It was around the year of 1552 B.C., when diabetes was first discovered. An Egyptian physician named Hesy-Ra had noted a very mysterious disease that had caused abnormal symptoms such as frequently urinating and making people abnormally thin or weak. Ants seemed to be lured to the people’s urine with the mysterious disease as well. In addition, a Greek physicist named Arateus had called this unknown disease which is now diabetes, “the melting down of flesh and limbs into urine” (Everyday Health). There was a very uncanny way that they were able to diagnose diabetes, with people who were known to be “water tasters” which were the ones that had tasted the urine of people who were suspected to be diagnosed with the disease. People who had a sweet taste in their urine were diagnosed with diabetes. In the 1800s scientists were finally able to use chemical tests to find sugar in people’s urine.
“Diabetes is a serious disease in which your body cannot properly control the amount of sugar in your blood because it does not have enough insulin” (APA). Type one and type two diabetes are the only types. Type 1 is where the body cannot provide any insulin, while with type 2 diabetes, your body can provide an efficient amount of insulin but the body is unable to use it effectively. This research essay will be focused on type 1 diabetes. Type 1 diabetes is an autoimmune disease, which is “caused by antibodies or lymphocytes produced against substances naturally present in the body” (APA). What happens, is that the body mistakes healthy cells as a marauder. The immune system in the body then begins to destroy specific beta cells that provide insulin in the pancreas. So when these cells are demolished, the body is unable to produce insulin.
The pancreas is able to adjust to the quantity of insulin in the body depending on the level of blood sugar. Some symptoms of diabetes include dehydration, periodic micturation, hungriness, tiredness, and unfocused sight. Both high and low blood pressures are just some of the many risk factors of diabetes. Some causes of high blood sugar include, “Not getting enough insulin, eating more food than usual, stress and being ill or having an infection, taking medicines that can raise blood sugar levels, the dawn phenomenon or the Somogyi effect, which can cause early-morning high blood sugar, adolescence, because of hormone changes and rapid growth, and pregnancy” (Web MD). The causes of low blood sugar are “taking too much insulin, skipping or delaying a meal or snack, exercising more than usual without eating enough food, drinking too much alcohol, especially on an empty stomach, taking medicines that can lower blood sugar, such as large amounts of aspirin and medicines for mental disorders, and starting your menstrual period, because hormonal changes may affect how well insulin works” (Web MD).
There are various symptoms and risk factors that contribute in reguard to the disease of type 1 diabetes. These symptoms can affect the body in three distinct ways: it can harm your arteries, heart as well as the brain. Your arteries will be damaged and become narrow, and can also lead to aneurysms. It will damage the arteries’ inner lining and aneurysms can cause internal bleeding, which is life-threatening. It can damage your heart with things like coronary artery disease, enlarged left heart, and heart failure. Coronary artery disease can affect your arteries that give blood to your heart muscle and an enlarged left heart can cause the left ventricle to condense, which is very life-threatening. Your brain can be damaged by Transient Ischemic Attack (TIA), strokes, and dementia. A TIA is like a mini heart attack which causes an interim disturbance of blood stock to your brain and strokes are when your brain is deprived from oxygen and nutrients. There are various symptoms and risk factors that contribute towards type 1 diabetes.
During pregnancy, this disease can be very dangerous to where there is a percentage of 3.3% of all live births in which diabetes is the most complicated medical complication. Pregnant women can also develop Gestational diabetes that can affect pregnant women with symptoms of high blood sugar. With type 1 diabetes, women have to be more prepared for the risks that come along during their pregnancies. Some risks during pregnancy include: preeclampsia, developing insulin resistance, worsening of diabetes complications, difficulty delivering, premature delivery, miscarriage, macrosomia, birth defects, jaundice, and hypoglycemia.
Preeclampsia is when there is high blood pressure while sometimes there is protein in the urine. Women can develop insulin resistance when “hormones can cause increased insulin secretion and decreased glucose produced by the liver, which can lead to hypoglycemia” (Beyond Type 1). Macrosomia is when babies are born larger due to women with diabetes. When having diabetes while pregnant, it can cause a birth defect where a liver condition named Jaundice causes a yellow-like blotch on the skin and eyes. Last but not least, Hypoglycemia is when there is low blood sugar at birth. These risks are what women have to face during pregnancy and aren’t always preventable.
To go more into detail about Preeclampsia, it is a condition that is a very serious problem during birth. It is something that doctors must watch very carefully as elevated blood pressure could put the child and mother at risk. It could progress towards an early birth and could risk having a seizure during birth. According to Centers For Disease Control and Prevention, “Being born too early can result in problems for the baby, such as breathing problems, heart problems, bleeding into the brain, intestinal problems, and vision problems. Women with type 1 or type 2 diabetes are more likely to deliver early than women without diabetes”. Throughout the mother’s entire pregnancy, there are huge risks being taken. High blood pressure is one of those risks and women with type 1 diabetes most often have high blood pressure than women who do not have diabetes. There are many birth defects, the painful dealing of symptoms, and life-threatening risks that come along with the pregnancy of a diabetic mother.
In some cases, diabetes is unable to be controlled and the baby’s blood sugar can tend to become high. When babies end up developing larger than their normal size, it is because the baby is “overfed”. The baby can sometimes cause irritation towards the mother during the end of her pregnancy. A larger child can lead to various situations during the carriage and the birthgiver could possibly have to give birth by Cesarean Section (C-section) where the mother goes into surgery to deliver the baby through her stomach. If a child has a Vaginal Birth, “the baby can be born with nerve damage due to pressure on the shoulder during delivery” (Centers for Disease Control and Prevention).
Low blood sugar is another serious problem women face during pregnancy as it can become very fatal if it is not treated quick enough. It is able to steered clear if they watch their sugar and are able to care for it in advance: “If a woman’s diabetes was not well controlled during pregnancy, her baby can very quickly develop low blood sugar after birth (Centers for Disease Control and Prevention). After birth, a baby’s sugar level is watched because a baby can have dangerously low blood sugar just after they are born. Miscarriages and stillbirths can also happen during the pregnancies of women with diabetes. Web MD states, “ A miscarriage is a loss of the pregnancy before 20 weeks. Stillbirth means that after 20 weeks, the baby dies in the womb”. Miscarriages and stillbirths happen very frequently during pregnancies and women with diabetes that cannot be managed have are more at risk of getting one of the two.
Type 1 diabetes is very common in the United States. According to many authors in the journal named, “Prevalence and Incidence of Type 1 Diabetes Among Children and Adults in the U.S..”, they quote “Using data collected by the National Health and Nutrition Examination Surveys in 1999–2010, the estimated overall prevalence of type 1 diabetes, defined as being on insulin since diagnosis, current insulin use, and age of onset <30 or <40 years, was 2.6 per 1,000 and 3.4 per 1,000, respectively, corresponding to 740,000 to 970,000 people of the U.S. civilian, noninstitutionalized population”. There is a high rate of insulin use in the United States, not even including other countries or regions of the world.
“The number of pregnancies complicated by diabetes increased significantly, by 44% in type 1 diabetes and 90% in type 2 diabetes, across the 15 years examined, to rates of 1 in 210 and 1 in 504 deliveries, respectively” (SpringerLink). Diabetes has started to increase and the rates were also going up as well. Since the percentages of early births had also gone up, it had become higher with women who had diabetes. As mentioned before, women with diabetes would sometimes have to go through a c-section to give birth. Springerlink explains how the rates of c-section childbirth with diabetic women was, “ Proportions of elective Caesarean sections (29.4% type 1 diabetes, 30.5% type 2 diabetes, 9.6% without diabetes) and emergency Caesarean sections (38.3% type 1 diabetes, 29.1% type 2 diabetes, 14.6% without diabetes) were greatly increased in women with diabetes and increased over time except for stable rates of emergency Caesarean section in type 1 diabetes”. Women with diabetes has increased in intervention during pregnancy, with earlier deliveries and increasing amounts of Caesarean section rates.
Various risks had come along with pregnancies of diabetic women and the outcomes of people with type 1 diabetes were changing. “Type 1 and type 2 diabetes confer significant additional risks in pregnancy, with increased rates of stillbirth, perinatal mortality, macrosomia, prematurity and operative delivery” (SpringerLink). These rates had been going up and they have shown that pregnancies have become more and more complicated with diabetic mothers. The article also adds, “Results of several national surveys between 1990 and 2008, including previous paper-based national surveys in Scotland in 1998/1999 and 2003/2004 showed that, despite marked improvement before these years, rates of stillbirth and perinatal mortality among women with diabetes prior to pregnancy continued to be broadly 3–5 times than those of the non-diabetic population”. These are just some of the many incidence and trends discussing pregnancies of diabetic women.
There are various ways that patients can be diagnosed with diabetes. There is an A1C test that is able to measure the people’s level of glucose over an amount of time. It is also called a hemoglobin A1C, as the test shows the quantity of glucose which ends up sticking to the red blood cells. Another test is named the Fasting Plasma Glucose which checks the person’s glucose measures. For this test patients should consume nothing, except water for at least eight hours prior.
Additionally, another test is named the Random, which examines your blood at any period throughout the time if they are having any serious diabetic manifestation. “Diabetes is diagnosed at blood glucose of greater than or equal to 200 mg/dl” (American Diabetes Association). There is also a test named the Oral Glucose Tolerance Test that takes a while, that is able to check glucose levels two hours prior and following when you drink a sweet beverage. After drinking this, it is able to show the how your body is able to process glucose. These are some of the many tests that determine whether a patient has diabetes or not.
When diabetes was first introduced into society, there were various ways of treatment that had been advised to people diagnosed with diabetes. Back then physicians had prescribed specific and odd ways to treat their diabetes. “In the 1700s and 1800s, physicians began to realize that dietary changes could help manage diabetes, and they advised their patients to do things like eat only the fat and meat of animals or consume large amounts of sugar” (Everyday Health). Physicians back at that time were unaware of what these treatments could actually do to their patients and were unaware that they could worsen the health of their patients and their diabetes. But physicians also had prescribed them to also frequently exercise , including horseback riding, because they had believed that this type of treatment could relieve the excessive urination that their patients had experienced. Exercise and excessive eating was just one of the few treatments that patients had been prescribed to. Specific diets had been introduced to patients to improve the disease of theirs. A french physician named Apollinaire Bouchardat had stated that his patient’s, ones diagnosed with diabetes, health had bettered based on restrictions. He had created specific restrictions to treat his patients. Some of the diets were “oat cure”, “potato therapy”, and “starvation diets” (Everyday Health). Over time, effective treatments have improved the health of people with diabetes.
Prenatal care is very important, especially when the patient has type 1 diabetes. Checking your blood glucose is one of the treatments during pregnancy. The blood glucose level is affected because of the patient’s diabetes, which can also make symptoms of low levels of glucose also very difficult to notice. “Blood glucose targets are designed to help you minimize the risk of birth defects, miscarriage and help prevent your baby from getting too large” (American Diabetes Association). It should be made a few hours following each meal since it is when glucose levels begin to peak with people who have diabetes. Pregnancy with diabetes is very hard to control and blood glucose checks are strongly recommended. Blood glucose checks help take care of the woman and her baby throughout her pregnancy.
Insulin is also an effective treatment during pregnancy which settles the blood glucose control. “Insulin can be injected with a syringe, an insulin pen, or through an insulin pump” (American Diabetes Association). The drug does not harm the baby, but since women are carrying their baby their insulin intake must increase. During the last 3 months of their pregnancy, their insulin needs go up because of the hormones from the placenta. In order for the baby to grow the placenta makes hormones but these hormones start to keep the mother from getting the insulin that she needs. During the end of their pregnancy the mother’s insulin rates will increase.
During pregnancy, women must eat certain foods to avoid problems with their glucose levels. Meal plans allow the mothers to avoid high and low glucose levels and can help with providing the right nutrients to allow their babies to grow healthy. Some foods that should be eaten are things like “vegetables, whole grains, nonfat dairy products, fruits, beans, lean meats, poultry and fish” (American Diabetes Association). There is a false fallacy that pregnant women have to eat more since they are eating for two when in reality they do not need to. The only thing that women must do is increase their calorie intake by 300 calories more each day. Women’s meal plans play an important role during pregnancy and can easily affect their baby if it is not carefully watched over.
To conclude this report, pregnancies have been very successful with women who have type 1 diabetes throughout their lives.During women’s pregnancies blood sugars fluctuate and insulin levels are all over the place.But with management of these insulin levels, keeping your sugars at a moderate level, seeking treatment and managing everything else going on with the mother and the baby, it will allow women to have a less complicated pregnancy while carrying their baby for nine months.What makes the pregnancies of these women challenging is the fact that higher blood sugars increase the risks of having complications with birth defects, including having a higher chance of having the baby grow bigger than the normal size.All pregnancies are complicated and have various risks, but pregnant women with type 1 diabetes must pay closer attention to their blood sugar levels and soon they will have a happy and healthy baby.