woman's fasting blood glucose to be lower than pre-pregnancy levels, while free fatty acid and ketone concentration increases. The placental insulin enzyme increases insulin degradation, and placental prolactin and estrogen can counteract the effects of insulin, reducing the patient's sensitivity to insulin. This condition is particularly pronounced in the second and third trimesters, increasing the insulin requirement. After delivery, insulin sensitivity returns to normal, and the insulin requirement decreases sharply. It is important to adjust the dosage promptly to avoid hypoglycemia. Pregnant women with diabetes are prone to urinary tract infections, polyhydramnios, and eclampsia, and may even develop ketoacidosis. Additionally, the incidence and mortality rates of fetal malformations, miscarriage, stillbirth, macrosomia, neonatal hypoglycemia, and respiratory distress syndrome are significantly higher, adversely affecting the pregnant woman and fetus. The severity of diabetes in pregnancy is more pronounced in younger women, those with longer disease duration, or those with existing vascular complications. Therefore, based on the severity of your diabetes, if it is particularly severe, it is advisable not to get pregnant.