Special Situations

Special Situations

Surgery

To plan a safe and successful surgery, the surgeon and attending physicians must know that the person they're treating has diabetes. While tests done before surgery can detect diabetes, the patient should inform the doctor of his or her condition. A surgical team also will evaluate the possible effect of complications of diabetes, such as heart or kidney problems.

Pregnancy

Bearing a child places extra demands on a woman's body. Diabetes makes it more difficult for her body to adjust to these demands and it can cause problems for both mother and baby. Some woman may develop a form of diabetes during pregnancy called gestational diabetes. Gestational diabetes develops most frequently in the middle and later months of pregnancy, after the time of greatest risk for birth defects. Although this kind of diabetes often disappears after the baby's birth, treatment is necessary during pregnancy to make sure the diabetes doesn't harm the mother or fetus.

A woman who knows she has diabetes should keep her condition under control before she becomes pregnant, so that her diabetes won't increase the risk of birth defects. A woman whose diabetes isn't well controlled may have an unusually large baby. Diabetes also increases the risk of premature birth and problems in the baby, such as breathing difficulties, low blood sugar and occasionally, death.

Blood glucose monitoring and treatment with insulin can ensure that a baby born to a mother with diabetes will be healthy. Oral diabetes drugs aren't given during pregnancy because the effects of these drugs on the unborn baby aren't known. By following the advice of a doctor trained to treat gestational diabetes, the mother can make sure her blood glucose is normal and her baby is well nourished.

Approximately half of women with gestational diabetes will no longer have abnormal blood glucose tests shortly after giving birth. However, many women with gestational diabetes will develop noninsulin-dependent diabetes later in their lives. Regular check-ups can ensure that if a woman does develop diabetes later, it will be diagnosed and treated early.

Is Diabetes Hereditary?

Scientists estimate that the child of a parent with noninsulin-dependent diabetes has approximately a 10 to 15 percent chance of developing noninsulin-dependent diabetes. If both parents have diabetes, the child's risk of having the disease increases. The child's health habits throughout his or her life will affect the risk of developing diabetes. Obesity, for example, may increase the risk of diabetes or cause it to occur earlier in life.

Noninsulin-dependent diabetes in a parent has no effect on the chances that his or her child will have insulin-dependent diabetes, the more severe form of diabetes.

Stress and Illness

One way the body responds to stress is to increase the level of blood glucose. In a person with diabetes, stress may increase the need for treatment to lower blood glucose levels. Illnesses such as colds and flu are forms of physical stress that a doctor can treat. The doctor will advise the person to drink plenty of fluids. When blood glucose is high, the body gets rid of glucose through urine, and this fluid needs to be replaced.

If nausea makes eating or taking oral diabetes drugs a problem, a doctor should be consulted. Not eating can increase the risk of low blood glucose, while stopping oral medications or insulin during illness can lead to very high blood glucose. A doctor may prescribe insulin temporarily for someone with diabetes who can't take medicine by mouth.

Great thirst, rapid weight loss, high fever, or very high urine or blood glucose are signs that blood sugar is out of control. If a person has these symptoms, a doctor should be called immediately.

Like illness, stress that results from losses or conflicts at home or on the job can affect diabetes control. Urine and blood glucose checks can be clues to the effects of stress. If someone finds that stress is making diabetes control difficult, a doctor can advise treatment and suggest sources of help.