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How Much Blood Sugar Is Normal During Pregnancy

Managing Diabetes During Pregnancy

Managing Diabetes During Pregnancy

Almost two million women of reproductive age have diabetes, and these numbers continue to rise, according to the Centers for Disease Control and Prevention. It is extremely important for women with diabetes to achieve normal blood glucose levels before they become pregnant, because if women have poorly controlled diabetes going into a pregnancy, they are at much higher risk for serious fetal complications. This improved control can be accomplished with education and medical management. Women with type 1 diabetes or type 2 diabetes are also at higher risk for: Large birth weight babies, resulting in more Cesarean deliveries and increased complications during delivery Premature births or fetal death Pre-eclampsia: a dangerous surge in blood pressure associated with protein in the urine Diabetic retinopathy: damage to the retina caused by high glucose levels Diabetic kidney disease Severe hypoglycemia: episodes of low blood glucose levels that can result in confusion or unconsciousness Ensuring a healthy pregnancy The good news is that women with uncomplicated diabetes who keep their blood glucose levels in a normal range before and during pregnancy have about the same chance of having a successful pregnancy as women without diabetes. The Joslin-Beth Israel Deaconess Pregnancy Program recommends the following blood glucose goals and medical assessments before pregnancy: Fasting and pre-meal blood glucose: 80-110 mg/dl Blood glucose one hour after meal: 100-155 mg/dl A1C, a blood test that measures average blood glucose over two to three months: less than 7 percent and as close to 6% as possible without hypoglycemia Review of diabetes and obstetrical history Eye evaluations to screen for and discuss risks of diabetic retinopathy Renal, thyroid, gynecological and sometimes c Continue reading >>

Glucose Test During Pregnancy For Gestational Diabetes

Glucose Test During Pregnancy For Gestational Diabetes

Congratulations! A baby is on the way. Your nine months will be filled with preparations, from decorating the nursery to stocking up on bibs and booties to going for regular checkups to ensure that you and your baby are as healthy as possible. One of the tests that you’ll have during this time is to check for gestational diabetes. A few weeks ago, we looked at Type 1 and Type 2 diabetes. Gestational diabetes, which is growing more common among pregnant women, will be our focus this week. What is gestational diabetes? Gestational diabetes, or GDM for short, is diabetes that occurs during pregnancy. In fact, it only occurs during pregnancy. (Gestational diabetes is not the same as diabetes in women who have existing diabetes and become pregnant). Diabetes, as most of you know, is a condition in which blood glucose levels go too high. High blood glucose levels can be harmful to you and, in the case of pregnancy, to your unborn child. Fortunately, blood glucose, or sugar, levels can be controlled during pregnancy, and in most instances, high blood sugar levels return to normal after the baby is delivered. According to the National Institutes of Health, up to 10% of pregnant women in the United States have gestational diabetes. What causes gestational diabetes? A lot of changes occur in the body during pregnancy, many of them occurring due to widely fluctuating hormone levels. The placenta, which is what connects the baby to the mother’s uterine lining, makes various hormones, and while this is a good thing, these hormones can sometimes make it hard for the body’s insulin to work properly (a condition called insulin resistance). As a result, blood sugar levels can start to climb in women who cannot produce enough insulin to deal with the insulin resistance. How do you Continue reading >>

Blood Sugar Level During Pregnancy, What's Normal?

Blood Sugar Level During Pregnancy, What's Normal?

The form of diabetes which develops during pregnancy is known as gestational diabetes. This condition has become predominant in the recent pastaccording to the 2009 article in American Family Physician. For instance, in the United States alone, it affects around 5% to 9% of all the pregnant women. Pregnancy aggravates the preexisting type 2 and type 1 diabetes. During pregnancy the sugar level may tend to be high sometimes, posing problems to the mother and the infant as well. However, concerning the sugar level during pregnancy, what's normal? Blood sugar control is one of the most essential factors that should be undertaken during pregnancy. When measures are taken to control blood sugar level during pregnancy, it increases chances of a successful pregnancy. The average fasting glucose for pregnant women without any diabetes condition range from 69 to 75 and from 105 to 108 immediately one hour after consuming food. If you have preexisting diabetes or you have developedgestational diabetes, the best way to handle the blood sugar level is to ensure that it remains in between the normal range, not going too low or high. According to the recommendations of the 2007, Fifth International Workshop-Conference on Gestational Diabetes, which established blood glucose goals especially for diabetic women, during the period of pregnancy, the fasting blood sugar should not exceed 96. Blood sugar should remain below 140 just one hour after eating and below 120 two hours later. Why Is It Important to Keep Normal Blood Sugar Level During Pregnancy? The most effective way to prevent complications related to diabetes is to control the amount or the level of blood sugar. This blood sugar control is very significant during pregnancy as it can: Minimize the risk of stillbirth as well as m Continue reading >>

Pregnancy And Diabetes: When And Why Your Blood Sugar Levels Matter Most

Pregnancy And Diabetes: When And Why Your Blood Sugar Levels Matter Most

The following is an excerpt from the book Pregnancy with Type 1 Diabetes by Ginger Vieira and Jennifer Smith, CDE & RD There are two things you can definitely expect will be said to you by total strangers, friends, and several family members because you have diabetes: “Doesn’t that mean your baby will be huge?” “So, is your baby probably going to get diabetes, too?” Both questions are rather rude–sure–but both implications are also very far from accurate. Yes: persistent high blood sugars during pregnancy can lead to a larger baby…but people without diabetes have very large babies, too. And people with diabetes have good ol’ fashioned regularly sized babies, too. There is no way to assure the size of a baby at birth. Skinny women can have huge babies just like an overweight woman can give birth to a very small baby. Women who eat a lot during pregnancy can have small babies! Very little of this is in our control. In the end, you can manage your diabetes extremely tightly and still have a larger than average baby because blood sugar control is not the only thing that impacts the size of your baby at birth, and more importantly, a larger baby is not the only or even most important complication a baby can experience due to mom’s elevated blood sugar levels. No: just because you have diabetes definitely does not mean your baby will have diabetes! And guess what, there’s nothing you can do during pregnancy to prevent or reduce your baby’s risk of developing diabetes…at least not that science and research is aware of at this time. So take a very deep breath, mama, because that is not something you can control, and your baby’s risk of developing type 1 diabetes is actually only about 2 percent higher than the risk of a non-diabetic woman’s baby de Continue reading >>

Glucose Screening Tests During Pregnancy

Glucose Screening Tests During Pregnancy

TWO-STEP TESTING During the first step, you will have a glucose screening test: You DO NOT need to prepare or change your diet in any way. You will be asked to drink a liquid that contains glucose. Your blood will be drawn 1 hour after you drink the glucose solution to check your blood glucose level. If your blood glucose from the first step is too high, you will need to come back for a 3-hour glucose tolerance test. For this test: DO NOT eat or drink anything (other than sips of water) for 8 to 14 hours before your test. (You also cannot eat during the test.) You will be asked to drink a liquid that contains glucose, 100 grams (g) . You will have blood drawn before you drink the liquid, and again 3 more times every 60 minutes after you drink it. Each time, your blood glucose level will be checked. Allow at least 3 hours for this test. ONE-STEP TESTING You need to go to the lab one time for a 2-hour glucose tolerance test. For this test: DO NOT eat or drink anything (other than sips of water) for 8 to 14 hours before your test. (You also cannot eat during the test.) You will be asked to drink a liquid that contains glucose (75 g). You will have blood drawn before you drink the liquid, and again 2 more times every 60 minutes after you drink it. Each time, your blood glucose level will be checked. Allow at least 2 hours for this test. Continue reading >>

Normal Blood Sugars In Pregnancy

Normal Blood Sugars In Pregnancy

I have until now avoided discussing the issue of what normal blood sugars should be in pregnancy because it looked like gynecologists were being more aggressive with blood sugar control during pregnancy then other doctors. Blood sugar control is particularly important in pregnancy because a fetus that is exposed to continually high blood sugars will experience significant changes in the way that its genes express which will affect its blood sugar metabolism for the rest of its life. High blood sugar will also make babies very large, which poses problems when it is time for delivery, some life-threatening. Blood sugars are lower in pregnant women because there is a higher blood volume during pregnancy, but it is starting to look like the targets gynecologists have been recommending, which would have been excellent for non-diabetic women are considerably higher than normal. This was made clear by a new meta-study that analyzed a series of studies of the blood sugars of a wide range of normal pregnant women using Continuous Glucose Monitoring, home testing, and hospital lab results. It makes it clear that the current targets for pregnancy are probably too high. Here is the full text version of the meta-study: Patterns of Glycemia in Normal Pregnancy: Should the current therapeutic targets be challenged? Teri L. Hernandez, et al. Diabetes Care July 2011 vol. 34 no. 7 1660-1668. It concludes that the following appear to be truly normal blood sugars for pregnant women: AVERAGE BLOOD SUGARS IN NORMAL PREGNANT WOMEN Fasting: 70.9 ± 7.8 mg/dl (3.94 mmol/L ± .43) One Hour Post Meal: 108.9 ± 12.9 mg/dl (6.05 ± .72 mmol/L) Two Hours Post Meal: 99.3 ±10.2 mg/dl (5.52 ± .57 mmol/L ) A commentary published in this month's Diabetes Care gives more insight into the importance of t Continue reading >>

Infant Of Diabetic Mother

Infant Of Diabetic Mother

Diabetes in pregnancy There are two types of diabetes that occur in pregnancy: Gestational diabetes. This term refers to a mother who does not have diabetes before becoming pregnant but develops a resistance to insulin because of the hormones of pregnancy. Pregestational diabetes. This term describes women who already have insulin-dependent diabetes and become pregnant. With both types of diabetes, there can be complications for the baby. It is very important to keep tight control of blood sugar during pregnancy. What causes diabetes in pregnancy? The placenta supplies a growing fetus with nutrients and water. It also produces a variety of hormones to maintain the pregnancy. Some of these hormones (estrogen, cortisol, and human placental lactogen) can block insulin. This usually begins about 20 to 24 weeks into the pregnancy. As the placenta grows, more of these hormones are produced, and insulin resistance becomes greater. Normally, the pancreas is able to make additional insulin to overcome insulin resistance, but when the production of insulin is not enough to overcome the effect of the placental hormones, gestational diabetes results. Pregnancy also may change the insulin needs of a woman with preexisting diabetes. Insulin-dependent mothers may require more insulin as pregnancy progresses. Who is affected by diabetes in pregnancy? About 5 percent of all pregnant women in the U.S. are diagnosed with gestational diabetes. Gestational diabetics make up the vast majority of pregnancies with diabetes. Some pregnant women require insulin to treat their diabetes. Why is diabetes in pregnancy a concern? The mother's excess amounts of blood glucose are transferred to the fetus during pregnancy. This causes the baby's body to secrete increased amounts of insulin, which result Continue reading >>

Diabetes In Pregnancy

Diabetes In Pregnancy

Gestational diabetes does not increase the risk of birth defects or the risk that the baby will be diabetic at birth. Also called gestational diabetes mellitus (GDM), this type of diabetes affects between 3% and 20% of pregnant women. It presents with a rise in blood glucose (sugar) levels toward the end of the 2nd and 3rd trimester of pregnancy. In 90% if cases, it disappears after the birth, but the mother is at greater risk of developing type 2 diabetes in the future. Cause It occurs when cells become resistant to the action of insulin, which is naturally caused during pregnancy by the hormones of the placenta. In some women, the pancreas is not able to secrete enough insulin to counterbalance the effect of these hormones, causing hyperglycemia, then diabetes. Symptoms Pregnant women generally have no apparent diabetes symptoms. Sometimes, these symptoms occur: Unusual fatigue Excessive thirst Increase in the volume and frequency of urination Headaches Importance of screening These symptoms can go undetected because they are very common in pregnant women. Women at risk Several factors increase the risk of developing gestational diabetes: Being over 35 years of age Being overweight Family members with type 2 diabetes Having previously given birth to a baby weighing more than 4 kg (9 lb) Gestational diabetes in a previous pregnancy Belonging to a high-risk ethnic group (Aboriginal, Latin American, Asian or African) Having had abnormally high blood glucose (sugar) levels in the past, whether a diagnosis of glucose intolerance or prediabetes Regular use of a corticosteroid medication Suffering from ancanthosis nigricans, a discoloration of the skin, often darkened patches on the neck or under the arms Screening The Canadian Diabetes Association 2013 Clinical Practice Gui Continue reading >>

Gestational Diabetes (diabetes During Pregnancy)

Gestational Diabetes (diabetes During Pregnancy)

Definition of Diabetes During Pregnancy: Gestational diabetes is a type of diabetes that starts during pregnancy. When the pregnant woman has diabetes, her body is not able to consume the sugar (glucose) in her blood as well as it should. So the level of glucose in the blood becomes above normal. Gestational diabetes occurs in 4% of pregnant women. It is usually diagnosed in the fifth or sixth month of pregnancy (Between the 24th and 28th weeks). Generally, Females are cured from gestational diabetes after delivery. Causes of gestational diabetes: Almost all women have some degree of impaired glucose intolerance during pregnancy due to the hormonal changes that occur during pregnancy. In this case, the level of glucose in the blood may be higher than normal, but not high enough to cause diabetes. During the last phase of the pregnancy (the third trimester), these hormonal changes place pregnant women at risk for gestational diabetes. During pregnancy, increased levels of certain hormones made in the placenta (the organ that connects the baby by the umbilical cord to the uterus) help shifting nutrients from the mother to the growing fetus. The placenta produces hormones to prevent developing low blood sugar. They stop the actions of insulin. Over the course of the pregnancy, these hormones produce impaired glucose intolerance, which increase the level of glucose in the blood. In order to decrease this level, the body makes more insulin to shuttle glucose into cells. Usually the mother's pancreas can produce more insulin (about three times the normal amount) to overcome the effect of the pregnancy hormones on glucose levels. When the pancreas cannot produce enough insulin to do it, the glucose levels will raise and cause gestational diabetes. Risk factors for Diabetes Dur Continue reading >>

Understanding Gestational Diabetes

Understanding Gestational Diabetes

Introduction Approximately 3 to 5 percent of all pregnant women in the United States are diagnosed as having gestational diabetes. These women and their families have many questions about this disorder. Some of the most frequently asked questions are: What is gestational diabetes and how did I get it? How does it differ from other kinds of diabetes? Will it hurt my baby? Will my baby have diabetes? What can I do to control gestational diabetes? Will I need a special diet? Will gestational diabetes change the way or the time my baby is delivered? Will I have diabetes in the future? This brochure will address these and many other questions about diet, exercise, measurement of blood sugar levels, and general medical and obstetric care of women with gestational diabetes. It must be emphasized that these are general guidelines and only your health care professional(s) can tailor a program specific to your needs. You should feel free to discuss any concerns you have with your doctor or other health care provider, as no one knows more about you and the condition of your pregnancy. What is gestational diabetes and what causes it? Diabetes (actual name is diabetes mellitus) of any kind is a disorder that prevents the body from using food properly. Normally, the body gets its major source of energy from glucose, a simple sugar that comes from foods high in simple carbohydrates (e.g., table sugar or other sweeteners such as honey, molasses, jams, and jellies, soft drinks, and cookies), or from the breakdown of complex carbohydrates such as starches (e.g., bread, potatoes, and pasta). After sugars and starches are digested in the stomach, they enter the blood stream in the form of glucose. The glucose in the blood stream becomes a potential source of energy for the entire body, sim Continue reading >>

Diabetes In Pregnancy: Low Blood Sugar

Diabetes In Pregnancy: Low Blood Sugar

How Can I Get Low Blood Sugar? You can get a low blood sugar (blood glucose) if you... Delay a meal Skip a meal or snack Eat too little Take too much insulin Exercise more than usual Drink alcohol without eating (drinking is not advised during pregnancy How will I Feel if My Blood Sugar is Low? Symptoms of low blood glucose are... Headache Dizziness Drowsiness Cold sweat Difficulty concentrating Pounding heart Difficulty talking Tingling of mouth Irritability Extreme hunger What Should I Do if My Blood Glucose Might Be Low? Sit down - Get help if available. Test your blood sugar - If your blood glucose is less than 70, eat or drink 15gms of carbohydrate (see below) or take 3 glucose tabs. Retest your blood sugar in 15 minutes - If your blood glucose has not increased at least 20 points, consume another 15 grams of carbohydrate. Repeat steps 2 and 3 until blood sugar is 70 or more (x2). Continue to monitor how you feel and retest your blood sugar as indicated. The Following Foods Have About 15 Grams of Fast-Acting Carbohydrates: 3-4 glucose tablets (with water) 1 tube glucose gel 1/2 cup fruit juice 1/3 cup regular JELL-O® (not diet) 1 tablespoon honey or sugar 1 tablespoon jam or jelly (not diet) 1/2 cup regular soda (not diet) 6 Life Savers® 4 Starbursts® 1 cup fat-free milk Continue reading >>

Diabetes During Pregnancy

Diabetes During Pregnancy

What is diabetes? Diabetes is a condition in which the body can't make enough insulin, or can't use insulin normally. Insulin is a hormone. It helps sugar (glucose) in the blood get into cells of the body to be used as fuel. When glucose can’t enter the cells, it builds up in the blood. This is called high blood sugar (hyperglycemia). High blood sugar can cause problems all over the body. It can damage blood vessels and nerves. It can harm the eyes, kidneys, and heart. In early pregnancy, high blood sugar can lead to birth defects in a growing baby. There are 3 types of diabetes: Type 1 diabetes. Type 1 diabetes is an autoimmune disorder. The body's immune system damages the cells in the pancreas that make insulin. Type 2 diabetes. This is when the body can’t make enough insulin or use it normally. It’s not an autoimmune disease. Gestational diabetes. This is a condition in which the blood glucose level goes up and other diabetic symptoms appear during pregnancy in a woman who has not been diagnosed with diabetes before. It happens in about 3 in 100 to 9 in 100 pregnant women. What causes diabetes during pregnancy? Some women have diabetes before they get pregnant. This is called pregestational diabetes. Other women may get a type of diabetes that only happens in pregnancy. This is called gestational diabetes. Pregnancy can change how a woman's body uses glucose. This can make diabetes worse, or lead to gestational diabetes. During pregnancy, an organ called the placenta gives a growing baby nutrients and oxygen. The placenta also makes hormones. In late pregnancy, the hormones estrogen, cortisol, and human placental lactogen can block insulin. When insulin is blocked, it’s called insulin resistance. Glucose can't go into the body’s cells. The glucose stays in Continue reading >>

Blood Sugar Levels During Pregnancy

Blood Sugar Levels During Pregnancy

Tweet Blood glucose control is one of the most important factors during pregnancy. Tight blood glucose control, helps to ensure the best chance of a successful pregnancy. Diabetes control is important for people who have diabetes going into their pregnancy as well as people who develop diabetes during their pregnancy (gestational diabetes). What is gestational diabetes? It has been reported that on average 2% to 4% of women develop temporary diabetes also known as gestational diabetes. This happens because they are unable to produce an increased amount of insulin to overcome the resistance levels. In gestational diabetes there is not normally any show of external symptoms normally recognised as characteristic of the disease for example excessive thirst, tiredness and increased urination. Blood sugar control during pregnancy Good blood glucose control reduces the risks of complications developing for the mother and baby. The target HbA1c for mothers before and during pregnancy is 6.1% (or 43 mmol/mol). [91] People with diabetes before their pregnancy will be advised to keep excellent control of their blood sugar before and throughout the pregnancy. The first eight weeks of the pregnancy are a critical period and so it is highly recommended that strong control is achieved prior to becoming pregnant wherever possible. Mothers who develop gestational diabetes will be treated initially with diet and exercise but may be put onto oral hypoglycaemics (tablets) or insulin injections if blood sugar levels remain high. Diabetes management To help you to meet the challenging blood glucose targets, you will be expected to test your blood glucose before each meal and 1 hour after eating. People taking insulin for their diabetes will also need to test before bed each night. You will h Continue reading >>

7 Techniques To Reduce Post-meal Spikes During Pregnancy

7 Techniques To Reduce Post-meal Spikes During Pregnancy

“Gary, I think I need more insulin at breakfast.” “Why do you say that, Julianne?” “Because I’m always having high readings right afterwards, and my obstetrician said I shouldn’t spike after I eat.” “And what happens after the spike?” “It usually comes down to normal before lunch. So do you think I should take more insulin?” After-meal blood sugar spikes can create quite a quandary for anyone with diabetes, particularly during pregnancy. Research has shown that fetal macrosomia (overgrowth of the baby) becomes more common when post-meal blood sugars exceed 120 mg/dl (6.7 mmol). With post-meal readings above 140 mg/dl (7.8 mmol), the risk more than doubles from baseline. Fetal macrosomia can cause many problems during pregnancy. When the baby grows and develops too rapidly, it can lead to a premature and more complicated birth. It may also cause injuries to occur to the baby during delivery. Why do after-meal blood sugars have such a major influence on the baby’s growth? Nobody knows for certain. Perhaps, when the mother’s blood sugar “spikes” suddenly after meals, the baby is fed more sugar than its pancreas can “cover” with insulin, and high fetal blood sugar results. And because the baby’s kidneys spill almost all excess sugar from the baby’s bloodstream back into the amniotic fluid, the baby then drinks in the extra glucose and winds up growing more than it should. Suffice to say that post-meal blood sugar spikes are something to avoid during pregnancy. But how do we do it? Getting back to Julianne’s question, if she takes more insulin, she’ll probably wind up hypoglycemic before lunch. Luckily, we have some excellent techniques for preventing the after-meal highs without having to take more mealtime insulin. What Causes Sp Continue reading >>

Gestational Diabetes

Gestational Diabetes

What is gestational diabetes? Gestational diabetes is first diagnosed during pregnancy. Like type 1 and type 2 diabetes, gestational diabetes causes blood sugar levels to become too high. When you eat, your digestive system breaks down most of the food into a sugar called glucose. Glucose enters your bloodstream so your cells can use it as fuel. With the help of insulin (a hormone made by your pancreas), muscle, fat, and other cells absorb glucose from your blood. But if your body doesn't produce enough insulin, or if the cells have a problem responding to it, too much glucose remains in your blood instead of moving into cells and getting converted to energy. When you're pregnant, your body naturally becomes more resistant to insulin so that more glucose is available to nourish your baby. For most moms-to-be, this isn't a problem: When your body needs additional insulin to process excess glucose in blood, the pancreas secretes more. But if the pancreas can't keep up with the increased demand for insulin during pregnancy, blood sugar levels rise too high because the cells aren't using the glucose. This results in gestational diabetes. Gestational diabetes needs to be recognized and treated quickly because it can cause health problems for mother and baby. Unlike other types of diabetes, gestational diabetes isn't permanent. Once a baby is born, blood sugar will most likely return to normal quickly. However, having gestational diabetes does make developing diabetes in the future more likely. Am I at risk of developing gestational diabetes? Anyone can develop gestational diabetes, and not all women who develop the condition have known risk factors. About 5 to 10 percent of all pregnant women get gestational diabetes. You're more likely to develop gestational diabetes if you Continue reading >>

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