Diabetes and pre-eclampsia
Affecting about 5% of pregnancies, pre-eclampsia is the medical term for abnormally high blood pressure which generally occurs in the second half of pregnancy.
The diagnosis is normally made after two documented blood pressure readings (at least 4 hours apart) of 140 over 90.
Women with pre-eclampsia may also show excess protein in their urine or decreased levels of platelets in their blood. A more detailed list of symptoms is in a previous blog post here
The condition causes health complications in both the mother and will not actually stop until the baby is delivered. This will normally happen through induction of labour at 37 or 38 weeks.
During pregnancy treatment to manage the condition includes:
- Medication to lower your blood pressure
- Anti-convulsant medication if you are fitting due to severe pre-eclampsia
Depending on the severity of the pre-eclampsia you will be closely monitored either daily at home or in hospital where you will have:
- regular blood pressure checks
- regular urine samples
- various blood tests
- ultrasound scans and
- electronic monitoring of the baby's heart rate
Diabetes and the increased risk of pre-eclampsia
Diabetes and pre-eclampsia are linked because higher levels of glucose in the blood can contribute to high blood pressure. It is believed that this consequently causes problematic changes to the way in which blood passes through the placenta.
This means that if you have diabetes, you are at twice the risk of developing pre-eclampsia. This applies to women with either type 1 or 2 diabetes before pregnancy as well as those developing diabetes during pregnancy (gestational diabetes).
Additionally having high blood pressure or kidney disease increases the risk. In fact, women with diabetic nephropathy (kidney disease) have quadruple the risk of developing pre-eclampsia.
Managing Gestational Diabetes
Women entering pregnancy with diagnosed diabetes will be familiar with the healthy lifestyle practices they should be following, but those who are found to have gestational diabetes (GD) should commit to making considerable changes including
- Following a healthier diet
There is a very helpful article about this here. This being the case it is important to eat in a healthy way during pregnancy in an effort to avoid contracting gestational diabetes (GD)
- Exercising regularly
- Frequent monitoring of blood glucose levels
- Possibly taking metformin or insulin therapy
Women who are diagnosed with GD should also be tested for diabetes 6-12 weeks after the baby is born and then every 12-36 months. Most will probably find that the condition disappears soon after they have delivered the baby.
However, some will continue to have diabetes or be at greater risk of developing it later - so a healthy lifestyle should be followed to delay or prevent its subsequent onset.
Future health effects of pre-eclampsia
In 2011 the American Heart Association listed both pre-eclampsia and gestational diabetes as risk factors for the future development of cardiovascular disease (CVD)
In 2016 European guidelines advised the monitoring of women with these health conditions in order to prevent the onset of CVD. This included advice about adopting a healthier lifestyle.
Unfortunately, many women are unaware of the relationship between pre-eclampsia/gestational diabetes and cardiovascular disease and those that do struggle with eating healthily and doing exercise when they are additionally coping with the demands of a new baby
There is some useful guidance from the NHS about this
I hope this has been helpful.
Although every effort is made to ensure that all health advice on this website is accurate and up to date it is for information purposes and should not replace a visit to your doctor or health care professional.
As the advice is general in nature rather than specific to individuals Dr Vanderpump cannot accept any liability for actions arising from its use nor can he be held responsible for the content of any pages referenced by an external link
