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What Should A Pregnant Woman's Blood Sugar Be?

Diabetes In Pregnancy

Diabetes In Pregnancy

Gestational diabetes refers to diabetes that is diagnosed during pregnancy. Gestational diabetes occurs in about 7 percent of all pregnancies, usually in the second half of the pregnancy. It almost always goes away as soon as your baby is born. However, if gestational diabetes is not treated during your pregnancy, you may experience some complications. Causes Pregnancy hormones cause the body to be resistant to the action of insulin, a hormone made by your pancreas that helps your body use the fuels supplied by food. The carbohydrates you eat provide your body with a fuel called glucose, the sugar in the blood that nourishes your brain, heart, tissues and muscles. Glucose also is an important fuel for your developing baby. When gestational diabetes occurs, insulin fails to effectively move glucose into the cells that need it. As a result, glucose accumulates in the blood, causing blood sugar levels rise. Diagnosis Gestational diabetes is diagnosed with a blood test. Your blood glucose level is measured after you drink a sweet beverage. If your blood sugar is too high, you have gestational diabetes. Sometimes one test is all that is needed to make a definitive diagnosis. More often, an initial screening test is given and, if needed, a longer evaluation is performed. Gestational diabetes usually does not occur until later in pregnancy, when the placenta is producing more of the hormones that interfere with the mother's insulin. Screening for gestational diabetes usually takes place between weeks 24 to 28. However, women at high risk are usually screened during the first trimester. Risk Factors There are a number of risk factors associated with gestational diabetes, including: Being overweight Giving birth to a baby that weighed more than 9 pounds Having a parent or siblin 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 >>

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

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 >>

Pregnant Women With High Blood Sugar May Put Their Babies At Risk For Congenital Birth Defects

Pregnant Women With High Blood Sugar May Put Their Babies At Risk For Congenital Birth Defects

Delivering a healthy baby is the goal, but a woman with elevated blood sugar levels could be damaging how her baby's tiny heart develops during pregnancy. Researchers from Stanford University School of Medicine in collaboration with Stanford Children’s Health have revealed women don’t need to have a diabetes diagnosis to put their babies at risk for two serious birth defects in the heart. The study, published in JAMA Pediatrics, delves deeper into the link between how blood sugar levels affect a mother and her baby. "We already knew that women with diabetes were at significantly increased risk for having children with congenital heart disease," said the study’s lead author Dr. James Priest, a postdoctoral scholar in pediatric cardiology, in a press release. "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." For the study, Priest and his colleagues analyzed blood samples taken from 227 pregnant women who were in their second trimester. The samples were taken at various points throughout the day and did not require women to fast beforehand. They were measuring for blood sugar (glucose) levels and insulin, which is a hormone that controls blood sugar. Out of the group of women, 55 infants had Tetralogy of Fallot, which means the baby was born with structural defects in both the heart and the blood vessels that connect the heart to the lungs. It most commonly causes “blue baby syndrome,” which occurs when the infant is unable to get enough oxygen. The group of mothers who gave birth to babies with that particular birth defect had a higher average blood glucose level compared to other mothers. Another 42 infants were born w 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 >>

High Blood Sugar In Pregnancy Puts Baby At Risk

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 >>

Gestational Diabetes

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 >>

Have Diabetes? 7 Tips For A Healthy Pregnancy

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 And Pregnancy

Diabetes And Pregnancy

One in twenty pregnant women in Australia is affected by diabetes. Although the disease can cause serious complications for mothers and babies, good planning and comprehensive antenatal care can keep you and your baby healthy. By Joanna Egan. Diabetes is a chronic condition characterised by the body's inability to control glucose levels in the blood. Glucose is a simple sugar found in foods such as breads, cereals, fruit, starchy vegetables, legumes, dairy products and sweets. A hormone produced by the pancreas, called insulin, converts this glucose into energy that is used to fuel the body. When a person has diabetes, they either don't produce enough insulin or are unable to use insulin effectively. This causes glucose to build up in their bloodstream. There are several types of diabetes: Type 1: People with type 1 diabetes don't produce insulin. As a result, they need to monitor their blood glucose levels carefully and require regular insulin injections (up to four times a day). Generally, type 1 diabetes arises in children and young adults, but it can occur at any age. Type 2: This is the most common form of diabetes. Some people have a genetic predisposition to developing the disease but often, it is caused by lifestyle factors such as high blood pressure, obesity, insufficient exercise and poor diet. People with type 2 diabetes produce insulin, but either don't produce enough or are unable to use it effectively. Generally, it is initially managed with healthy eating and regular physical activity, but as the condition progresses, glucose-lowering tablets and/or insulin injections may be prescribed. Gestational diabetes: This form of diabetes develops, or is first diagnosed, during pregnancy. It usually appears late in the second trimester and resolves after childbir Continue reading >>

How To Decrease Your Blood Sugar In Pregnancy

How To Decrease Your Blood Sugar In Pregnancy

If your doctor has told you you have elevated blood sugar levels, you probably already know the potential risks. Uncontrolled blood sugar during pregnancy increases your risk of developing gestational diabetes, a potentially serious condition that can complicate delivery, according to the National Institutes of Health, and even increase your child's risk of developing type-2 diabetes later in life. Fortunately, for most women, reducing blood sugar is as simple as changing your diet, according to Aviva Romm, a physician, midwife and author of "The Natural Pregnancy Book." It's not about deprivation or eating bland, tasteless foods. Instead, you can lower blood sugar levels while enjoying delicious, natural foods. Low Glycemic Index Foods Foods can be rated based on how quickly they are converted to glucose. Some foods, such as white bread, pasta, white rice, donuts and most processed foods, quickly become glucose and raise blood sugar, while causing inflammation. Whole, natural foods are usually "low-glycemic index" foods, meaning they reduce inflammation and lower blood sugar levels. The key to maintaining healthy blood sugar levels during pregnancy, says Dr. Sean Daneshmand, M.D., a San Diego obstetrician and the founder of Miracle Babies, is "eating low glycemic index (GI) type foods as much as possible." He adds, "Low GI types of foods include beans; sunflower and pumpkin seeds; whole intact grains, including oats, wheat and barley; and most vegetables and fruits." He recommends avoiding high GI foods, such as white bread, white rice, most breakfast cereals and potatoes. Improve Digestion Los Angeles-based clinical nutritionist Stella Metsovas, B.S., CCN, says people tend to overlook the importance of digestion in maintaining healthy blood sugar levels. She says, "Op Continue reading >>

Gestational Diabetes

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 >>

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

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 >>

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 >>

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 >>

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 >>

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