Can people who suffer diabetes get married or pregnant?

      No matter what type of diabetes the patients have, as long as they cooperate well in the three aspects of diet, medication and exercise, diabetes would be controlled at a satisfactory level for a long time, and those who have not suffered serious complications can get married. Lawfully speaking, people who suffer Diabetes are not prohibited to marriage. However, when finding a partner, people are prone to find someone who does not have diabetes or a family history of diabetes, because diabetes has a genetic predisposition. After marriage, as long as you insist on strengthening self-management under the guidance of a doctor. The regularity of life and the use of medication in accordance with the doctor's advice can make diabetes control reach the standard, and also make family life as happy as a normal person.

     After marriage, diabetic patients have been well controlled. Those who have no heart, brain, eyes, kidney organs and other serious complications can become pregnant. However, you should choose to strictly control blood sugar and keep it at a normal level as much as possible to conceive, which is beneficial to the growth and development of the fetus. Especially the first 3 months of pregnancy is very important, because only in the environment of normal blood sugar concentration can fertilization be guaranteed. The eggs grow and develop normally. Attention should be paid to observe and prevent the occurrence of fetal malformations and miscarriage, premature delivery, intrauterine death, and giant fetuses. If a diabetic woman has been diagnosed with pregnancy, a systematic obstetric examination must be performed. Care must be taken for those who have high blood pressure, normal heart, brain, kidney function and fundus, or minor lesions. The pregnancy can be continued under close observation of obstetrics and experienced specialists. If diabetes is controlled and stable during pregnancy, promptly treat obstetrics Complications, you can give birth smoothly. If diabetes worsens during pregnancy, the pregnancy should be terminated.

What effect does pregnancy have on diabetes?

I.  No diabetes may appear before

(1) Gestational diabetes: During pregnancy, the placenta secretes a large amount of estrogen, progesterone, placental prolactin, etc. These hormones all have the effect of resisting insulin. Therefore, during pregnancy, more insulin must be secreted by the pancreatic β cells to maintain the body Blood sugar is normal. For women with low pancreatic islet reserve, abnormal glucose metabolism (including impaired glucose tolerance and even diabetes) will occur during pregnancy, which is called gestational diabetes.

(2) Renal diabetes: The renal blood flow increases during pregnancy and the glomerular filtration rate increases, so the glomerular filtration of glucose and other nutrients increases. When the renal tubule's ability to absorb glucose is exceeded, the glucose Excreted in the urine, diabetes occurs, and blood sugar is normal at this time, which is called renal diabetes.

II.  Changes in the condition of original diabetes

(1) Diabetes during pregnancy is not only serious, but also often complicated: because the fetus uses glucose and vomiting during pregnancy, hypoglycemia is prone to occur in the first 20 weeks of pregnancy. Hypoglycemia during pregnancy can increase fetal mortality by 4 times. In addition, as mentioned earlier, the placenta secretes a large amount of estrogen, progesterone, and placental prolactin during pregnancy. These hormones all have the effect of resisting insulin, making the relative secretion of insulin even more insufficient, so blood sugar is increased. Placental prolactin also breaks down fat, so pregnant women with diabetes are prone to ketoacidosis.

(2) The blood glucose of pregnant women during childbirth fluctuates greatly: during childbirth, due to uterine contractions, breath-holding, and other actions, a large amount of glycogen needs to be consumed to supply energy, while women usually eat less during this period, which can reduce blood sugar. Excessive emotional tension in the labor period causes blood sugar to rise. Therefore, the blood sugar of pregnant women during labor fluctuates greatly. If the sugar cannot be supplied in time and insulin is used reasonably, it is easy to develop into ketoacidosis.

(3) After childbirth, due to the discharge of the placenta and the recovery of maternal hormones, the blood insulin-resistant hormones are significantly reduced. At this time, if you neglect to lower the insulin dose, it is easy to cause hypoglycemia, and attention should be paid. Generally, the amount of insulin on the second day after delivery can be reduced to 1/3-1/2 of the amount used during pregnancy.

What effect does diabetes have on pregnancy, fetuses, and newborns?

Diabetes has a great influence on pregnancy. In addition to the low pregnancy rate, there are also many maternal and infant complications. The fetal and infant mortality rate is far greater than that of non-diabetic patients, as follows.

I.  Impact on pregnant women

Elevated blood sugar and disorder of glucose metabolism caused by diabetes can cause many complications, such as vascular disease, neuropathy, and weakened immunity. The specific effects of diabetes on pregnancy and parturient are as follows.

(1) Low pregnancy rate: Patients with severe diabetes have 2/3 irregular menstruation and are less likely to become pregnant due to affected gonadal function.

(2) High abortion rate: mainly due to the imbalance of female hormone ratio.

(3) The incidence of pregnancy-induced hypertension is high: generally 3-4 times that of normal pregnant women, mainly due to damage to small blood vessel endothelial cells, narrowing of the official cavity, and increased vascular resistance.

(4) Polyhydramnios: The high sugar content in the amniotic fluid of the patient stimulates the secretion of the amniotic membrane to increase, resulting in polyhydramnios, which will increase the burden on the heart and lungs of pregnant women, thereby increasing the incidence of cardiopulmonary dysfunction in pregnant women. And too much amniotic fluid can cause premature rupture of membranes and premature delivery.

(5) Urinary tract infection: Positive urine glucose is conducive to the propagation of pathogenic bacteria in the urinary tract, so urinary tract infection is prone to occur. At the same time, diabetic patients tend to produce urinary tract sepsis due to their decreased white blood cell phagocytosis and bactericidal function.

(6) Delayed labor and postpartum hemorrhage: Because the body's glycogen reserves are reduced and energy is less, although there is high blood sugar but lack of insulin and cannot be used, it leads to poor uterine contractility and causes delayed labor or postpartum hemorrhage.

(7) The perinatal mortality rate of pregnant women is relatively high: due to factors such as pregnancy-induced hypertension, cardiopulmonary dysfunction, hemorrhage, infection, etc., the perinatal mortality rate of pregnant women has increased.

(8) Ketoacidosis: Metabolic disorders during pregnancy are more complicated. In addition, insulin is absolutely or relatively insufficient. If it is not adjusted in time, it will aggravate metabolic disorders, which will accelerate lipid metabolism, produce a large number of ketones, and cause acidosis. Decreased blood sugar in the early and second trimesters without reducing insulin or too strict dietary restrictions during pregnancy can cause starvation ketosis.

II.  Impact on the fetus and newborns

(1) The high rate of fetal malformations: due to the metabolic disorders and hypoxia of pregnant women, especially the poor blood glucose control in the first 7 weeks of pregnancy, there may be many malformations.

(2) Increase in perinatal mortality: Diabetes leads to placental dysfunction and reduced oxygen supply. After 36 weeks of gestation, the fetus's oxygen demand increases, so perinatal mortality increases.

(3) Increasing incidence of macrosomia: macrosomia (referring to fetuses weighing more than 4000g) can hinder delivery, increase the dystocia rate, and increase the mortality of fetuses and pregnant women.

(4) Increased preterm birth rate: The causes of preterm birth are polyhydramnios, fetal distress, high blood pressure during pregnancy, or other serious complications, and the pregnancy needs to be terminated early.

(5) Increasing incidence of fetal growth restriction: Severe diabetes can cause vascular disease, which can reduce the blood supply to the placenta in pregnant women, leading to fetal malnutrition and growth restriction.

(6) Newborns are prone to respiratory distress syndrome: most of the newborns with poor blood sugar control and diabetes have poor lung development, and there are fewer alveolar surfactants, which can make the newborns have difficulty breathing, respiratory failure and death.

(7) Neonatal hypoglycemia: the higher the mother's blood sugar, the higher the incidence of neonatal hypoglycemia.

(8) Newborns are prone to hyperbilirubinemia, polycythemia, hypocalcemia, hypomagnesemia, and hyperphosphate.

Because diabetes has a great influence on pregnancy, the time of conception should be when blood sugar control is good. Close monitoring should be done after pregnancy to strictly control blood glucose levels to prevent excessive or low blood glucose levels to reduce complications and mortality of mothers and infants.

Under what circumstances should pregnant women be cautious about diabetes?

Pregnant women are prone to diabetes when they have the following conditions, so oral glucose tolerance test should be done for early diagnosis and treatment, so as not to delay the condition.

(1) Aged over 30.

(2) Body mass index before pregnancy; more than 24kg/㎡.

(3) There is a family history of diabetes and a history of abnormal glucose tolerance.

(4) History of unexplained stillbirth, stillbirth, or miscarriage, history of huge babies, especially history of shoulder dystocia, history of fetal malformation or polyhydramnios, history of preeclampsia in the past, history of gestational diabetes in previous pregnancy.

(5) The fetus is found to be too large and excessive amniotic fluid during pregnancy.

(6) Itching of the vulva and repeated Candida infections.

(7) Urine glucose appears in the first trimester.

High-risk pregnant women should undergo a glucose tolerance test (OGTT) at the first antenatal check-up, and the remaining pregnant women should undergo an oral glucose tolerance test for 24-28 weeks.

What is the cause of gestational diabetes?

The cause of gestational diabetes is unknown. It is considered to be related to the following factors.

(1) Insulin resistance: In the middle and late stages of pregnancy, due to changes in hormones in the body, pregnant women's sensitivity to insulin gradually decreases, and different degrees of insulin resistance appear, prone to gestational diabetes or aggravation of the original diabetes.

(2) Genetic factors: People with family history of diabetes, family history of gestational diabetes or previous gestational diabetes are more likely to develop gestational diabetes.

(3) Adipocyte factors: Studies have found that certain factors secreted by adipocytes are related to the occurrence of gestational diabetes. In the plasma of patients with gestational diabetes, the concentration of adiponectin was significantly reduced, and the concentration of resistin was significantly increased.

(4) Inflammatory factors: Studies have shown that C-reactive protein, tumor necrosis factor, and interleukin-6 may be involved in the occurrence of gestational diabetes.