What Should A Pregnant Woman's Blood Sugar Be?

Pre-existing Diabetes And Pregnancy

When Joy contacted TheDiabetesCouncil, she wanted to know if she would ever be able to get pregnant and have a healthy baby with her Type 1 diabetes. She had previously heard that there were risks that came with being pregnant and she needed some guidance. We decided to put together a comprehensive guide which would shed light on pregnancy with pre-existing diabetes. We hope Joy and others who have similar questions concerns will benefit from the information provided here, as they work to get the strict diabetes control that is needed. Let’s take a look at what it takes to have a healthy pregnancy and baby despite having diabetes. What this article is about In this article, we will look at how you can manage your diabetes during pregnancy for your health and the health of your baby. We will learn about the guidelines for managing diabetes during pregnancy, and provide you with a detailed instruction. We will explore what women with pre-existing diabetes need to know before they get pregnant, and what they need to know in order to experience a healthy pregnancy with diabetes. What this article is not about Gestational diabetes, or diabetes acquired after pregnancy. I want to stress that this article is not about gestational diabetes. We have already covered the topic of Gestational Diabetes for which the in-depth article can be found here: How opinions on pre-existing diabetes and pregnancy have changed over time Back in the 1980’s, I strongly urged all my teenage patients with diabetes to stay on birth control and prevent pregnancy with diabetes. The outcome was never too good when they got pregnant, had out of control diabetes, and the complications that would arise from the pregnancy. Outcomes are still grave if tight control is not achieved before and during the Continue reading >>

Gestational Diabetes

What is gestational diabetes? Diabetes is a medical condition that causes high blood glucose (blood sugar). When there is too much sugar in the blood, it can cause health problems. Insulin is a hormone that helps the body regulate glucose levels in the blood. When there isn’t enough insulin or the body can’t use it properly, blood sugar levels can get too high. Diabetes that develops during pregnancy is called gestational diabetes. It can cause health problems for both the mother and her developing baby during the pregnancy, and it may cause problems after birth. For example, when a mother’s blood sugar levels are too high, the baby's development may be delayed. The baby could also grow very large, which may make a C-section delivery necessary. All pregnant women will be tested for gestational diabetes at some point during the pregnancy. If mothers have risk factors, like age or weight problems, being pregnant with multiples, significant family history of diabetes or having gestational diabetes in a previous pregnancy, they may be tested earlier and more often than women without additional risk factors. Diagnosing gestational diabetes All pregnant women will be screened for gestational diabetes. Most health care providers recommend a glucose screening test between the 24th and 28th weeks of pregnancy. When women have risk factors for gestational diabetes, the test may be done in the first trimester. If this test shows an increased blood sugar level, a three-hour glucose tolerance test may be done after a few days of following a special diet. If results of the second test are in the abnormal range, gestational diabetes is diagnosed. Once diagnosed, your doctor will likely recommend counseling that shows you how to eat properly and test your own blood sugar up to fo Continue reading >>

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 >>

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 >>

High Blood Sugar In Pregnancy Puts Baby At Risk

Print Font: CHICAGO — The higher a pregnant woman’s level of blood sugar, the greater the risk to her newborn — whether the mother has diabetes or not, the largest study on the problem suggests. More women opting for preventive mastectomy - but should they be? Rates of women who are opting for preventive mastectomies, such as Angeline Jolie, have increased by an estimated 50 percent in recent years, experts say. But many doctors are puzzled because the operation doesn't carry a 100 percent guarantee, it's major surgery -- and women have other options, from a once-a-day pill to careful monitoring. The findings released Friday may lead to more women being diagnosed with diabetes during pregnancy and given stricter diet advice or medication to lower blood sugar. The research involved more than 23,000 pregnant women in nine countries. It found a surprisingly strong relationship between the blood sugar levels of the women and the rate of big babies and first-time Caesarean sections, said lead investigator Dr. Boyd Metzger of Northwestern University. The newborns also were more likely to have low blood sugar levels and high insulin levels if their mothers’ blood sugar levels were higher. The problems can lead to obesity, diabetes and high blood pressure later in life. Risks for large babies Large babies risk shoulder damage and other injuries if delivered vaginally and lead to more C-sections, which also pose health risks to mothers and babies. Large babies were defined in the study as those bigger than 90 percent of those born in the local population, so large Thai babies would be smaller than large U.S. babies. Researchers reported the findings Friday at the American Diabetes Association’s annual scientific meeting. The higher the mother’s blood sugar, the more Continue reading >>

Blood Sugar Levels For Pregnant Women With Diabetes

Whether you had diabetes before you got pregnant or you developed diabetes during your pregnancy, you'll need to keep a close eye on your blood sugar levels. Tight control will help you avoid complications and long-term health problems for both you and your baby. You're eating differently because your body needs more energy to help your baby grow and be healthy. And your changing hormones affect how your body makes and uses insulin. In the later parts of your pregnancy, you may become more insulin resistant, so blood sugar builds up to higher levels. How often should you check your blood sugar? Pre-existing diabetes: Before and after meals and before bedtime If you are pregnant and have type 1 diabetes, your doctor might sometimes ask you to check your blood sugar in the middle of the night, around 3 a.m. You should check your fasting urine ketones every day, too. For every type of diabetes, if you're pregant you need to see your doctor at least once a month, perhaps as often as once a week. Continue reading >>

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 >>

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

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 >>

How To Cut Risk Of High Blood Sugar When You’re Pregnant

When you’re pregnant, you may wonder why your obstetrician asks for a urine sample at prenatal checkups. One thing your doctor watches is glucose. It’s normal for some to show up, but if it shows up repeatedly or in large amounts, it is sometimes a sign that you have gestational diabetes (high blood sugar during pregnancy). Most women get screened for gestational diabetes between 24 and 28 weeks into their pregnancy. If there is a lot of glucose in your urine in early prenatal visits, however, you’ll probably do the screening sooner. “For people who have risk factors for gestational diabetes, we usually recommend that they get screening early in pregnancy — usually in the first trimester,” says Ob/Gyn Jeff Chapa, MD. What are the risk factors? Your doctor likely will talk to you about several risk factors during your early checkups. Dr. Chapa says you are more likely to get gestational diabetes if: You are overweight, with a body mass index over 30 You are over age 25 You had a baby that weighed more than 9 pounds Your blood sugar levels are high in the urine or blood Your family has a history of type 2 diabetes You had gestational diabetes before Women who have a few of these factors often get an early screening. How does the screening work? Your doctor will ask you to take a test called the oral glucose tolerance test. Here’s what happens: During the test, you quickly drink a sweetened liquid which contains 50 grams of glucose. Your body absorbs this glucose quickly, causing your blood sugar levels to rise. You will have blood drawn from your arm about 60 minutes after drinking the sugary liquid. The blood test measures how well your body processes the glucose solution. If your test results are not normal, you likely will take a similar test, but you wil 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 >>

Blood Sugar Level During Pregnancy: What’s Considered Normal?

Changes in hormone levels during pregnancy cause your body to change, and you might find yourself falling prey to illnesses more easily. The blood running through your body carry these hormones – so changes arise in them easily as well. Let’s look at blood sugar levels during pregnancy: What is gestational diabetes, what are the risks and what should you do if you have a high blood sugar level? Blood sugar level during pregnancy: Does “high” mean gestational diabetes? Blood sugar level refers to the glucose in the blood. According to the American Diabetes Association, one is considered diabetic when a fasting plasma glucose level of more than 126 mg/dL (7.0 mmol/l) or a casual plasma glucose level of more than 200 mg/dL (11.1 mmol/l).1 If you’re at risk of getting gestational diabetes, your OB-GYN might recommend that you take a glucose screening test to check your glucose level in Week 24 of pregnancy. A blood sugar level of about 130 to 140mg/dL is considered high, and a level of more than 200 mg/dL means there is a high possibility that you have gestational diabetes.2 The effects of hormones on your blood during pregnancy cause sugar levels to go higher than pre-pregnancy sugar levels. Although gestational diabetes can be an indication of a slight metabolic disorder, once the pregnancy ends, blood levels in such cases usually return to normal without the need for medical intervention. Why do pregnant women have high blood glucose levels during pregnancy? What makes blood sugar levels in your body drop? Insulin is the key hormone that does so. When levels of insulin decrease during pregnancy, blood sugar levels does not drop because of not enough insulin is secreted to metabolize the glucose in the blood. During pregnancy, your insulin levels decrease becaus Continue reading >>

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 >>

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 >>

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 >>