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28 Weeks Pregnant With Twins Gestational Diabetes

New Optimal Screening Threshold For Gestational Diabetes In Twin Pregnancies

New Optimal Screening Threshold For Gestational Diabetes In Twin Pregnancies

New Optimal Screening Threshold for Gestational Diabetes in Twin Pregnancies New Optimal Screening Threshold for Gestational Diabetes in Twin Pregnancies Ideal 1-hour 50-g glucose challenge test cutoff 135 mg/dL, say researchersin the American Journal of Obstetrics & Gynecology A common complication, gestational diabetes affectsapproximately 6-7% of pregnant women. Currently, screening is done in two stepsto help identify patients most at risk; however, the suggested levels foradditional testing were based on singleton pregnancy data. Now investigatorshave analyzed data from twin pregnancies and have determined that the optimalfirst step cutoff for additional screening appears to be a blood sugar levelequal to or greater than 135 mg/dL for women carrying twins. Their findings arepublished in the American Journal ofObstetrics & Gynecology. Representing approximately 3.3% of all live births in theUnited States, twin pregnancies present unique medical challenges; however,most of the available data regarding GDM testing thresholds are based onsingleton pregnancies. Since carrying twins amplifies the normal physicalchanges that accompany pregnancy, a team of researchers from the Icahn Schoolof Medicine at Mount Sinai and the New York University School of Medicine setout to pinpoint the most effective screening cutoff for women pregnant withtwins. Currently, the American Congress of Obstetricians andGynecologists advocates a two-step diagnostic approach. Women are screenedbetween 24-28 weeks, using a nonfasting 1-hour 50-g glucose challenge test(GCT). If a patient exceeds the recommended cutoff (between 130 mg/dL and 140 mg/dL),additional testing is performed to diagnose or rule out GDM. In this study, doctors analyzed data from 475 womenpregnant with twins who were treated Continue reading >>

Having Twins? Beware Of Gdm

Having Twins? Beware Of Gdm

Home Blogs Jaclyn Stewart's blog Having Twins? Beware of GDM twins gestational diabetes (GDM) multiples Posted by Jaclyn Stewart on Aug 8th, 2012 Many pregnant women are at risk for developing gestational diabetes. Gestational diabetes, or GDM, is a form of diabetes that comes on only for the duration of pregnancy in women with no prior history of the condition. The symptoms of GDM are the same as those associated with Type 1 or Type 2 Diabetes. There are many circumstances that might increase your risk for GDM. If you are over the age of 25 when you enter your pregnancy, you have a higher risk. Also, if you are overweight, your chances for getting GDM increase. Women especially susceptible to GDM are those with a family history of Diabetes in any of its forms. While many of these risk factors make contracting GDM easy to predict, there is one risk factor that is difficult in itself to predict. Having twins will increase your likelihood of getting gestational diabetes. A recent study proved that women who were pregnant with twins were much more likely to contract gestational Diabetes. Obviously, you cannot control whether or not you will have twins or a singleton birth, but knowing youre more likely to get GDM might make it easier to prepare for and treat. Treating GDM is essentially the same as treating Type 1 or Type 2 Diabetes outside of pregnancy. Your goal should be to keep blood sugar levels consistent, and doing so is a matter of a balanced diet, regular exercise and checking blood levels often to see if insulin is needed. If you do get GDM when you are pregnant with twins, there might be some negative side effects. One of the major side effects of GDM is that babies are born larger than normal. Since twins are naturally smaller than other babies, their size inc Continue reading >>

Gestational Diabetes: Causes, Symptoms And Treatments

Gestational Diabetes: Causes, Symptoms And Treatments

Gestational diabetes has become one of the most common pregnancy complications in the US, with about 7 percent of pregnant women developing the condition. But just because it’s more widespread doesn’t mean it comes without risks. So what is gestational diabetes—and how can you minimize your chances of getting it? In this article What is gestational diabetes? What causes gestational diabetes? Gestational diabetes symptoms Gestational diabetes treatment How to prevent gestational diabetes What Is Gestational Diabetes? Gestational diabetes means your body can’t properly regulate your blood sugar levels while you’re pregnant—either because you don’t produce enough insulin or your body can’t properly use the insulin it does produce. That causes your blood sugar levels to spike when you eat, leading to a condition called hyperglycemia. Most moms-to-be diagnosed with gestational diabetes experience diabetes only during pregnancy, and the condition clears up soon after birth. But 5 to 10 percent of women continue to have type 2 diabetes after pregnancy, and those whose diabetes clears up after childbirth are still at a 20 to 50 percent risk of developing type 2 diabetes within the next 10 years. So why are doctors so concerned about this condition? “Gestational diabetes puts the mom and baby at increased risk for pregnancy complications,” says Sherry A. Ross, MD, a Santa Monica, California-based ob-gyn and author of She-ology: The Definitive Guide to Women’s Intimate Health. Period. For moms, those include: High blood pressure Preeclampsia Preterm labor C-section Gestational diabetes effects on baby can increase the risk of: Higher birth weight Shoulder dystocia (when the shoulders get stuck in the birth canal) Congenital malformations (such as abnormal sp Continue reading >>

Diabetes And Pregnancy

Diabetes And Pregnancy

Diabetes and your unborn baby Diabetes is a condition in which the amount of sugar (glucose) in the blood is too high. Glucose comes from the digestion of starchy foods, such as bread and rice. Insulin, a hormone produced by your pancreas, helps your body to use glucose for energy. Three types of diabetes can affect you when you're pregnant: type 2 diabetes – long-term conditions that women may have before they get pregnant (pre-existing diabetes) gestational diabetes – develops only in pregnancy and goes away after the baby is born The information on this page is for women who have pre-existing diabetes in pregnancy. Most women with diabetes have a healthy baby, but diabetes does give you a higher risk of some complications. If you already have diabetes If you already have type 1 or type 2 diabetes, you may be at a higher risk of: having a large baby – which increases the risk of a difficult birth, having your labour induced, or a caesarean section People with type 1 diabetes may develop problems with their eyes (diabetic retinopathy) and their kidneys (diabetic nephropathy), or existing problems may get worse. If you have type 1 or type 2 diabetes, your baby may be at risk of: not developing normally and having congenital abnormalities, particularly heart and nervous system abnormalities being stillborn or dying soon after birth having health problems shortly after birth, such as heart and breathing problems, and needing hospital care developing obesity or diabetes later in life Reducing the risks if you have pre-existing diabetes The best way to reduce the risk to your own and your baby's health is to ensure your diabetes is controlled before you become pregnant. Ask your GP or diabetes specialist (diabetologist) for advice. You should be referred to a diabetic Continue reading >>

Early Detection: Gestational Diabetes & Preeclampsia

Early Detection: Gestational Diabetes & Preeclampsia

Diabetes and preeclampsia are among two of the reasons why regular prenatal visits are so important. Gestational Diabetes: The Basics Chances are you'll sail through pregnancy without trouble. But even if you're feeling great, you should still seek regular prenatal care because some health problems that could hurt your baby are symptomless. These include gestational diabetes, which raises blood sugar levels during pregnancy, and preeclampsia, a form of high blood pressure. But with early detection and treatment, you can manage these problems and still have a healthy baby. What Is It? Gestational diabetes occurs when pregnancy hormones interfere with the body's ability to use insulin, the hormone that turns blood sugar into energy, resulting in high blood sugar levels. Each year, up to 4 percent of women develop this serious illness in pregnancy. While most women with gestational diabetes have no symptoms, a small number may experience extreme hunger, thirst, or fatigue. How Do I Know If I Have It? Your doctor will probably screen you for gestational diabetes between your 24th and 28th weeks of pregnancy. If you have certain risk factors (see "Who's at Risk?" below), your doctor may opt to screen you sooner. During your screening, you'll drink a sugary liquid, then take a blood test. If your blood sugar levels appear high, you'll need to take a longer test, during which you'll drink more liquid and your blood sugar will be tested several times to determine whether you have gestational diabetes. What Are the Risks Associated with It? Women who fail to seek treatment for gestational diabetes run the risk of giving birth to big babies (9 pounds or more), since much of the extra sugar in the mother's blood ends up going to the fetus. Larger babies are more likely to suffer b Continue reading >>

Gestational Diabetes - My Story And Recipes

Gestational Diabetes - My Story And Recipes

This is a little bit of a departure from my normal blog posts. However, I thought sharing my experience with gestational diabetes would be good to raise awareness and let other pregnant gals hear a first hand account. I hope you keep reading and that you learn something. The recipes, ideas and meal suggestions are healthy for anyone diabetic or not. Heading into my third trimester gestational diabetes was not on my radar. It blindsided me. I didn't expect to be diagnosed. I've been very proactive about my health. I've focused on eating well, maintaining a good weight and getting exercise. I only had two of the risk factors: I'm over 25 and I do have history of type II diabetes from both my maternal grandfather and paternal grandmother. Although they both were diagnosed late in life and already had other health problems so it just didn't seem relevant. When I failed the first 1-hour non-fasting glucose test I figured it was a fluke and I would pass the longer 3-hour fasting glucose test. I didn't. For the 1-hour glucose test, anything over 130mg/dL (or 140mg/dL depending on your doctor) is high enough to warrant the three-hour test. If your blood sugar is over 200mg/dL they don't even bother with the 3-hour test and confirm a diagnosis of gestational diabetes. Usually pregnant women are tested between 24 and 28 weeks. At week 28 my blood sugar tested at 138 mg/dL. What is considered elevated blood glucose levels vary by doctor and practice. From what I've read, I go to a fairly conservative practice. Below you can see the American Diabetes Association scores to diagnose gestational diabetes verses the practice I go to and then what my scores were. The 3-hour fasting glucose test involves not eating for 12 hours, then having blood drawn. That's the first fasting score. Th Continue reading >>

Gestational Diabetes

Gestational Diabetes

KEY POINTS Most pregnant women get a test for gestational diabetes at 24 to 28 weeks of pregnancy. If untreated, gestational diabetes can cause problems for your baby, like premature birth and stillbirth. Gestational diabetes usually goes away after you have your baby; but if you have it, you’re more likely to develop diabetes later in life. Talk to your health care provider about what you can do to reduce your risk for gestational diabetes and help prevent diabetes in the future. What is gestational diabetes? Gestational diabetes (also called gestational diabetes mellitus or GDM) is a kind of diabetes that can happen during pregnancy. Seven out of every 100 pregnant women (7 percent) develop gestational diabetes. It’s a condition in which your body has too much sugar (called glucose) in the blood. When you eat, your body breaks down sugar and starches from food into glucose to use for energy. Your pancreas (an organ behind your stomach) makes a hormone called insulin that helps your body keep the right amount of glucose in your blood. When you have diabetes, your body doesn’t make enough insulin or can’t use insulin well, so you end up with too much sugar in your blood. This can cause serious health problems, like heart disease, kidney failure and blindness. It’s really important to get treatment for diabetes to help prevent problems like these. Can gestational diabetes cause problems during pregnancy? Most of the time gestational diabetes can be controlled and treated during pregnancy to protect both you and your baby. But if not treated, it can cause problems during pregnancy, including: Preeclampsia. This is when a pregnant woman has high blood pressure and signs that some of her organs, like her kidneys and liver, may not be working properly. Signs of pre Continue reading >>

Twins And Gestational Diabetes

Twins And Gestational Diabetes

Started by Minimouse27, Sep 12 2013 08:40 AM I've had my second incident of thrush in this pregnancy (first confirmed with swab, second is my assumption based on symptoms in past few days) and I've never had thrush in my life before! Canesten seems to do the trick though, and works quickly and effectively on me. I'm also now treating DH. No thrush with DS pregnancy, also no GD - my sugar levels were really great in fact. In my early twenties however, I did have mild insulin resistance due to PCOS. I'm just wondering - I know GD is a higher chance with twins and two placentas - how many of you had it? When were you tested for it - my OB told me last week it is 28 weeks (like a singleton) but I am wondering if I should request the GTT test earlier this time to put my mind at ease? Also, for those with GD, was thrush a symptom for you? (sorry about all the questions. I'm starting a new even healthier eating plan today, with lots of low GI foods). I have my GD test at 28 weeks as per normal and had no issues passing it. That said besides the twins I don't have any risk factors or family history to make me suspect I'd get it. I had GD with my DD so OB said that I would absoloutely get it again with the twins. She was right. I was tested at 16 weeks and again at 28 weeks. I mangaged to hold it off til 28 weeks but went straight on to insulin at 28 weeks. Diabetic educator explained that twice the placenta means twice insulin resistance hormone floating around. I don't belong in the twins section, but I'm insulin resistant and had GD with DS and about 99% sure I will get it again this time. I have never had trush in my life, so for me they're certainly not related. I believe I will be tested for GD sometime around early or mid second trimester, rather than 28 weeks this time. Continue reading >>

32 - 36 Weeks The Toughest Time...

32 - 36 Weeks The Toughest Time...

Between 32 - 36 weeks are what we know to be the toughest time for gestational diabetes. It's at around this point that we typically see insulin resistance worsen. You think you have your gestational diabetes diet sussed out and you can literally wake and eat the same breakfast you've been tolerating well for weeks on end and get crazy blood sugar levels?! What the heck is going on and what did you do wrong???... Firstly, you've done NOTHING wrong! This is to be expected and is completely normal and typical with gestational diabetes. To understand what's going on, we need to understand a bit about gestational diabetes and how it works... Gestational diabetes is a progressive condition Gestational diabetes typically presents itself between 24 - 28 weeks. It is for this reason that it is around this time where screening for gestational diabetes typically takes place. It should be noted that insulin resistance can be detected much earlier than this time also, especially in subsequent pregnancies where the mother previously had gestational diabetes. Many ladies are told that earlier diagnosis means that they may have undiagnosed Type 1 or Type 2 diabetes. We have found that this is not the case when ladies are tested following the birth of their baby and so we advise not panicking and waiting until you have your post birth diabetes testing before causing yourself too much distress. Further information on post birth diabetes testing can be found here. Gestational diabetes is caused by increased hormones levels from the placenta that cause insulin resistance. Those diagnosed with gestational diabetes are not able to increase insulin production to meet the additional requirement, or they cannot use the insulin which has been made effectively and so blood sugar levels remain to Continue reading >>

28 Weeks Pregnant With Twins! 3 Hour Glucose Test Update

28 Weeks Pregnant With Twins! 3 Hour Glucose Test Update

The best deals on the nicest things and one couple's infertility journey. 28 Weeks Pregnant with Twins! 3 Hour Glucose Test Update Hi, babies! Last week was a big week for a couple of reasons. One; I was really nervous about the 3 hour glucose test. I failed the first test because my levels were too high after drinking 50 grams of sugar, so my doctor had me come in to take the 3 hour test. I really didnt want to have to worry about managing gestational diabetes, plus the thought of having large babies (which is one the side effects of gestational diabetes) was giving your mama bear some anxiety! Having two babies that are growing at a rate of a half pound each, so one pound total, per week is stretching my body to the limits as it is. The part thats hard about that is when the babies are big but their lungs, etc. arent developed yet. I went into the doctors office at 8:15 am last Wednesday and drank 100 grams of sugar in a matter of 5 minutes. It was delicious. And by delicious, I mean I would have rather eaten a giant chocolate cake instead. I Googled it afterward, and 100 grams is about 24 teaspoons of sugar. You two were wiggling around a lot in my belly a LOT afterward, and then you stopped after a bit. Sugar crash?! Note to self: do not feed you sugar. Ever. The nurse drew my blood immediately after I drank the glucose drink, then drew it every hour on the hour for 3 hours. Im not sure why she just didnt leave the needle in my arm like they did at the ER when I went there at 13 weeks. She had to poke me 4 times! I got the call on Friday that I do not have gestational diabetes. YIPPEE!! Its such relief. Your daddy and I are going to get another ultrasound at maternal fetal medicine at the hospital on Wednesday. We are excited to see your cute little selves getting Continue reading >>

Pregnant With Twins Gestational Diabetes ??s - Mothering Forums

Pregnant With Twins Gestational Diabetes ??s - Mothering Forums

Parenting Multiples > Pregnant with Twins Gestational Diabetes ??s I'm 30 weeks preganant with twins and just failed that stupid 3-hour GTT test (just by a little they said). Now my Dr's are insisting I see a dietician. However, we live in a rural area and the small-town hospital here doesn't have a dietician that specializes in maternity cases (let alone multiples). I'm afraid this visit will just be a waste of time. Can anyone give me good advice about what I should be doing/expecting now? I'm a little freaked out at this point b/c the nurse they had call me with the results was going on and on about possible birth defects from GD as well as the possibility of stillbirth, etc. From what I've read this is only a problem if you have undiagnosed diabetes early in your pregnancy. Is this true? I want to take this seriously, but how much difference is changing my diet (which I have been very careful about up until now) is going to make at this point? Any thoughts from anyone who has gone through this stuff? Hi, I had GD during my pregnacy it was my first time dealing with it and was told that it is due to carrying twins. They told me it was slight but still insisted I tested my blood from my finger after each meal. OUCH it really got on my nerves after a while and I realized what made it go up, like after eating a bowl of oatmeal. So I did meet with a dietician and was told to cut out carbs. My biggest down fall was pasta I ate two bowls of it. You need to make you diet consist of high protein, meats, chicken eggs, bacon, fish all vegetables are good. Stay away from potatoes though. Cut out breads, pasta, muffins, oartmeal all things high in CARBS or have very small portions maybe once a day. If you eat a sandwich add mayo have one slice of toast instead of two. If you ha Continue reading >>

Gestational Diabetes

Gestational Diabetes

I failed my 1 hour test so I took my 3 hour test on Friday. It looks like my glucose levels were normal during your 1 and 3, however my levels during hour 2 were very high (like 30 "points" over normal). What does that mean? I know I can wait and talk to my doctor at my next appointment, but I just want to get my poop in a group before that appointment and learn something before then! PS there are times where I feel sick after eating, like sick to my stomach. Could that be the diabetes at work? I had gestational diabetes with my last pregnancy.. eating never made me feel sick or anything.. wish I had some advice but I am curious as to why you were tested this early? I've only ever been tested at around 28 weeks with my first 2 and I asked at my last appointment if I'd be tested early because I did have it with my second and they said nope I would be tested at 28 weeks! Hope you get the information you're looking for!! When I was first diagnosed with it, they immediately had my follow up with a nutritionist and that helped me a lot figuring out what I could and couldn't eat :) I'm not sure why I was tested so early. I believe the lab lady said that this is something they are just starting at my obgyn. I'm also a fatty so that may have something to do with it! I think it all depends on your doctor. I passed my 1 hour test but my scores were above average (above an average person but still below gestational diabetes) and my doctor elected to skip 3 hour test and send me straight to nutritionist. I have had prior intolerance which is why they tested me early b I go to a group of doctors and the second doctor said it could go either way whether or not further follow up would necessary for me but he would defer to the first doctor. It seems like each doctor has different thr Continue reading >>

Twins And Gestational Diabetes...advice Anyone??

Twins And Gestational Diabetes...advice Anyone??

Twins and Gestational Diabetes...advice anyone?? I dont post on here very often, but im hoping you twin mums and twin mums to be could provide me with some advice or support if possible???? I am currently 28 weeks pregnant with non identical boys and have just been diagnosed with Gestational Diabetes As if the shock of having twins wasnt enough (concieved naturally after the first month of trying!) and having no twins in our family, i now am not only rhesus negative, but now have this too! Has anyone else experienced GD with twins at all and was everything ok, or do you know of anyon who has? Feeling really down and miserable right now, as I appear to be getting everything where odds are low which is making me worry even more!! Any advice or words of wisdom appreciated... HI hun. Firstly, please try not to worry. My twin pregnancy was my third, and I had GD diagnosed at 28wks too - but as it turned out, once I began to take my blood sugars, it actually wasn't. All my post meal bloods were normal, despite my fasting test being positive for GD. It was explained to me that when there are two placentas, the demands on the body are so much greater than in a singleton pregnancy. You are making more insulin, processing more and the strain can make GD show up, but it it isn't genuine GD. Even if it is GD, then it can be easily controlled with a few minor adjustments to your diet. Regular meals, less carbs less sweet stuff. It is quite rare for a lady to go on and require insulin to control it. In the end I took bloods for a few weeks, and once they looked ok carried on as normal - my diet was good anyway, so didn't have to cut back on anything. As it transpires my twins were huge at term due to genetics and NOT GD. As for rhesus negative satus, I have that too, and in 3 pregna Continue reading >>

I Am 31 Weeks, And Have Gestational Diabetes...

I Am 31 Weeks, And Have Gestational Diabetes...

I delivered my son at 39 weeks by emergency c-section. I had gestational diabetes. My doctor told me that my baby was going to be at least a 9lb. or 10lb. baby. When he was born, he weighed 7lbs. 7.6 oz. Talk about a prediction? Doctors do not know everything, they can only speculate, just like us. My advice during pregnancy, THE BEST ADVICE I RECEIVED WAS... forget that you are eating for two, make healthy choices, splurge in moderation, exercise when possible. It did help me control my diabetes. I had gestational diabetes with my son and it also runs in my family to have huge babies. My doctor made me go full term plus a week. She etimated my son to weigh about 8lbs. He weighed 9lbs 12oz and I had him vaginally. I can't help but think maybe if she had induced me a little early it would've save me a few stitches and him a broken collar bone. Trust your instincts. My son felt huge and my doctor wouldn't listen to me. Also did your mother or grandmother have large babies? (my sister weighed 11 lbs 3 oz) Really the best thing you can do for yourself is to control your diet. Which will be extremely hard because diabetes gives you an insatiable hunger. Watch starch nd sugar the last month especially because sugar promotes cellular growth and thats all the baby does the last month. Your doc may want you to have another ultrasound closer to the end to estimate how big the baby is. Hang in there. I'm right there with you at 31 wks with #2 hoping he ends up smaller than his big bro. Please keep in mind that the weight of your baby right now is only an estimate and babies can weigh less or more than what they are estimated to weigh even with the help of an ultrasound. My third child was estimated to be 8 lbs just days before he was born. He was 10lbs and 6 oz, born at 41 weeks a Continue reading >>

Complications In A Multiples Pregnancy

Complications In A Multiples Pregnancy

Home / Multiples Pregnancy / Complications in a Multiples Pregnancy Of all the types of multiple births , twins normally face the fewest medical problems and complications. Each additional baby a woman carries during her pregnancy increases the possibility of developing pregnancy complications . What are the most common complications associated with multiples? Preterm labor/delivery is defined as delivery before 37 completed weeks of pregnancy. The length of gestation typically decreases with each additional baby. On average most single pregnancies last 39 weeks, twin pregnancies 36 weeks, triplets 32 weeks, quadruplets 30 weeks, and quintuplets 29 weeks. Almost 60% of twins are delivered preterm, while 90% of triplets are preterm. Higher order pregnancies are almost always preterm. Many times premature labor is a result of preterm premature rupture of the membranes (PPROM). PPROM is rupture of the membranes prior to the onset of labor in a patient who is less than 37 weeks of gestation. Low birth weight is almost always related to preterm delivery. Low birth weight is less than 5.5 pounds (2,500 grams). Babies born before 32 weeks and weighing less than 3.3 pounds (1,500 grams) have an increased risk of developing complications as newborns. They are at increased risk for having long-term problems such as mental retardation, cerebral palsy , vision loss, and hearing loss. Multiple pregnancies grow at approximately the same rate as single pregnancies up to a certain point. The growth rate of twin pregnancies begins to slow at 30 to 32 weeks. Triplet pregnancies begin slowing at 27 to 28 weeks, and quadruplet pregnancies begin slowing at 25 to 26 weeks. IUGR seems to occur because the placenta cannot handle any more growth and because the babies are competing for nutrien Continue reading >>

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