Info Gestational Diabetes
What is Gestational Diabetes? In order to understand gestational diabetes, it is necessary to understand how insulin works. The hormone insulin which comes from the pancreas controls blood sugar. The role of insulin is to get the sugar into the cells. If for any reason the insulin is not working properly or there is not enough of it, the blood sugar will rise and if it rises high enough we call it diabetes. The difference between diabetes and gestational diabetes is that diabetes simply means your blood sugar is too high whereas gestational diabetes is any diabetes that arises or is first identified during pregnancy. During pregnancy the afterbirth or placenta releases hormones that circulate through your body. These hormones block how the insulin works and thus raise the blood sugar the purpose being to provide energy for the baby. Therefore, even in a normal pregnancy the pancreas has to make a lot of extra insulin just to keep the situation controlled. When the pancreas is not making enough insulin to overcome the blockage from these hormones, the blood sugar will rise, and this is called gestational diabetes. What causes it? The main problem is a mother’s pancreas not able to make enough insulin. There is a resistance to the insulin being made caused by the placental hormones but a normal pancreas can usually make enough insulin to overcome this insulin resistance. If the pancreas does not make the extra insulin, the sugar will rise and gestational diabetes occurs. What are the risk factors? The mothers weight can be a factor. If cells are swollen with fat owing to weight problems prior to pregnancy or if during the pregnancy excess weight is gained, it is more difficult for the insulin to get sugar into the cells. You are expected to gain weight in pregnancy, jus Continue reading >>
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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
High Blood Sugar in Pregnancy Gestational diabetes is a form of diabetes that occurs during pregnancy. The term 'gestational' refers to pregnancy. When a woman develops high blood glucose (sugar) during pregnancy but has never had elevated blood glucose in the past, she is diagnosed with gestational diabetes. Gestational diabetes affects how the cells use glucose, the body's main fuel source. Gestational diabetes causes high blood glucose levels that can adversely affect pregnancy and the baby's health. The good news is that expectant mothers can help control gestational diabetes by exercising and eating healthy foods ensuring a healthy pregnancy and baby. Gestational diabetes mellitus and type II diabetes mellitus are different problems but have some key similarities. In either case, your insulin is not working well or it is not being produced in sufficient supply to keep blood glucose levels normal. In pregnancy, some insulin resistance is expected, as the placenta makes hormones that work against insulin. But as long as the pancreas can keep up with the demand to counteract the pregnancy hormones from the placenta, blood glucose levels can remain normal. If the pancreas cannot keep up, then gestational diabetes is the result. Risks Factors for Gestational Diabetes Pregnant women with any of the following appear to be at an increased risk for developing gestational diabetes; the risk increases when multiple risk factors are present. They include: Obesity Glycosuria - sugar in your urine Family history of diabetes You have a prior history of gestational diabetes in previous pregnancies If you are of Black, Hispanic, Asian or American Indian descent Over the age of 25 What are the Risks to Babies Born to Mothers with Gestational Diabetes? Gestational Diabetes affects yo Continue reading >>
- Women in India with Gestational Diabetes Mellitus Strategy (WINGS): Methodology and development of model of care for gestational diabetes mellitus (WINGS 4)
- Leeds diabetes clinical champion raises awareness of gestational diabetes for World Diabetes Day
- Gestational Diabetes: The Overlooked Form of Diabetes
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 >>
Weight And High Blood Sugar During Pregnancy May Cause Risks For Baby
Pregnant women who are even marginally overweight or with high blood sugar levels could face risks not only for themselves, but for their unborn babies. Northwestern University’s Dr. Boyd Metzger talks about the effect of a mother’s blood sugar levels on pregnancy and what women can do to help prevent problems. Metzger’s research has showed that women with slightly high levels of blood sugar could raise blood sugar levels in unborn babies. And the latest review of the data suggests that elevated blood sugar levels, as well as too much weight gain, can lead to riskier pregnancies. Obstetricians routinely monitor a mother-to-be’s weight and blood sugar during pregnancy. Women may develop gestational diabetes, which is any form of glucose intolerance or high blood sugar that begins during pregnancy. The American Diabetes Association estimates that 18 percent of pregnant women develop this condition. Metzger is a professor of metabolism and nutrition in the Division of Endocrinology, Metabolism & Molecular Medicine at Northwestern University’s Feinberg School of Medicine. He was the lead researcher of a large-scale international study focusing on weight gain and blood sugar levels during pregnancy. What are your areas of interest and expertise?I am interested in gestational diabetes. I also study the impact of a mother’s nutrition on the development of the fetus. As the lead investigator in the Hyperglycemia and Adverse Pregnancy Outcome study, can you explain a little bit about what you researched and how you did it?There has been a debate about how much high blood sugar contributes to an increased risk in adverse pregnancy situations. The purpose of the study was to determine where and how blood sugar levels, regardless of other factors, can affect a fetus. So Continue reading >>
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 >>
A Pregnant Woman's Weight, Blood Sugar Levels And Blood Pressure Affect The Baby's Size
Overweight and obesity during pregnancy causes a larger baby to be born. Even high blood sugar levels cause larger babies, while high blood pressure in the mother leads to smaller babies. This was shown in a new international study in which researchers at Sahlgrenska Academy collaborated. It has long been known that overweight women and women with gestational diabetes tend to give birth to larger babies, but until now, it has been unclear if the baby’s size is caused by these maternal traits, and which factors are significantly involved in the connection between the size of the mother and the baby’s size. International collaboration In an international research collaboration led by the universities of Exeter and Bristol, in collaboration with researchers from Sahlgrenska Academy, researchers have been able to show that overweight and higher glucose levels during pregnancy lead to the baby being born with a higher birth weight, while high blood pressure in the mother causes a lower birth weight. Larger babies The group concluded that mothers with higher blood sugar levels tend to give birth to larger babies, even at levels that are not considered unhealthy. “An extremely high or extremely low birth weight can be a health risk for the newborn infant. Higher and lower birth weights are also linked to diseases such as type 2 diabetes, later in life. Knowledge of which traits of the mother affect the baby’s birth weight can, in the future, help us to reduce the number of children that are born too large or too small,” says Dr. Rachel Freathy at the University of Exeter Medical School, one of the researchers that led the study. More than 30 000 women In contrast to what some other studies show, the new study published in the scientific journal, JAMA, shows that the Continue reading >>
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 >>
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 >>
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 >>
Braden Diabetes Center - Gestational "in Pregnancy" Diabetes
Whether a woman is already living with diabetes and decides to have a child or she develops gestational diabetes during pregnancy, women with diabetes can, and do, have healthy babies. However, because mother and baby are both at risk for complications, these pregnancies are deemed “high risk”. Both mother and baby will need to be closely monitored throughout the pregnancy by a specialist called a perinatologist. Thanks to a special collaboration with UCSF and Marin General Hospital, Braden Diabetes Center patients can now be followed by a perinatologist without leaving Marin. Weight gain and hormonal changes are a normal part of pregnancy. These changes cause a woman’s body to make less insulin, a hormone that helps the body use glucose for energy and maintain healthy levels of blood glucose. What’s more, the body uses insulin less effectively during pregnancy, a condition known as insulin resistance. By late pregnancy, all women experience a degree of insulin resistance. 9.2% of these women will develop gestational diabetes.1 Pregnant women are routinely tested for gestational diabetes some time between weeks 24 and 28 of pregnancy. If a woman is diagnosed with gestational diabetes, she must take immediate action to manage her blood sugar. Her OB/GYN or nurse midwife will likely collaborate with an endocrinologist, a diabetes educator, and a dietitian to help her with meal planning. It’s essential to have a blood glucose test 6 to 12 weeks post-partum to see if blood glucose is still elevated. Most women’s blood glucose levels return to normal. However, in 5 to 10 percent of women, blood glucose levels do not return to normal, and they are then diagnosed with diabetes. Continue reading >>
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 >>
Blood Glucose Targets
Aiming for blood glucose levels as close to target as possible can help reduce the risk of heath problems for you and your baby. Your diabetes in pregnancy team will discuss individual blood glucose targets with you. Current Australian guidelines for women with type 1 or type 2 diabetes during pregnancy recommend blood glucose levels between 4.0 - 5.5 mmol/L fasting/before meals and less than 7mmol/L two hours after meals. However, for women with type 1 diabetes, the targets below may be suggested by your diabetes in pregnancy team to take into account the need for optimal blood glucose levels during pregnancy, while minimising the risk of hypos. Your team may also advise you to monitor your blood glucose levels at other times. Fasting/before meals: 4.0 – 6.0 mmol/L 2 hours after each meal: 5.5 - 7.5 mmol/L Continue reading >>
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Have Diabetes? 7 Tips For A Healthy Pregnancy
Dealing with disease and pregnancy Pregnancy is full of challenges—and even more so if you have type 1 or type 2 diabetes. So how do you handle a demanding disease and pregnancy? It may not be as hard as you think, says Cheryl Alkon, author of Balancing Pregnancy With Pre-Existing Diabetes. But you do need a plan. Before starting a family, check out these 7 tips that can help you ace diabetes management and have a healthy pregnancy. Get your blood sugar under control If you're thinking about getting pregnant, you need to kick bad habits (like smoking), lose weight (if you're overweight), and take prenatal vitamins. You can add one more item to the list if you have diabetes: Get your blood sugar under control. If your blood sugar levels are too high or too low, you may have a tough time getting pregnant. "In that case, your body may recognize that it's not a hospitable place for a pregnancy," says Alkon. Women with type 2 diabetes are particularly at risk for polycystic ovary syndrome (PCOS), which can also make it difficult to get pregnant. Medications that stimulate ovulation, such as Clomid and Serophene, can help. Assemble a diabetes team Pregnant women with diabetes could have up to three times as many appointments as women at a lower risk of complications. Find a high-risk obstetrician to monitor your pregnancy and check whether your endocrinologist is willing to work with your ob-gyn. "You want doctors who really know what diabetes is all about," says Alkon. The constant monitoring, ultrasounds, and additional blood sugar tests add up. So "make sure you know the ins and outs of your insurance plan," she adds. Consider going off oral medications Most doctors suggest that pregnant women with type 2 diabetes discontinue oral medications, says Alkon. This is because Continue reading >>
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 >>
