Legs: at this level, damage in the nerve condition diabetic neuropathy, which is responsible for severe pain in the extremities and the risk of amputations by infection or gangrene. The heart: People with diabetes are more prone to heart attacks, which in turn are associated with high levels of cholesterol, and high blood pressure, ischemic heart disease is called this. The brain: in this body, diabetes is responsible for the development of cerebral infarcts (strokes) or bleeding. Impact on pregnancy. Patients with this disease should have pre-conception health screening and pregnancy should ideally be planned to avoid the risk of complications from the first trimester secondary to hyperglycemia, as they are: threats of abortion, miscarriage or birth defects. This is accomplished by keeping a good control of blood glucose that mean less than 105 mg in fasting fasting levels and less than 120 mg 2 hrs. After food (postprandial), as well as glycated hemoglobin (HbA1c) levels below 7%.
In our hospital we have found that the chronicity of the disease in these patients ranges from 4 to 20 years and a greater evolution time the presence of chronic complications is greater. This is important for the prognosis maternal since both retinopathy and nephropathy risk exacerbating during gestation. Metabolic control during pregnancy is irregular with decrease in insulin requirements and tendency to hypoglycemia in the first 12 weeks of gestation, with moderate and severe uncontrolled peaks to the 16 and 28 weeks respectively, to once again present tendency to hypoglycemia at the end of the pregnancy. Arterial hypertension of variable intensity, either preview or the detected during pregnancy (Preeclampsia) is present in 60% of cases and severe nephropathy defined as one creatinine greater than 1.5 mg/dl associated with difficult to control hypertension confers high risk of fetal loss (miscarriages or deaths (intrauterine fetal death) between the second and third quarters.