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What Are Blood Sugar Levels For Pregnancy

Gestational Diabetes During Pregnancy

Gestational Diabetes During Pregnancy

Has your doctor diagnosed you with gestational diabetes (GD or GDM), a form of diabetes that appears only during pregnancy? While it might feel overwhelming at first, it turns out that this pregnancy complication is much more common than you might think. In fact, up to 9.2 percent of pregnant women have GD, according to a 2014 analysis by the Centers for Disease Control and Prevention (CDC). Know that with careful monitoring and treatment, it can be managed, and you can have a safe and healthy pregnancy. READ MORE: What causes gestational diabetes? Who's most at risk? What are the symptoms? How is it diagnosed? What are the complications? How can you prevent gestational diabetes? How is it treated? What happens to mom and baby after birth? What causes gestational diabetes? Gestational diabetes usually starts between week 24 and week 28 of pregnancy when hormones from the placenta block insulin — a hormone produced in the pancreas that regulates the body's metabolism of fats and carbs and helps the body turn sugar into energy — from doing its job and prevent the body from regulating the increased blood sugar of pregnancy effectively. This causes hyperglycemia (or high levels of sugar in the blood), which can damage the nerves, blood vessels and organs in your body. Who’s most at risk for gestational diabetes? While researchers aren't certain why some women get gestational diabetes while others don’t, they do know that you may be at an increased risk if: You are overweight. Having a BMI of 30 or more going into pregnancy is one of the most common risk factors for gestational diabetes because the extra weight affects insulin's ability to properly keep blood sugar levels in check. You have a higher level of abdominal fat. Recent research published in the American Di Continue reading >>

Glucose Tolerance Test (gtt)

Glucose Tolerance Test (gtt)

What is a glucose tolerance test? A glucose tolerance test (GTT) diagnoses diabetes in pregnancy by checking how well your body regulates your blood sugar levels. Gestational diabetes, or GD, is a common pregnancy complication. It's thought to affect one pregnant woman in six. Although GD is common, testing for it is not routine. Your midwife will offer you the test only if she thinks there's a chance you could develop GD. Usually, you'll have the test when you’re between 24 weeks and 28 weeks pregnant. You could have the test earlier than this, usually at 16 weeks, depending on your medical history and where you live in the UK. For example, your midwife will offer the GTT sooner if you’ve had GD before. Why do I need a GTT? GD doesn’t often cause obvious symptoms, which is why testing is important. If GD isn’t recognised and treated it may put your health and your baby's health at risk. GD happens when your body fails to make enough insulin. Insulin is a hormone that keeps your blood sugar levels stable. It also helps your body to store sugar for when you need it later. During pregnancy, your body has to produce extra insulin to meet your baby’s needs, especially when he's growing rapidly. If your body can't make enough insulin, you may end up with too much sugar in your blood, resulting in GD. Having too much sugar in your blood may mean that your baby grows large. This increases your chances of having an induced labour, and a caesarean birth. GD, especially if it's not controlled, even raises the risk of a baby being stillborn. That's why it's so important to follow the advice of your midwife or doctor if you're diagnosed with GD. Am I at risk of developing GD? You’re more likely to develop GD if: Your body mass index (BMI) is 30 or above. You have previo Continue reading >>

How To Test Your Blood Sugar Levels In Pregnancy

How To Test Your Blood Sugar Levels In Pregnancy

Test Frequently In order to build a healthy plan for controlling gestational diabetes, the goal must be to keep your blood sugar levels in the normal range throughout the day. This must be priority #1. When we eat foods that are healthy and normal for our body, sugar is released slowly and converted into blood glucose in a manner that maintains normal blood sugar levels. Eating unhealthy foods such as highly processed foods that are full of sugar, creates a rapid release of glucose and results in a higher than normal blood sugar level. The first step in a healthy plan for controlling gestational diabetes is knowing what your blood sugar level is by testing at intervals throughout the day. Women with gestational diabetes should measure their blood glucose levels at least four times a day. You should include a fasting blood sugar and a blood sugar one or two hours after each meal. Your results should be recorded in a glucose log, along with dietary information about what foods you ate. The glucose log will help your physician decided if you should begin an ant-hyperglycemic medication along with your diabetic diet. Conversely, your physician may decrease the frequency of glucose monitoring if you are in good control with diet alone. Keeping blood glucose levels in a healthy range at all times requires eating a healthy meal every 3-4 hours, getting regular exercise and if necessary taking insulin or other glucose lowering (hypoglycemic) medications. Achieving a normal maternal blood glucose level decreases the chance of having pregnancy related complications such as preeclampsia, preterm labor, and delivery of a large baby. Recommended Glucose Monitoring Levels The American College of Obstetricians and Gynecologists (ACOG) and the American Diabetes Association (ADA) both h Continue reading >>

Diabetes And Pregnancy

Diabetes And Pregnancy

Sometimes pregnancy causes the blood sugar to rise in women who do not have diabetes. This is called gestational diabetes. What is diabetes? Diabetes mellitus (just called diabetes from now on) occurs when the level of sugar (glucose) in the blood becomes higher than normal. There are two main types of diabetes. These are called type 1 diabetes and type 2 diabetes. For further information about diabetes, see separate leaflets called Type 1 Diabetes and Type 2 Diabetes. Sometimes pregnancy causes the blood sugar to rise in women who do not have diabetes. This is called gestational diabetes (see below). How does pregnancy affect diabetes? How does pregnancy affect diabetes? Play VideoPlayMute0:00/0:00Loaded: 0%Progress: 0%Stream TypeLIVE0:00Playback Rate1xChapters Chapters Descriptions descriptions off, selected Subtitles undefined settings, opens undefined settings dialog captions and subtitles off, selected Audio TrackFullscreen This is a modal window. Beginning of dialog window. Escape will cancel and close the window. TextColorWhiteBlackRedGreenBlueYellowMagentaCyanTransparencyOpaqueSemi-TransparentBackgroundColorBlackWhiteRedGreenBlueYellowMagentaCyanTransparencyOpaqueSemi-TransparentTransparentWindowColorBlackWhiteRedGreenBlueYellowMagentaCyanTransparencyTransparentSemi-TransparentOpaqueFont Size50%75%100%125%150%175%200%300%400%Text Edge StyleNoneRaisedDepressedUniformDropshadowFont FamilyProportional Sans-SerifMonospace Sans-SerifProportional SerifMonospace SerifCasualScriptSmall CapsReset restore all settings to the default valuesDoneClose Modal Dialog End of dialog window. Pregnancy makes the body need more insulin to control the levels of sugar (glucose) in the body. Therefore, women with diabetes usually need more treatments to control their blood sugar when t 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 >>

Treatment

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 >>

Gestational Diabetes

Gestational Diabetes

What is gestational diabetes? Gestational diabetes is a condition marked by high blood glucose (sugar) levels that are discovered during pregnancy. It is defined as carbohydrate intolerance. About two to 10 percent of all pregnant women in the U.S. are diagnosed with gestational diabetes. Am I at risk for gestational diabetes? These factors increase your risk of developing diabetes during pregnancy: Being overweight before becoming pregnant (if you are 20% or more over your ideal body weight) Family history of diabetes (if your parents or siblings have diabetes) Being over age 25 Previously giving birth to a baby that weighed more than 9 pounds Previously giving birth to a stillborn baby Having gestational diabetes with an earlier pregnancy Being diagnosed with pre-diabetes Having polycystic ovary syndrome Being African-American, Hispanic/Latino, Asian-American, American Indian, or Pacific Islander American Keep in mind that half of women who develop gestational diabetes have no known risk factors. What causes gestational diabetes? Gestational diabetes is caused by some hormonal changes that occur in all women during pregnancy. The placenta is the organ that connects the baby (by the umbilical cord) to the uterus and transfers nutrients from the mother to the baby. Increased levels of certain hormones made in the placenta can prevent insulin—a hormone that controls blood sugar—from managing glucose properly. This condition is called "insulin resistance." As the placenta grows larger during pregnancy, it produces more hormones and increases this insulin resistance. Usually, the mother’s pancreas is able to produce more insulin (about three times the normal amount) to overcome the insulin resistance. If it cannot, sugar levels will rise, resulting in gestational dia Continue reading >>

Glucose Screening And Glucose Tolerance Tests

Glucose Screening And Glucose Tolerance Tests

Why do I need a glucose screening test during pregnancy? Most healthcare practitioners routinely recommend a glucose screening test (also called a glucose challenge test or GCT) between 24 and 28 weeks of pregnancy to check for gestational diabetes. Gestational diabetes is a high blood sugar condition that some women get during pregnancy. Between 2 and 5 percent of expectant mothers develop this condition, making it one of the most common health problems during pregnancy. And because the condition rarely causes any symptoms, testing is the only way to find out whether you have it. Like any screening test, the GCT won't give you a diagnosis. Instead, it's designed to identify as many women as possible who may have a problem and need more testing to find out. So a positive result doesn't mean that you have gestational diabetes. In fact, only about a third of women who test positive on the glucose screen actually have the condition. If you test positive on the screening, you'll need to take the glucose tolerance test (GTT) – a longer, more definitive test that tells you for sure whether you have gestational diabetes. Your practitioner may want you to be screened earlier than 24 weeks if a routine urine test shows a lot of sugar in your urine or if you're considered high risk. If the results are normal, you'll be screened again at 24 to 28 weeks. Of course, if you were diagnosed with diabetes before pregnancy, you won't need to be screened. Instead, you'll continue to work with your practitioner to manage your condition during pregnancy. How is the glucose screening test done? When you arrive for the test, you're given a sugar solution that contains 50 grams of glucose. The stuff tastes like a very sweet soda pop (it comes in cola, orange, or lime flavor), and you have to Continue reading >>

Gestational Diabetes

Gestational Diabetes

What Is Gestational Diabetes? Gestational diabetes sometimes develops when a woman is pregnant. It’s when the blood glucose level (blood sugar level) of the mother goes too high during pregnancy. Having an elevated blood glucose level during pregnancy can cause problems for your baby—if it’s left untreated. Fortunately, doctors are vigilant about checking for gestational diabetes so that it can be identified and effectively managed. A pro-active treatment plan helps you have a good pregnancy and protects the health of your baby. Gestational Diabetes Symptoms Gestational diabetes doesn’t often cause noticeable symptoms for the mother. Other types of diabetes (eg, type 1 diabetes or type 2 diabetes) do cause symptoms such as increased thirst, but that is hardly ever noticed in gestational diabetes. Because there aren’t often symptoms, it’s very important to be tested for a high blood glucose level when you’re pregnant. (Your doctor will most likely test you for gestational diabetes sometime between the 24th and 28th week. You can learn more about the diagnostic process here.) Then your doctor will know if you need to be treated for gestational diabetes. Gestational Diabetes Causes and Risk Factors Gestational diabetes develops when your body isn’t able to produce enough of the hormone insulin during pregnancy. Insulin is necessary to transport glucose—what your body uses for energy—into the cells. Without enough insulin, you can build up too much glucose in your blood, leading to a higher-than-normal blood glucose level and perhaps gestational diabetes. The elevated blood glucose level in gestational diabetes is caused by hormones released by the placenta during pregnancy. The placenta produces a hormone called the human placental lactogen (HPL), also Continue reading >>

Monitoring Your Own Glucose Levels

Monitoring Your Own Glucose Levels

You measure your glucose levels through a finger-prick test. You should have been shown how to do this when you were told that you had gestational diabetes. You will also have discussed the ideal blood glucose levels for you during your pregnancy. The ideal target glucose levels are below but your team may have talked to you about your individual target level: fasting: 5.3 mmol/litre 1 hour after meals: 7.8 mmol/litre 2 hours after meals: 6.4 mmol/litre. How to monitor your blood glucose levels Watch this film from Diabetes UK or read the instructions below. To monitor your glucose, you will be given a blood glucose monitor. This is designed for you to measure your own blood glucose levels at home, or wherever you happen to be, by checking a drop of your blood. You produce the blood by using a finger pricker. There is less sensation in the sides of your fingers than the tips or the underneath. Try to prick the side of your finger, near the tip. To monitor your glucose, you will be given a blood glucose monitor. This is designed for you to measure your own blood glucose levels at home, or wherever you happen to be, by checking a drop of your blood. You produce the blood by using a finger pricker. There are many different brands of meter on the market, but they all work in similar ways: Step 1 Wash your hands. Step 2 Set up a finger pricker with a clean needle. Step 3 Insert one end of a test strip (usually a long, thin paper-type strip) into the meter. Step 4 Use the finger pricker to prick the side of your finger. Step 5 When a spot of blood appears where you pricked you finger, place it onto the end of the testing strip that is sticking out of the meter to transfer the blood. Step 6 After a few seconds, the meter will display your blood glucose level. Step 7 Clean the 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 >>

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 >>

High Blood Sugar In Pregnancy Linked To Heart Defects

High Blood Sugar In Pregnancy Linked To Heart Defects

A new study says elevated blood-sugar levels, even those that don't signal gestational diabetes, may be linked to a baby's risk of having a heart defect. A new study, published in JAMA Pediatrics, has found a link between elevated blood-sugar levels in pregnancy and a baby's chance of having a congenital heart defect. Although health risks for babies of women with gestational diabetes have been well studied, this is the first research indicating a connection between elevated blood-sugar levels of pregnant women, below the diabetes cutoff, and infant heart defects. "Diabetes is the tail end of a spectrum of metabolic abnormalities. We already knew that women with diabetes were at significantly increased risk for having children with congenital heart disease. What we now know, thanks to this new research, is that women who have elevated glucose values during pregnancy that don't meet our diagnostic criteria for diabetes also face an increased risk," said the study's lead author, James Priest, M.D., from the Stanford University School of Medicine and Lucile Packard Children's Hospital in a press release. Two major defects To reach their conclusions, researchers looked at blood samples from 277 California women in their second trimester of pregnancy. A control group was made up of 180 women carrying fetuses without congenital heart disease. The remaining women were carrying infants with one of two major heart defects: either tetralogy of Fallot, a structural heart problem that doesn't allow enough oxygen to circulate in baby's body, or dextrotransposition of the great arteries, a condition in which the two main arteries carrying blood away from baby's heart are reversed. Blood samples collected at different times of day measured both blood-glucose and insulin levels. Resear Continue reading >>

Diabetes In Pregnancy: Management From Preconception To The Postnatal Period

Diabetes In Pregnancy: Management From Preconception To The Postnatal Period

Testing your blood glucose levels You care team should talk with you about when you should test your blood glucose levels during the day. Diabetes type and treatment When should I test? Women with type 1 diabetes Fasting (before breakfast) Before other meals 1 hour after all meals Bedtime Women with type 2 diabetes or gestational diabetes having 2 or more insulin injections a day Fasting (before breakfast) Before other meals 1 hour after all meals Bedtime Women with type 2 diabetes or gestational diabetes having any of the following: changes to diet and exercise tablets (metformin and/or glibenclamide) 1 insulin injection a day Fasting (before breakfast) 1 hour after all meals You and your care team should agree ideal (or target) blood glucose levels that are right for you and are manageable without causing problems with hypoglycaemia. If you are taking metformin or glibenclamide tablets, or you are on insulin, you should be advised to aim for the following target blood glucose levels, unless this leads to difficulties with hypoglycaemia: If you are not able to test until 2 hours (rather than 1 hour) after a meal, the target glucose level at that time should be below 6.4 mmol/litre. If you are on insulin or glibenclamide, you should also be advised to keep your blood glucose above 4 mmol/litre, because of the risk of hypoglycaemia. An HbA1c test tells you your average blood glucose levels over the last 2 to 3 months. Your care team will review your insulin treatment with you, and may suggest a different type to help you achieve your blood glucose targets. Your care team should explain how being pregnant can make it harder for you to recognise hypoglycaemia, especially in the first 3 months. You should make sure you have fast‑acting forms of glucose, such as sugar‑co 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 >>

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