Blood Sugar Spike During Labor

Gestational Diabetes

Home » About Diabetes » Pregnancy » Gestational Diabetes Gestational Diabetes Gestational diabetes is the type of diabetes that occurs during pregnancy. Like other forms od diabetes, gestational diabetes affects the way the body uses the glucose [sugar] in the blood and as a result the blood sugars rise too high. The glucose in the blood is the body’s main source of energy. If gestational diabetes is untreated or uncontrolled, it can result in a variety of health problems for both that mother and baby. So it is important that a treatment plan is worked out to keep blood sugars within the normal range. The good news is that controlling blood sugars can help to ensure a healthy pregnancy and a healthy baby. Signs and Symptoms Most women do not have any signs or symptoms of gestational diabetes but your healthcare professional will check for gestational diabetes as part of your prenatal care. When signs and symptoms do occur they include: Excessive thirst Increased urination. About 3 to 5% of all pregnant women develop gestational diabetes. The Causes of Gestational Diabetes Normal metabolism Normally during digestion the body breaks down the carbohydrates you eat into simple sugars [glucose] and this glucose is absorbed into the blood and transported around the body by the blood vessel system to provide the energy needed for all our activities. This process cannot take place without insulin. Insulin is produced in the pancreas, a gland behind the stomach, and helps the glucose to pass into the cells to provide energy and maintains normal levels of glucose in the blood. The liver also plays a part in maintaining normal blood glucose levels. When there is more glucose in the cells than your body needs for energy, it is removed from the blood and stored it in the liver Continue reading >>

Pregnancy With Diabetes

A Doable Challenge Women with Type 1 or Type 2 diabetes who are considering pregnancy have reason to feel optimistic. That’s because women with diabetes can and do experience healthy, uneventful pregnancies and give birth to perfectly healthy babies. That said, however, a pregnancy with preexisting diabetes is always considered high-risk, and its outcome is largely dependent on a woman’s efforts to keep her blood glucose levels as close to the normal range as possible for the entire duration of her pregnancy. The American Diabetes Association recommends blood glucose goals for pregnant women that are lower than those suggested for the general population: 60–99 mg/dl before meals and 100–129 mg/dl one hour after eating. Anyone with diabetes knows that staying in that range every day for nine months requires tremendous commitment, even when not pregnant. Achieving those goals while pregnancy hormones are wreaking havoc with your insulin needs and while your whole body is growing and changing is another thing altogether. Add morning sickness, exhaustion, swollen ankles, and normal pregnancy anticipation into the mix, and you have a full bag of stress triggers. So how does a pregnant woman with diabetes manage to keep herself and her baby healthy while also balancing her usual family, work, and other life responsibilities? This article offers strategies based on experiences from my own two pregnancies as well as those from other women with diabetes who have made the effort to do all that was in their power to bring healthy children into the world. (Note: This article focuses on women with existing Type 1 or 2 diabetes before pregnancy rather than women who develop gestational diabetes during pregnancy). Pregnancy preparation When I first mentioned wanting to have a Continue reading >>

Managing Diabetes During Labour

Your own blood glucose levels in the time leading up to the birth have an important effect on your baby’s blood glucose levels. The higher your blood glucose is, the higher the glucose supply will be to your baby before birth. The extra glucose stimulates the baby’s pancreas to make more insulin. At birth, your glucose supply to your baby suddenly stops, but your baby may continue to produce excess insulin for several hours and even up to one or two days after birth. This can cause hypoglycaemia in the baby. If you have blood glucose levels close to the recommended range during labour, this lowers the risk of your baby having low blood glucose levels at birth. When an induction or caesarean section is planned, your diabetes in pregnancy team will discuss with you a plan for managing your diabetes. This will include adjustment of your insulin doses/pump rates or changing the way insulin will be delivered. When you are in labour, your blood glucose levels will usually be monitored hourly and the amount of insulin you are being given will be adjusted to keep your blood glucose in the normal range. An intravenous (IV) insulin infusion and IV glucose (sugar) are often used throughout labour, which allow small amounts of insulin and glucose to run into your blood continuously. Alternatively, rapid-acting insulin injections every two to four hours may be used during labour to manage your blood glucose levels. If you use an insulin pump, you may be able to continue using it, but with changes to your basal rates and smaller bolus doses. This will only be the case if this can be managed safely at the hospital where you will deliver your baby and blood glucose levels can be kept within the target range. Continue reading >>

11 Everyday Things That Spike Blood Sugar

Thinkstock 11 Everyday Things That Spike Blood Sugar If you’re living with type 2 diabetes, your doctor has probably told you time and time again that maintaining control over your blood sugar is essential. “Controlling blood sugar is important for two main reasons,” says Lynn Grieger, a registered dietitian and certified diabetes educator in Prescott, Arizona. “On a day-to-day basis, people just feel better when their blood sugar stays in a healthy range. Over the long term, it’s the best thing you can do to prevent complications of diabetes from occurring.” Diabetes complications include nerve damage, kidney disease, skin conditions, eye damage, high blood pressure, stroke, and more, according to the American Diabetes Association (ADA). One of the main contributors to high blood sugar is a diet too rich in carbohydrates, which once digested turn into sugar (glucose). Certain high-carb foods (for example white bread, white-flour pasta, sugary drinks, and french fries) can send your blood sugar levels soaring. “Many people with diabetes also get into trouble with processed foods, which have added sugars they may not know about,” adds Gregory Dodell, MD, an endocrinologist in New York City. The good news is that by sticking to a diabetes-friendly diet, incorporating physical activity into your day, taking medications (if recommended by your doctor), and regularly measuring your blood sugar levels, you can gain better control over type 2 diabetes. There are some triggers of high blood sugar, however, that are out of your control and can even sneak up on you. If you have the flu, for example, or if you're menstruating, you may experience a sudden rise in blood sugar. Because of such triggers, it can be difficult to keep blood sugar under control even when y Continue reading >>

Pre-existing Diabetes And Pregnancy

If you have type 1 or type 2 diabetes and are planning a family, you should plan your pregnancy as much as possible. Controlling your blood sugars before conception and throughout pregnancy gives you the best chance of having a trouble-free pregnancy and birth and a healthy baby. If you have diabetes and your pregnancy is unplanned, there’s still plenty you can do to give your baby the best start in life. The information on this page is for women who have diabetes before becoming pregnant. If you develop diabetes during pregnancy, it is called gestational diabetes. Planned pregnancy Visit your doctor or diabetes educator at least 6 months before you start trying to fall pregnant, if you can. You will be given advice and guidance on controlling your blood sugars as tightly as possible, and taking necessary supplements like folate. You may also be advised to change medications. If you are healthy and your diabetes is well controlled when you become pregnant, you have a good a chance of having a normal pregnancy and birth. Diabetes that is not well controlled during pregnancy can affect your health long-term and can also be risky for your baby. Unplanned pregnancy Not everybody can plan their pregnancy. If you have diabetes and think you might be pregnant, see your doctor as soon as you can. Your healthcare team You may be cared for by a team of health professionals including: an obstetrician who can handle high risk pregnancies a specialist experienced in diabetes care during pregnancy, who may be an endocrinologist or who may be a general physician a diabetes educator to help you manage your diabetes a dietician who can provide dietary advice at all the different stages - before conception, while pregnant and after the birth a midwife who is experienced in all aspects Continue reading >>

What Might Go Wrong In The Third Trimester?

Weeks 28 through 40 bring the arrival of the third trimester. This exciting time is definitely the home stretch for expectant mothers, but it also presents a time where complications can occur. Just as each trimester can bring its own challenges, so can the third trimester. Prenatal care is especially important in the third trimester because the types of complications that can arise at this time are more easily managed if detected early. You’ll likely start visiting your obstetrician every other week from 28 to 36 weeks, then once per week until your little one arrives. According to the American Diabetes Association, as many as 9.2 percent of pregnant women have gestational diabetes. Gestational diabetes occurs because the hormonal changes of pregnancy make it more difficult for your body to effectively use insulin. When insulin cannot do its job of lowering blood sugar to normal levels, the result is abnormally high glucose (blood sugar) levels. Most women have no symptoms. While this condition is usually not dangerous for the mother, it poses several problems for the fetus. Specifically, macrosomia (excessive growth) of the fetus can increase the likelihood of cesarean delivery and the risk of birth injuries. When glucose levels are well-controlled, macrosomia is less likely. At the beginning of the third trimester (between weeks 24 and 28), all women should get tested for gestational diabetes. During the glucose tolerance test (also known as the screening glucose challenge test), you will consume a drink that contains a certain amount of glucose (sugar) and at a specified time later your doctor will test your blood sugar levels. For the oral glucose tolerance test, your blood sugar levels are checked after you have fasted for at least eight hours and you’ve drank Continue reading >>

Expecting The Best: Diabetes, Pregnancy, And Blood Glucose Control

by Laura Hieronymus, RN, MSEd, CDE and Patti Geil, MS, RD, LD, CDE Pregnancy can be a special and exciting time in a woman's life. The anticipation begins as soon as you hear the words: “You're expecting a baby.” Once you've gotten used to the amazing news, you may wonder about such things as whether the baby will be a boy or a girl, when the baby is due, and, perhaps most important, what you need to do in the meantime to make sure the baby stays healthy and develops normally. All women feel a certain amount of anxiety and sometimes even fear about how pregnancy will affect them, and whether their baby will be healthy and normal. Women with diabetes are no different, but they do have one more thing to be concerned about: maintaining control of blood glucose levels. This is true whether a woman has type 1 or type 2 diabetes before becoming pregnant, or whether she is diagnosed with a condition called gestational diabetes during pregnancy. The good news is that if a woman who has diabetes (of any type) learns as much as she can about managing her blood glucose, and puts that knowledge into practice, she can have a healthy pregnancy and a healthy baby. Blood glucose control essential Optimal blood glucose control is important throughout pregnancy, both for the mother's health and the baby's. Glucose in a mother's blood crosses the placenta to her baby, affecting the baby's blood glucose level. (The placenta, a flat circular organ, links the unborn baby to the mother's uterus, to provide oxygen, nutrients, and the elimination of wastes.) The baby begins making its own insulin around 13 weeks gestation. If the baby is constantly exposed to high levels of glucose, it is as if the baby were overeating: The baby produces more insulin to absorb the excess glucose, resulting Continue reading >>

Diabetes During Pregnancy Can Be Deadly For Your Child

WEDNESDAY, Nov. 27, 2013 — Diabetes can raise your risk for heart disease, kidney disease, blindness, and more, but did you know it can also affect your children's health? Babies are are more likely to die in the womb or shortly after birth when its mother has diabetes, according to a new study published in the journal Diabetologia, and experts say the findings show the importance of managing your blood sugar during pregnancy. Researchers from Newcastle University in the UK looked at data on more than 1,500 women with either type 1 or type 2 diabetes who gave birth in 1996, and compared them to healthy women who gave birth during the same year. They found that babies were nearly 5 times more likely to die in the womb and nearly 2 times as likely to die within their first year of life when born to diabetic mothers compared to babies born to healthy mothers, even when researchers excluded the increased risk of death from birth defects. Uncontrolled blood sugar during pregnancy can lead to a host of congenital issues and birth defects, according to the study, such as cleft lip, cleft palate, kidney defects and limb deficiencies, which greatly increase a baby’s risk of death. However, researchers excluded deaths from these defects, finding that simply having high blood sugar can be deadly for your child. “It’s not uncommon for infants born to diabetic mothers to have breathing problems,” said Scott Drab, PharmD, a diabetes specialist and associate professor of pharmacy and therapeutics at the University of Pittsburgh School of Pharmacy. “Oftentimes women with diabetes will go into premature labor and will deliver early, which raises the risk for death.” In addition, insulin can pass through the placenta, which can be deadly for newborns. “Some infants will h Continue reading >>

Treatment

If you have gestational diabetes, the chances of having problems with the pregnancy can be reduced by controlling your blood sugar (glucose) levels. You'll also need to be more closely monitored during pregnancy and labour to check if treatment is working and to check for any problems. Checking your blood sugar level You'll be given a testing kit that you can use to check your blood sugar level. This involves using a finger-pricking device and putting a drop of blood on a testing strip. You'll be advised: how to test your blood sugar level correctly when and how often to test your blood sugar – most women with gestational diabetes are advised to test before breakfast and one hour after each meal what level you should be aiming for – this will be a measurement given in millimoles of glucose per litre of blood (mmol/l) Diabetes UK has more information about monitoring your glucose levels. Diet Making changes to your diet can help control your blood sugar level. You should be offered a referral to a dietitian, who can give you advice about your diet, and you may be given a leaflet to help you plan your meals. You may be advised to: eat regularly – usually three meals a day – and avoid skipping meals eat starchy and low glycaemic index (GI) foods that release sugar slowly – such as wholewheat pasta, brown rice, granary bread, all-bran cereals, pulses, beans, lentils, muesli and porridge eat plenty of fruit and vegetables – aim for at least five portions a day avoid sugary foods – you don't need a completely sugar-free diet, but try to swap snacks such as cakes and biscuits for healthier alternatives such as fruit, nuts and seeds avoid sugary drinks – sugar-free or diet drinks are better than sugary versions; be aware that fruit juices and smoothies contain s Continue reading >>

The Truth About Gestational Diabetes {and Why It’s Not Your Fault!}

So you’ve had the Glucose Tolerance Test, or maybe you’ve been monitoring you’re blood sugar levels at home, and your blood sugar readings were high. You have been given a diagnosis of Gestational Diabetes. If your experience was anything like mine, an Obstetrician or midwife gave you a pamphlet on ‘Diabetes and Pregnancy’, referred you to a dietician and endocrinologist for management, and then sent on your way. And now you’re at home, and all the questions you didn’t think to ask are flooding in… What the heck is it? And what does it mean? Will my baby be alright? Do I need a caesarean? Will I need to be on insulin? What can I eat? Do I have to stop eating CHOCOLATE?!?!?! There is some debate against the use of routine testing to diagnose Gestational Diabetes, and also questioning about giving the diagnosis of Gestational Diabetes as a label on pregnant women. Dr. Sarah Buckley recommends avoiding routine testing for Gestational Diabetes for most women. Henci Goer and Dr Michael Odent are among many pregnancy and childbirth professionals who argue against diagnosing women with gestational diabetes, citing unnecessary stress and interventions as one of the risks of the Gestational Diabetes diagnosis. Nevertheless, whether you want to call it Gestational Diabetes or Pregnancy-Induced Insulin Resistance, or just high blood sugar levels in pregnancy, some women do have elevated blood sugar levels and need some extra help. Gestational Diabetes Mellitus (GDM or GD) is described as a form of diabetes that develops during pregnancy, and usually goes away 4-6 weeks postpartum. In a pregnant woman without Gestational Diabetes, the body works ‘as usual’. You eat, your stomach breaks down your food, you start to digest it, and the glucose from the carbohydrate Continue reading >>

Gestational Diabetes - Induction At 39 Weeks?

I am 37 weeks pregnant with my third child. I was diagnosed with GD at 18 weeks; I had it with baby #2, which is why I was screened early. I began my pregnancy with normal BMI and have gained 32 pounds to date. I take 22u of NPH insulin at night to control my morning blood sugars (target below 95). I have successfully controlled daytime blood sugars with diet. Baby has been monitored twice weekly since 32 weeks (NST on Mondays, biophysicals on Thursdays) and has passed each test with flying colors. Last week, my OB told me she wanted to induce at 39 weeks. She indicated that this was "the standard of care" recommended by ACOG for women with insulin-dependent GD. I protested, saying that I carried my second child to term. (He weighed 8 lb 14 oz - I delivered him without pain meds and with minimal pushing - his blood sugar did crash following the birth, but I labored at home and had not been instructed about how to monitor my glucose levels during labor.) At today's biophysical, baby measured 7 lb 4 oz. I'm aware of the high margin of error, but I'm worried this measurement is only going to fuel my OB's fire. Can you please provide me with some studies and/or statistics I can share with my OB, to support my desire to start labor naturally? I don't like the idea of laboring with Pitosin (which would likely equal pain meds), nor am I interested in forcing baby out before she's ready. Thank you! Continue reading >>

Gestational Diabetes And Giving Birth

The latest guidance from NICE, published in 2015, has extended the time by which women with gestational diabetes should give birth to 40 weeks, 6 days – not much less than the general guidance for all pregnant women, which is 42 weeks. If you have not gone to birth at this point, induction of labour will be recommended. "When I was in the hospital, I felt I didn’t know what was going on. I would have liked more information about that part so I could have been better prepared." Gemma, mum of one The main reason for induction is to prevent stillbirth. For all women, the risk increases when their pregnancy goes past 42 weeks. However, one study has shown that women with gestational diabetes may be at risk earlier. So for this reason, the guidance in England and Wales states that if you have gestational diabetes, you should not go beyond 40 weeks, 6 days. An induction or caesarean may also be advised if your baby is very large (macrosomia) – as this may cause difficulties during the birth. On the other hand induction may also be recommended if the team detects poor growth in your baby. In Scotland, most women with diabetes in pregnancy are induced within 40 weeks. The guidance says that this decision should be determined on an individual basis. If you are taking diabetes medication or insulin, it recommends that you should be assessed at 38 weeks and delivered by 40 weeks. Choices you might need to make for labour and birth Most women with gestational diabetes have a healthy birth. But before you make your birth plan, you may need to take some things into account to make sure you and your baby are safe during and after the birth. If you have gestational diabetes, you will have less choice about where to deliver your baby. This is because you will need to deliver your Continue reading >>

Gestational Diabetes And Induction Of Labour – What You Should Know

Gestational Diabetes and Induction Gestational diabetes (GD) was once a relatively rare condition, occurring in about 4% of pregnancies. In recent years, the rate of women developing GD has doubled, and experts believe the incidence of the disease will keep increasing. Most women with GD are told by their care providers they will need to be induced before their due date, destroying their hopes for a natural and intervention free birth. Having GD can have a big impact on mothers’ and babies’ health during pregnancy, but does it really need to change how we give birth? What Is Gestational Diabetes? Gestational diabetes is a condition that only occurs during pregnancy. Certain pregnancy hormones interfere with your body’s ability to use insulin. Insulin converts blood sugar into usable energy, and if this doesn’t happen, blood sugar levels rise. Insulin resistance can cause high blood glucose levels and can eventually lead to gestational diabetes. Some women will have symptoms of GD, while others will have none. Many women can manage the condition without treatment other than dietary and exercise changes. Around 20% of women will need insulin injections. So for many women, well managed diabetes means they can still have healthy babies and normal births. Induction Of Labour Many care providers routinely recommend that women with gestational diabetes be induced around 38-39 weeks. The most common reasons given for induction at this gestation are to prevent stillbirth, and to prevent babies growing too large for vaginal birth. However, the evidence related to induction for women with GD comes from the review of one trial, which looked at 200 women who had either GD, Type 1 or Type 2 diabetes. The World Health Organization states this evidence for induction before 41 w Continue reading >>

Gestational Diabetes: Symptoms, Diagnosis & Complications

MORE Gestational diabetes is a type of diabetes that develops, or is first diagnosed, during pregnancy. The condition, like other forms of diabetes, involves high blood sugar levels. Often times, gestational diabetes is a temporary disorder that occurs around the second trimester of pregnancy, and disappears after a woman gives birth. "Even if a woman had required quite a bit of therapy and treatment to keep her blood sugars under control when she was pregnant … usually the day after delivery, [her] sugars go back down to normal," said Dr. Christopher Glantz, a professor of obstetrics and gynecology at the University of Rochester Medical Center. But women who've had gestational diabetes should be monitored closely after birth, because they are more likely to develop diabetes later in life, according to the National Institutes of Health (NIH). A 2014 study from the Centers for Disease Control and Prevention found that between 4 and 9 percent of pregnant women in the United States develop gestational diabetes. Gestational diabetes occurs more frequently among certain ethic groups, including African Americans, Hispanics, American Indians, Asians, and Pacific Islanders according to the March of Dimes. Symptoms Women with gestational diabetes usually have no symptoms or mild, non-life-threatening symptoms, according to the NIH. These symptoms are mostly related to abnormal blood sugar levels, and can include fatigue, excessive thirst and increased urination. Causes During pregnancy, changes happen in the mother's body to make sugar more available to the fetus, Glantz said. One of these changes is that the placenta produces hormones that interfere with the action of insulin, a hormone that helps sugar (or glucose) get from the bloodstream into cells. This means that sugar i Continue reading >>

Diabetes In Pregnancy: Management From Preconception To The Postnatal Period

See other NICE guidance for NICE information for the public on care for women and their babies during labour (intrapartum care), induction of labour and caesarean section. You should be advised to have your baby in a hospital that has special facilities to care for sick babies 24 hours a day, in case these are needed. During your pregnancy (and especially in the last 3 months), your care team should explain about your options for giving birth. This should include information about the benefits and risks of having your labour induced compared with letting the pregnancy carry on, and of having a 'normal' (vaginal) birth compared with a caesarean section. This is especially important if you are having a large baby. If you have had a caesarean section before, you may still be able to have a vaginal birth this time. If you have certain health problems (such as being very overweight or having spinal nerve‑related problems such as sciatica), you may be advised to see an anaesthetist to talk about the best method of pain relief during the birth. Timing of the birth is important, because if your pregnancy carries on for too long this may increase the chance of problems for you and/or your baby. You should be advised to have your labour induced, or a caesarean section if this is the best option for you, during week 37 or week 38 of pregnancy. You may be advised to have your baby earlier than this if there are complications (such as high blood pressure or a slowing down of your baby's growth). You should be advised to have your labour induced, or a caesarean section if this is the best option for you, before 41 weeks of pregnancy if you have not had your baby by this time. You may be advised to have your baby earlier than this if there are complications (such as high blood press Continue reading >>