Diabetes in children is increasingly threatening. WHO and the Ministry of Health stated that prevention efforts begin during pregnancy.
Child diabetes cases in Indonesia continue to increase and have become a serious threat to public health. The Indonesian Pediatrician Association (IDAI) stated that in January 2023, the number of cases of childhood diabetes will increase seventy times compared to the 2010 period. There has been a lot of research calling for limiting the amount of sugar intake per day in children.
The World Health Organization (WHO) has long emphasized the importance of physical activity in children and is wary of the hidden sugar content in sweetened foods and drinks. However, the escalation in the number of cases has not encouraged a newer approach to preventing childhood diabetes, namely preventive efforts from the time of the mother’s pregnancy. The Ministry of Health and public health professionals need to immediately consider preventing diabetes in children from the womb.
Impact of High Blood Sugar Levels During Pregnancy
A study in 2019 stated that pregnant women with high blood sugar levels have health risks for themselves and their babies. The International Association of Diabetes and Pregnancy Study Groups (IADPSG) determines that a pregnant woman’s blood sugar level is in the high category when her fasting sugar is 92 mg/dl, or one hour after being given glucose fluid in an oral glucose tolerance test (OGTT) reaches 180 mg/dl, or two hours after OGTT the figure is 153mg/dl.
The impact of high blood sugar levels can occur in the short term or long term. Short-term impacts on mothers include complicating the birthing process due to large babies and increasing the risk of labor caesar and preeclampsia. Meanwhile, the long-term negative effect is that the mother is seven times more likely to develop type 2 diabetes in the future.
In babies, the short-term effects that occur can include: stillbirth (stillbirth), premature birth, or hypoglycemia (low blood sugar) at birth. Apart from that, the long-term impact is that babies born will be more likely to become obese at childhood and are at greater risk of developing diabetes.
Pregnancy illustration. Shutterstock
Therefore, managing the mother’s blood sugar levels during pregnancy is a small thing but has a big impact on the child’s future. If pregnant women’s high blood sugar levels can be managed well, the risk of their child developing diabetes can be minimized.
During pregnancy, the mother’s body uses insulin less effectively (insulin resistance) which causes blood sugar levels to rise. This condition is called gestational diabetes.
Usually people think that this is a normal change that will disappear when the baby is born or what is usually called “baby congenital”. Even though some of these conditions disappear after delivery, some also persist.
According to research in 2015, the condition of pregnant women with high blood sugar levels can be treated in several ways. First, lifestyle modifications that can be made include changes in diet, weight management during pregnancy, and physical activity.
A pregnant woman with high blood sugar levels needs to get information and knowledge about managing their food. Health workers should not just give general advice to simply reduce rice and sugar, as we often hear. However, specific information is also needed that explains the type and amount of food that pregnant women should consume.
Second, the right food choices will determine the success of the mother’s healthy diet. Nutritious foods, such as vegetables, whole grains, and protein, are very important for mothers. Foods that are high in sugar and simple carbohydrates should be avoided. Consumption of fruit needs to be considered because some fruit contains high levels of natural sugar.
The things mentioned above help mothers manage their weight during pregnancy. Changing your diet is an easy and difficult thing. A person’s eating pattern is a habit that has been formed over a long period of time which is usually difficult to modify. Therefore, pregnant women need to get support from family and health workers to change their diet.
Pregnancy illustration. Shutterstock
Benefits of Regular Exercise and Medication
Apart from changing diet, pregnant women with high blood sugar levels need to do regular physical activity. Light exercise such as walking in the morning can help prevent spikes in blood sugar levels.
Unfortunately, we rarely see pregnant women doing physical activity. Pregnancy is often seen as a vulnerable period because pregnant women are considered to be in a “weak” condition. So, pregnant women are advised to rest and not do anything “physical” for the safety of mother and baby. In fact, on paper, more than 50 percent of pregnant women with gestational diabetes can be managed with lifestyle modifications.
If the methods above are unsuccessful in reducing the mother’s blood sugar levels to the desired level, another route that can be taken is to use medication. A study reported that oral medication to lower blood sugar levels was proven safe for pregnant women. However, this is still a matter of debate.
Another option that can be taken is insulin therapy. This method is believed to be safe and effective for managing blood sugar levels during pregnancy. If the condition of high blood sugar levels in pregnancy is handled properly, mother and baby can gain health benefits. Mothers can avoid various pregnancy complications and reduce the risk of developing diabetes in the future.
As for babies, managing their mother’s blood sugar levels can help reduce the risk of obesity and diabetes in childhood. This step is an “investment” offer for the health of Indonesian mothers and children.
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This article was written by Ririn Wulandari, doctoral student at the School of Healthcare, University of Leeds. First published in The Conversation.
2023-11-19 20:29:50
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