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Babies Born To Mothers With Gestational Diabetes Are Often Underweight

Managing Gestational Diabetes

Managing Gestational Diabetes

3 Staying in Balance Three-quarters of women with gestational diabetes can manage it through diet alone.Toxemia or preeclampsia is the medical term for high blood pressure that is caused by pregnancy. Symptoms of this type of high blood pressure include swelling of the feet and lower legs. High blood pressure is not good for you or for your baby. It can be life threatening. If you develop toxemia, your activity may need to be limited, you may be hospitalized, or have a cesarean birth. Like gestational diabetes, the high blood pressure usually goes away once the baby is born. Urinary tract infections are more common for women with gestational diabetes. Besides the discomfort of burning with urination and frequent urination, urinary tract infections may lead to premature birth. A program of meal planning, exercise, and possibly insulin therapy will help you keep your blood-sugar level within the normal range and your body healthy. Earlier in this book, we told you that gestational diabetes is like Type 2 diabetes, except that it’s temporary and that it’s activated by your pregnancy. Certain hormones from your placenta block the insulin made by your pancreas from doing its job, which is to help your cells absorb the sugar in your blood. The result is not enough sugar in your cells to give you strength and energy and too much in your blood, which can be dangerous and even fatal if not treated. To correct this situation, you have to reduce the amount of sugar/glucose coming into your body (but not too much!) by changing your diet. About three-quarters of the women who get gestational diabetes are able to control their blood sugar levels through changes in their diets. You can also reduce the amount of sugar/glucose in your bloodstream by exercising. If both of these solu Continue reading >>

Gestational Diabetes

Gestational Diabetes

Overview Gestational diabetes develops during pregnancy (gestation). Like other types of diabetes, gestational diabetes affects how your cells use sugar (glucose). Gestational diabetes causes high blood sugar that can affect your pregnancy and your baby's health. Any pregnancy complication is concerning, but there's good news. Expectant women can help control gestational diabetes by eating healthy foods, exercising and, if necessary, taking medication. Controlling blood sugar can prevent a difficult birth and keep you and your baby healthy. In gestational diabetes, blood sugar usually returns to normal soon after delivery. But if you've had gestational diabetes, you're at risk for type 2 diabetes. You'll continue working with your health care team to monitor and manage your blood sugar. Symptoms For most women, gestational diabetes doesn't cause noticeable signs or symptoms. When to see a doctor If possible, seek health care early — when you first think about trying to get pregnant — so your doctor can evaluate your risk of gestational diabetes as part of your overall childbearing wellness plan. Once you're pregnant, your doctor will check you for gestational diabetes as part of your prenatal care. If you develop gestational diabetes, you may need more-frequent checkups. These are most likely to occur during the last three months of pregnancy, when your doctor will monitor your blood sugar level and your baby's health. Your doctor may refer you to additional health professionals who specialize in diabetes, such as an endocrinologist, a registered dietitian or a diabetes educator. They can help you learn to manage your blood sugar level during your pregnancy. To make sure your blood sugar level has returned to normal after your baby is born, your health care team wil Continue reading >>

Gestational Diabetes Independently Increases Birth Length And Augments The Effects Of Maternal Bmi On Birth Weight: A Retrospective Cohort Study

Gestational Diabetes Independently Increases Birth Length And Augments The Effects Of Maternal Bmi On Birth Weight: A Retrospective Cohort Study

Go to: Abstract Objective: To investigate the effect of the interaction between gestational diabetes mellitus (GDM) and maternal body mass index (BMI) on the individual neonatal growth parameters. Design: Retrospective cohort study. Setting: A tertiary maternity service in Sydney, Australia, between 2005 and 2009. Population: A cohort of 8859 women. Methods: Generalized linear models. Main outcome measures: Neonatal growth parameters, represented by z-scores for infant birth weight (BW), birth length (BL), and head circumference (HC) in GDM and non-GDM groups. Results: Only GDM alone had an independent and positive effect on BL (p = 0.02) but not on BW or HC. In addition, in pregnancies complicated with GDM, the association between maternal weight and BW was significantly stronger (p < 0.001). In combination, GDM and maternal BMI significantly affected z-score differences between BW and BL (p < 0.001), in that underweight mothers had babies that were lighter relative to their length and inversely obese mothers had babies that were heavier relative to their length. Conclusion: GDM independently influences BL and increases the association between maternal BMI and BW. In accordance with the hypothesis of the fetal origins of health and disease, the pronounced effects of GDM on fetal growth patterns demonstrated in this study are likely to influence long-term health outcomes in children. Keywords: birth weight, birth length, head circumference, gestational diabetes mellitus, maternal BMI Continue reading >>

Ob Chapter 11: Pregnancy At Risk: Preexisting Conditions

Ob Chapter 11: Pregnancy At Risk: Preexisting Conditions

In planning for the care of a 30-year-old woman with pregestational diabetes, the nurse recognizes that the most important factor affecting pregnancy outcome is the: b. Number of years since diabetes was diagnosed. c. Amount of insulin required prenatally. d. Degree of glycemic control during pregnancy. d. Degree of glycemic control during pregnancy. Concerning the use and abuse of legal drugs or substances, nurses should be aware that: a. Although cigarette smoking causes a number of health problems, it has little direct effect on maternity-related health. b. Caucasian women are more likely to experience alcohol-related problems. c. Coffee is a stimulant that can interrupt body functions and has been related to birth defects. d. Prescription psychotherapeutic drugs taken by the mother do not affect the fetus; otherwise, they would not have been prescribed. b. Caucasian women are more likely to experience alcohol-related problems. Screening at 24 weeks of gestation reveals that a pregnant woman has gestational diabetes mellitus (GDM). In planning her care, the nurse and the woman mutually agree that an expected outcome is to prevent injury to the fetus as a result of GDM. The nurse identifies that the fetus is at greatest risk for: b. Congenital anomalies of the central nervous system. A 26-year-old primigravida has come to the clinic for her regular prenatal visit at 12 weeks. She appears thin and somewhat nervous. She reports that she eats a well-balanced diet, although her weight is 5 pounds less than it was at her last visit. The results of laboratory studies confirm that she has a hyperthyroid condition. Based on the available data, the nurse formulates a plan of care. What nursing diagnosis is most appropriate for the woman at this time? b. Imbalanced nutrition: Continue reading >>

Understanding Gestational Diabetes

Understanding Gestational Diabetes

Introduction Approximately 3 to 5 percent of all pregnant women in the United States are diagnosed as having gestational diabetes. These women and their families have many questions about this disorder. Some of the most frequently asked questions are: What is gestational diabetes and how did I get it? How does it differ from other kinds of diabetes? Will it hurt my baby? Will my baby have diabetes? What can I do to control gestational diabetes? Will I need a special diet? Will gestational diabetes change the way or the time my baby is delivered? Will I have diabetes in the future? This brochure will address these and many other questions about diet, exercise, measurement of blood sugar levels, and general medical and obstetric care of women with gestational diabetes. It must be emphasized that these are general guidelines and only your health care professional(s) can tailor a program specific to your needs. You should feel free to discuss any concerns you have with your doctor or other health care provider, as no one knows more about you and the condition of your pregnancy. What is gestational diabetes and what causes it? Diabetes (actual name is diabetes mellitus) of any kind is a disorder that prevents the body from using food properly. Normally, the body gets its major source of energy from glucose, a simple sugar that comes from foods high in simple carbohydrates (e.g., table sugar or other sweeteners such as honey, molasses, jams, and jellies, soft drinks, and cookies), or from the breakdown of complex carbohydrates such as starches (e.g., bread, potatoes, and pasta). After sugars and starches are digested in the stomach, they enter the blood stream in the form of glucose. The glucose in the blood stream becomes a potential source of energy for the entire body, sim Continue reading >>

How Gestational Diabetes Affects You & Your Baby

How Gestational Diabetes Affects You & Your Baby

When you're pregnant, hormone changes can make your blood sugar level rise. Gestational diabetes will raise the odds of pregnancy complications. After you're diagnosed, your doctor or midwife will want to watch your health and your baby's health closely for the rest of your pregnancy. Most women with gestational diabetes have healthy pregnancies and healthy babies. Getting good treatment makes all the difference. How Will It Affect My Baby? Your higher blood sugar affects your baby, too, since they gets nutrients from your blood. Your baby stores that extra sugar as fat, which can make them grow larger than normal. They're more likely to have certain complications: Injuries during delivery because of their size Low blood sugar and mineral levels when they're born Jaundice, a treatable condition that makes the skin yellowish Pre-term birth Later in life, your baby might have a greater chance of obesity and diabetes. So help your child live a healthy lifestyle -- it can lower their odds for these problems. How Will It Affect Me? You might have: A higher chance of needing a C-section Pre-term birth Your blood sugar will probably return to normal after you give birth. But you'll have a higher risk of developing type 2 diabetes later or gestational diabetes again with another pregnancy. A healthy lifestyle can lower the odds of that happening. Just as you can help your child, you can lower your own chances of obesity and diabetes. Although you may need a C-section, many women with gestational diabetes have regular vaginal births. Talk to your doctor or midwife about your delivery options: Does my baby need to be delivered by C-section? How accurate are birth-weight estimates? Could my baby be smaller than you think? What are the risks to my baby and I if I don’t have a C-s Continue reading >>

Hypoglycemia In The Newborn

Hypoglycemia In The Newborn

What is hypoglycemia in the newborn? Hypoglycemia is a condition in which the amount of blood glucose (sugar) in the blood is lower than normal (under 50 mg/dL). Who is affected by hypoglycemia in the newborn? Babies who are more likely to develop hypoglycemia include: Babies born to diabetic mothers may develop hypoglycemia after delivery when the source of glucose (via the umbilical cord) is gone and the baby's insulin production metabolizes the existing glucose. Small for gestational age or growth-restricted babies may have too few glycogen stores. Premature babies, especially those with low birthweights, who often have limited glycogen stores (sugar stored in the liver) or an immature liver function. Babies born under significant stress. Babies who experience temperature instability (for instance, get cold) or when mothers were treated with certain drugs (for instance, terbutaline) Infants of diabetic mothers Babies who are large for their gestational age. This is associated with gestational diabetes, but also with forms of congenital hyperinsulinism What causes hypoglycemia in the newborn? Hypoglycemia may be caused by conditions that: Lower the amount of glucose in the bloodstream. Prevent or lessen storage of glucose. Use up glycogen stores (sugar stored in the liver). Inhibit the use of glucose by the body. Many different conditions may be associated with hypoglycemia in the newborn, including the following: Inadequate maternal nutrition in pregnancy Excess insulin produced in a baby of a diabetic mother Severe hemolytic disease of the newborn (incompatibility of blood types of mother and baby) Birth defects and congenital metabolic diseases Birth asphyxia Cold stress (conditions that are too cold) Liver disease Infection Why is hypoglycemia in the newborn a con Continue reading >>

Gestational Diabetes

Gestational Diabetes

Home The Diet Weekly Record Physiology FAQ Principles Special Needs No-Risk Diet Weight Gain Salt Water Bed Rest Herbal Diuretics Vegetarian Twin Pregnancy The Twin Diet Premature Labor Swelling Blood Pressure Pre-eclampsia HELLP/Hemorrhage Mistaken Diagnoses IUGR Underweight Babies Obesity Anemias Gestational Diabetes Abruption Brewer/ACOG Topics News Stories Inaccuracies Research In Memory Letters History Suppression Resources Other Issues Morning Sickness Colds and Flu About Contact Registry Registry II Registry III "Keep your nutritional needs clearly in mind" There is a summary and list of suggestions at the end of this page The following description of gestational diabetes is reprinted from The Brewer Medical Diet for Normal and High-Risk Pregnancy, by Gail Sforza Brewer [Krebs] with Thomas Brewer, M.D., published in 1983. While the standards recommended by the Diabetes Data Group may have been revised in more recent years to yet another, possibly even lower blood glucose level, which I will be researching in coming weeks, the principles advocated by Dr. Brewer in this reprint remain relevant. For an additional source on gestational diabetes, please see "Gestational Diabetes: Myth or Metabolism?", by Joy Jones, RN, which has been reprinted at the end of this page. For more information on testing for blood glucose and proper nutrition for apparently elevated blood glucose levels, please see Understanding Diagnostic Tests in the Childbearing Year, by Anne Frye, CPM, listed on our "Resources" page. Perhaps you can obtain a cop Continue reading >>

Does A Mother’s Diet Affect Baby’s Size? 6 Things You Need To Know

Does A Mother’s Diet Affect Baby’s Size? 6 Things You Need To Know

You’re eating for two, have some more! Mmm, maybe a smaller portion? You don’t want a big baby. Your belly looks small. Have another serving. You don’t want a skinny baby! You really shouldn’t eat that burger. How about a salad instead? The endless advice from friends, and even strangers, can leave a mother wondering what, if any, control she really has over her baby’s size. Does your diet affect how big or small your baby will be? Can you eat more to help your baby pack on some weight in utero? Will dieting keep your baby small, and the birth easier? The average weight for a term infant is around 2500-5000g (5 lbs 8 oz – 8 lbs 8oz). A baby over 5000g is typically considered big. It’s important to note, however, that a ‘big’ baby doesn’t automatically mean an unhealthy baby; neither does it mean birth complications. While your diet can affect your baby’s health, and even his size, it might not be in the way you think. The quality, not just the quantity, of what you eat can have some impact on your baby’s size, but it can also affect his metabolism and health – even into adulthood. Here are 6 things to know about your diet, and the effects it has on your baby’s size: #1: There Are Many Factors Which Affect Baby’s Size A mother’s diet certainly has the potential to affect her baby’s size. However, there are many other factors, including: Genetics: the genes coming from both mother and father can determine a baby’s size Pre-existing medical conditions, such as anaemia, diabetes, cardiac disease, etc Maternal age: mothers over 35 are more at risk for a larger baby, probably due to medical conditions which are more common as we age, rather than just the mother’s age. Teens are more at risk for smaller babies Pre-pregnancy weight: underwe Continue reading >>

Gestational Diabetes

Gestational Diabetes

Definition Gestational diabetes is a type of diabetes that occurs in non-diabetic women during pregnancy. Diabetes is a disease in which the pancreas is unable to produce insulin or use the insulin it produces in the proper way. Gestational diabetes affects about 3 to 6 percent of all pregnant women. It usually begins in the fifth or sixth month of pregnancy (weeks 24 and 28) and usually disappears shortly after delivery. Description After a meal, a portion of the food a person eats is broken down into sugar (glucose). The sugar then passes into the bloodstream and the cells via a hormone called insulin, produced by the pancreas. Normally, the pancreas produces the right amount of insulin to accommodate the quantity of sugar. However, if the person has diabetes, either the pancreas produces little or no insulin, or the cells do not respond normally to the insulin. In gestational diabetes, the woman is producing the right amount of insulin, however, the effect of insulin is partially blocked by a variety of other hormones (such as progesterone, prolactin, estrogen, cortisol and human placental lactogen) made in the placenta (the organ that provides nourishment to the baby while developing inside the mother). This process is called insulin resistance, and begins about 20 to 28 weeks into pregnancy. As the placenta grows, more of these hormones are produced and the greater the insulin resistance becomes. In most women, the pancreas is able to make additional insulin to overcome insulin resistance. When the pancreas makes all the insulin it can and there still is not enough to overcome the effect of these hormones, gestational diabetes results. Causes Any woman can develop gestational diabetes during pregnancy, however, there are certain factors that put a woman more “at Continue reading >>

Why Gestational Diabetes Is On The Rise

Why Gestational Diabetes Is On The Rise

Gestational diabetes cases are soaring, and you (as well as your baby) might be at risk without even knowing it. Find out gestational diabetes symptoms and diet. Gestational diabetes mellitus (GDM), or high blood sugar during pregnancy, used to be relatively rare, occurring in about 3 percent to 4 percent of pregnancies. But in recent years, the rate has doubled—now, up to 6 percent to 8 percent of moms-to-be are diagnosed with this prenatal complication. And new recommendations lowering the cutoff point for diagnosis may lead to an even more dramatic increase. If these new guidelines from an international panel of 50 experts are adopted in the United States, 16 percent of pregnant women may hear the words, "You have gestational diabetes." In women with GDM, excess glucose (blood sugar) passes from the mother's bloodstream through the placenta. Serious pregnancy complications include preeclampsia (a serious high blood pressure condition that can be fatal), preterm delivery and delivery of overweight babies, often via Cesarean section. Some 70 percent to 80 percent of women diagnosed with GDM in the United States eventually develop type II diabetes. New research is showing that GDM can have long-term consequences for children as well. "Children of women with GDM are at risk for developing type II diabetes themselves," says Danielle Downs, Ph.D., an associate professor of kinesiology and obstetrics and gynecology at Pennsylvania State University who conducts research on gestational diabetes. But even normal-size babies who are born to mothers with untreated GDM are at greater risk of becoming overweight kindergarteners—and, consequently, overweight adults. Although being overweight is a major risk factor for GDM, only about half of women diagnosed with it carry excess Continue reading >>

Pregnant Ladies, Take Note: You Can Be Healthy And Fit And Still Get Gestational Diabetes

Pregnant Ladies, Take Note: You Can Be Healthy And Fit And Still Get Gestational Diabetes

The one-hour glucose test is something every pregnant woman is asked to take. For the test, you chug a sugary drink, wait an hour, have your blood drawn, and then go about your day. The test is designed to check for gestational diabetes, a form of high blood sugar that affects pregnant women, and most women don’t hear or think about it again. That’s how I was, until I was told that I seriously flunked mine—and I didn’t take the news well. In fact, I'm pretty sure I blurted out something like, "How is that possible?" After all, the typical gestational diabetes patient is someone who has gained a lot of weight during their pregnancy and doesn’t exercise often. (Two of the major recommendations for women diagnosed with gestational diabetes are to follow a healthy diet and exercise more.) At seven months pregnant, I haven’t gained much weight, I eat healthy, and I run four miles, five days a week. My doctor also told me in the same visit that my baby bump is “measuring small,” and she wants to keep a close eye on it. WTF is going on?! According to the Centers for Disease Control and Prevention (CDC) anywhere from one in 50 to one in 20 pregnant women has gestational diabetes, so this is a fairly common issue. I just didn’t think it would be my issue. But, apparently, you can develop gestational diabetes and be an otherwise healthy person. Like type 2 diabetes, “gestational diabetes is linked to excess weight gain and lack of exercise,” Anita Avery, M.D., an ob/gyn at Michigan State University, tells SELF. “However, plenty of otherwise healthy women who are in good shape can still develop gestational diabetes.” That’s why women are screened with a blood test, rather than just those who are thought to have a chance of having gestational diabetes ba Continue reading >>

Infant Of Diabetic Mother

Infant Of Diabetic Mother

Women may have diabetes during pregnancy in 2 ways: Gestational diabetes is high blood sugar (diabetes) that starts or is first diagnosed during pregnancy. If the diabetes is not well controlled during pregnancy, the baby is exposed to high blood sugar levels. This can affect the baby and mom during the pregnancy, at the time of birth, and after birth. Infants who are born to mothers with diabetes are often larger than other babies. Larger infants make vaginal birth harder. This can increase the risk for nerve injuries and other trauma during birth. Also, C-sections are more likely. The infant is more likely to have periods of low blood sugar (hypoglycemia) shortly after birth, and during first few days of life. Mothers with poorly controlled diabetes are also more likely to have a miscarriage or stillborn child. If the mother had diabetes before her pregnancy, her infant has an increased risk of birth defects if the disease was not well controlled. Continue reading >>

What Are The Risks Of Gestational Diabetes?

What Are The Risks Of Gestational Diabetes?

A risk means there is a chance that something might happen. With every pregnancy there are some risks, but if you have gestational diabetes your risks of some things will be increased. Managing your blood sugar level brings these risks right down again though and most women with gestational diabetes have healthy pregnancies and healthy babies. These things are very unlikely to happen to you, but understanding the risks may help you see why it is important that you follow your healthcare team’s advice. The risks linked to gestational diabetes are caused by blood glucose levels being too high. If you can keep your blood glucose as close as possible to the ideal level, your risks will be reduced. Risk of having a large baby (macrosomia) If your blood glucose level is high, it can cause high blood glucose levels in your baby. Your baby will produce more insulin in response, just like you do. This can make your baby grow larger than normal. This is called macrosomia. Babies weighing more than 4kg (8lb 8oz) at birth are called macrosomic. Macrosomia increases the risk of: Birth trauma - either the mother or baby can be affected when it is difficult for the baby to be born. Trauma may include physical symptoms, such as bone fractures or nerve damage for the baby, or tearing and severe bleeding for the mother as well as psychological distress. Shoulder dystocia - where the baby’s shoulder is stuck in your pelvis once the head has been born. This can squash the umbilical cord, so the team need to use additional interventions to deliver the baby quickly and safely. It means you may have labour induced early or to have a caesarean section so that your baby is born safely. Your baby's weight will be monitored carefully in pregnancy to see whether these interventions are needed. Continue reading >>

Infant Of Diabetic Mother

Infant Of Diabetic Mother

There are two types of diabetes that occur in pregnancy: Gestational diabetes--when a mother who does not have diabetes before becoming pregnant develops a resistance to insulin because of the hormones of pregnancy. Pregestational diabetes--women who already have insulin-dependent diabetes and become pregnant. With both types of diabetes, there can be complications for the baby. It is very important for a mother to maintain very close control of her diabetes during pregnancy. The placenta supplies a growing fetus with nutrients and water, as well as produces a variety of hormones to maintain the pregnancy. Some of these hormones (estrogen, cortisol, and human placental lactogen) can have a blocking effect on insulin. This is called contra-insulin effect, which usually begins about 20 to 24 weeks into the pregnancy. As the placenta grows, more of these hormones are produced, and insulin resistance becomes greater. Normally, the pancreas is able to make additional insulin to overcome insulin resistance, but when the production of insulin is not enough to overcome the effect of the placental hormones, gestational diabetes results. Pregnancy also may change the insulin needs of a woman with existing diabetes as a medical condition. Insulin-dependent mothers may require more insulin as pregnancy progresses, sometimes as much as 30 percent over the prepregnancy dose. Who is affected by diabetes in pregnancy? About 5 percent of all pregnant women in the U.S. are diagnosed with gestational diabetes. Gestational diabetics make up the vast majority of pregnancies with diabetes. Some pregnant women require insulin to treat their diabetes. The mother's excess amounts of blood glucose are transferred to the fetus during pregnancy. This causes the baby's body to secrete increased am Continue reading >>

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