Having A Healthy Pregnancy With Type 1 Diabetes
Kerri Sparling was 7 years old when she was diagnosed with type 1 diabetes. She grew up believing that she'd never be able to have children of her own. But by the time she became an adult, significant technological advances in managing the illness gave her hope. With two decades of blood sugar control under her belt, Sparling eventually looked around for models of a healthy pregnancy with type 1 diabetes. Aside from Julia Robert’s character in the movie Steel Magnolia, she didn’t find much. Roberts’ character had type 1 diabetes and successfully carried a child to term, only to die soon after from diabetes complications. “It wasn’t a positive image,” Sparling said. Undaunted by the Hollywood dramatization, Sparling did her own research and, in preparation for pregnancy and with the help of her endocrinologist, worked for more than a year to get her A1C — a standard test to find out average blood sugar levels over several months — below seven. Sparling, now 34, has a 3-year-old daughter and confirms that while type 1 diabetes and pregnancy might be a challenging mix, a healthy pregnancy and a healthy baby are both possible. That said, pregnancy demanded a lot more insulin than she was used to taking, and she had to spend the last month of her pregnancy in the hospital with pre-eclampsia (high blood pressure in pregnancy) before her 6-pound, 13-ounce baby girl was delivered by Caesarean section. “Pregnancy has a definitive end,” Sparling said. “I felt I could make it through to the end of that. But diabetes goes on and on.” Like Sparling, other diabetic women can get pregnant. But without proper monitoring and extra precautions, the chronic illness puts both the mother and the baby at risk for various complications. Here are some of the important m Continue reading >>
Type 1 Or Type 2 Diabetes And Pregnancy
Problems of Diabetes in Pregnancy Blood sugar that is not well controlled in a pregnant woman with Type 1 or Type 2 diabetes could lead to problems for the woman and the baby: Birth Defects The organs of the baby form during the first two months of pregnancy, often before a woman knows that she is pregnant. Blood sugar that is not in control can affect those organs while they are being formed and cause serious birth defects in the developing baby, such as those of the brain, spine, and heart. Download Chart[PDF – 167KB] An Extra Large Baby Diabetes that is not well controlled causes the baby’s blood sugar to be high. The baby is “overfed” and grows extra large. Besides causing discomfort to the woman during the last few months of pregnancy, an extra large baby can lead to problems during delivery for both the mother and the baby. The mother might need a C-Section to deliver the baby. The baby can be born with nerve damage due to pressure on the shoulder during delivery. C- Section (Cesarean Section) A C-section is a surgery to deliver the baby through the mother’s belly. A woman who has diabetes that is not well controlled has a higher chance of needing a C-section to deliver the baby. When the baby is delivered by a C-section, it takes longer for the woman to recover from childbirth. High Blood Pressure (Preeclampsia) When a pregnant woman has high blood pressure, protein in her urine, and often swelling in fingers and toes that doesn’t go away, she might have preeclampsia. It is a serious problem that needs to be watched closely and managed by her doctor. High blood pressure can cause harm to both the woman and her unborn baby. It might lead to the baby being born early and also could cause seizures or a stroke (a blood clot or a bleed in the brain that ca Continue reading >>
Gestational Diabetes (gd)
What is gestational diabetes? Gestational diabetes (GD) happens when you have too much sugar (glucose) in your blood during pregnancy. Your blood sugar levels can go up when your body isn’t producing enough of a hormone called insulin. Insulin helps: the cells in your body to get energy from blood sugar your body to store any blood sugar that isn’t needed During pregnancy, hormones make it harder for your body to use insulin efficiently. So your body has to make extra insulin, especially from mid-pregnancy onwards. If your body can't make enough extra insulin, your blood sugar levels will rise and you may develop GD. Having too much sugar in your blood can cause problems for you and your baby, so you’ll have extra care during your pregnancy. On average, GD affects one mum-to-be in 20. GD goes away after your baby is born, because it's a condition that's only caused by pregnancy. The other types of diabetes, which are not caused by pregnancy, are type 1 diabetes and type 2 diabetes. Some women have diabetes, without realising it, before they become pregnant. If this happens to you, it will be diagnosed as GD during your pregnancy. What are the symptoms of gestational diabetes? You probably won't notice any symptoms if you have GD. That's why you'll be monitored by your midwife, and offered a test if she thinks you're at risk. GD symptoms are like normal pregnancy symptoms, and easy to miss. By the time you have clear symptoms, your blood sugar levels may be worryingly high (hyperglycaemia) . Symptoms of hyperglycaemia include: feeling more thirsty needing to wee more often than usual having a dry mouth feeling more tired getting recurring infections, such as thrush, and UTIs having blurred vision If you have any of these symptoms, tell your midwife or doctor straig Continue reading >>
- Women in India with Gestational Diabetes Mellitus Strategy (WINGS): Methodology and development of model of care for gestational diabetes mellitus (WINGS 4)
- Leeds diabetes clinical champion raises awareness of gestational diabetes for World Diabetes Day
- Gestational Diabetes: The Overlooked Form of Diabetes
Diabetes And Pregnancy
Sometimes pregnancy causes the blood sugar to rise in women who do not have diabetes. This is called gestational diabetes. What is diabetes? Diabetes mellitus (just called diabetes from now on) occurs when the level of sugar (glucose) in the blood becomes higher than normal. There are two main types of diabetes. These are called type 1 diabetes and type 2 diabetes. For further information about diabetes, see separate leaflets called Type 1 Diabetes and Type 2 Diabetes. Sometimes pregnancy causes the blood sugar to rise in women who do not have diabetes. This is called gestational diabetes (see below). How does pregnancy affect diabetes? How does pregnancy affect diabetes? Play VideoPlayMute0:00/0:00Loaded: 0%Progress: 0%Stream TypeLIVE0:00Playback Rate1xChapters Chapters Descriptions descriptions off, selected Subtitles undefined settings, opens undefined settings dialog captions and subtitles off, selected Audio TrackFullscreen This is a modal window. Beginning of dialog window. Escape will cancel and close the window. TextColorWhiteBlackRedGreenBlueYellowMagentaCyanTransparencyOpaqueSemi-TransparentBackgroundColorBlackWhiteRedGreenBlueYellowMagentaCyanTransparencyOpaqueSemi-TransparentTransparentWindowColorBlackWhiteRedGreenBlueYellowMagentaCyanTransparencyTransparentSemi-TransparentOpaqueFont Size50%75%100%125%150%175%200%300%400%Text Edge StyleNoneRaisedDepressedUniformDropshadowFont FamilyProportional Sans-SerifMonospace Sans-SerifProportional SerifMonospace SerifCasualScriptSmall CapsReset restore all settings to the default valuesDoneClose Modal Dialog End of dialog window. Pregnancy makes the body need more insulin to control the levels of sugar (glucose) in the body. Therefore, women with diabetes usually need more treatments to control their blood sugar when t Continue reading >>
Diabetes Pregnancy Complications And Concerns
1. Preeclampsia (gestational hypertension or high blood pressure). Women with Type 1 are predisposed to this because they often have higher blood pressure to begin with. 2. Insulin resistance. During pregnancy, the placenta supplies a growing fetus with nutrients and water and produces hormones to maintain the pregnancy. In early pregnancy, hormones can cause increased insulin secretion and decreased glucose production by the liver, which can lead to hypoglycemia (low blood glucose). In later pregnancy, some hormones (estrogen, cortisol and human placental lactogen) can have a blocking effect on insulin, a condition called insulin resistance. As the placenta grows, more hormones are produced, and insulin resistance becomes greater. 3. Worsening diabetes complications. Any health issues with organs, glands, or your nervous system may worsen during pregnancy due to the increased difficulty of keeping blood glucose in the target range. 4. Macrosomia. Women with diabetes are more likely to have a larger-than-average baby. 5. Issues during delivery. This is often due to the larger size of the baby, sometimes necessitating a caesarean section or early inducement of delivery. A larger baby may also run the risk of shoulder dystocia, in which the shoulders of the baby fail to pass the pubic symphysis. 6. Birth defects. Largely the result of blood sugar levels that aren’t in target safe ranges, these include respiratory distress syndrome (RDS), cardiovascular issues, and problems affecting development of the brain, spine, kidneys, gastrointestinal tract, limbs, and mouth. 7. Miscarriage (loss of the baby before 20 weeks gestation) or stillbirth (after 20 weeks). This may be due to possible birth defects caused by excessive sugar in the blood. Return to Pregnancy and Type 1 Dia Continue reading >>
I Have Gestational Diabetes. How Will It Affect My Baby?
Will gestational diabetes hurt my baby? Most women who develop diabetes during pregnancy go on to have a healthy baby. Dietary changes and exercise may be enough to keep blood sugar (glucose) levels under control, though sometimes you may also need to take medication. But untreated gestational diabetes can cause serious problems. If blood sugar levels remain elevated, too much glucose ends up in the baby's blood. When that happens, the baby's pancreas needs to produce more insulin to process the extra sugar. Too much blood sugar and insulin can make a baby put on extra weight, which is stored as fat. This can make the baby grow very large (macrosomia). Also, high blood sugar levels during pregnancy and labor increase the risk of a baby developing low blood sugar (hypoglycemia) after delivery. That's because the baby's body produces extra insulin in response to the mother's excess glucose. Insulin lowers the amount of sugar in the blood. The signs and symptoms of hypoglycemia in an infant include: jitteriness weak or high-pitched cry floppiness lethargy or sleepiness breathing problems skin that looks blue trouble feeding eye rolling seizures A baby may also be at higher risk for breathing problems at birth, especially if blood sugar levels aren't well controlled or the baby is delivered early. (If you have gestational diabetes, your baby's lungs tend to mature a bit later). The risk of newborn jaundice is higher too. If your blood sugar control is especially poor, the baby's heart function could be affected as well, which can contribute to breathing problems. Gestational diabetes sometimes thickens a baby's heart muscle (hypertrophic cardiomyopathy), causing the baby to breathe rapidly and not be able to get enough oxygen from her blood. It's understandable to feel anxi Continue reading >>
Pregnancy If You Have Diabetes
If you have diabetes and plan to have a baby, you should try to get your blood glucose levels close to your target range before you get pregnant. Staying in your target range during pregnancy, which may be different than when you aren’t pregnant, is also important. High blood glucose, also called blood sugar, can harm your baby during the first weeks of pregnancy, even before you know you are pregnant. If you have diabetes and are already pregnant, see your doctor as soon as possible to make a plan to manage your diabetes. Working with your health care team and following your diabetes management plan can help you have a healthy pregnancy and a healthy baby. If you develop diabetes for the first time while you are pregnant, you have gestational diabetes. How can diabetes affect my baby? A baby’s organs, such as the brain, heart, kidneys, and lungs, start forming during the first 8 weeks of pregnancy. High blood glucose levels can be harmful during this early stage and can increase the chance that your baby will have birth defects, such as heart defects or defects of the brain or spine. High blood glucose levels during pregnancy can also increase the chance that your baby will be born too early, weigh too much, or have breathing problems or low blood glucose right after birth. High blood glucose also can increase the chance that you will have a miscarriage or a stillborn baby.1 Stillborn means the baby dies in the womb during the second half of pregnancy. How can my diabetes affect me during pregnancy? Hormonal and other changes in your body during pregnancy affect your blood glucose levels, so you might need to change how you manage your diabetes. Even if you’ve had diabetes for years, you may need to change your meal plan, physical activity routine, and medicines. Continue reading >>
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 >>
- Women in India with Gestational Diabetes Mellitus Strategy (WINGS): Methodology and development of model of care for gestational diabetes mellitus (WINGS 4)
- Leeds diabetes clinical champion raises awareness of gestational diabetes for World Diabetes Day
- Gestational Diabetes: The Overlooked Form of Diabetes
Diabetes And Pregnancy
What is diabetes? Diabetes is a condition in which the body can't produce enough insulin, or it can't use it properly. Insulin is the hormone that allows glucose (sugar) to enter the cells to be used as fuel. When glucose cannot enter the cells, it builds up in the blood. This is called hyperglycemia or high blood sugar. Damage from diabetes comes from the effects of hyperglycemia on other organ systems including the eyes, kidneys, heart, blood vessels, and nerves. In early pregnancy, hyperglycemia can result in birth defects. What are the different types of diabetes? There are three basic types of diabetes including: Type 1 diabetes. Also called insulin-dependent diabetes mellitus (IDDM), type 1 diabetes is an autoimmune disorder in which the body's immune system destroys, or attempts to destroy, the cells in the pancreas that produce insulin. Type 1 diabetes usually develops in children or young adults, but can start at any age. Type 2 diabetes. A metabolic disorder resulting from the body's inability to make enough, or properly use, insulin. It used to be called noninsulin-dependent diabetes mellitus (NIDDM). Gestational diabetes. A condition in which the blood glucose level is elevated and other diabetic symptoms appear during pregnancy in a woman who has not previously been diagnosed with diabetes. Diabetes is a serious disease, which, if not controlled, can be life-threatening. It is often associated with long-term complications that can affect every system and part of the body. Diabetes can contribute to eye disorders and blindness, heart disease, stroke, kidney failure, amputation, and nerve damage. What happens with diabetes and pregnancy? During pregnancy, the placenta supplies a growing fetus with nutrients and water. The placenta also makes a variety of horm Continue reading >>
Pregnancy
Pregnancy in women with type 1 or type 2 diabetes usually results in a normal delivery with no effects on the mother’s or the child’s long-term health. However, poorly controlled blood glucose levels during pregnancy can have long term effects for mum and baby, as well as complications during delivery. You can have a healthy pregnancy and a good outcome with planning, multidisciplinary care and excellent control of blood glucose levels. If you develop diabetes during pregnancy, it is called gestational diabetes. Learn more about gestational diabetes. Pre-pregnancy care for people with diabetes First talk to your doctor, credentialled diabetes educator and obstetrician for pre-pregnancy planning and care. You can receive advice and guidance on blood glucose management, a review of all self care skills and knowledge, an assessment of diabetes equipment and management of hypoglycaemia and hyperglycaemia. High blood glucose levels can increase the risk of having a baby with a birth defect. However this can be minimised by ensuring excellent blood glucose control at the time of conception and during the first eight weeks of pregnancy. Careful attention to nutrition is essential, not only for good diabetes control, but to meet the body’s increased nutritional requirements during pregnancy. Exercise is also helpful in maintaining general fitness and good blood glucose control. Breast-feeding There is no reason why women with diabetes should not breast-feed. Insulin requirements are generally slightly lower during this time. Insulin does not pass into the breast milk and is not harmful to the baby. Hypoglycaemia can be an issue. You should discuss with your doctor or credentialled diabetes educator about strategies to minimise hypoglycaemia. Resources Type 1 Diabetes and Continue reading >>
Maternal Mortality In Type 1 Diabetes
The ultimate complication of type 1 diabetes in combination with pregnancy is maternal death, which may result from complications of the pregnancy itself, diabetes and associated diseases, or causes related to neither pregnancy nor diabetes. From the clinical point of view, the greatest reward would be to identify possible preventable causes of maternal death beforehand, especially because these patients are under close surveillance during the entire pregnancy and postpartum period. The reported incidence of maternal mortality of pregnant type 1 diabetic women has been ∼0.5% (1,2), which is 5–20 times higher than that of the general obstetric population. However, these estimates date back prior to 1980, and because of the developments in both the obstetric management and the treatment of diabetes during the past 20 years, we have estimated the risk of death and analyzed the causes of maternal mortality in a large single referral center for all pregnant type 1 diabetic women from Southern Finland. Between 1975 and 1997, 972 type 1 diabetic women delivered, or intended to deliver, in the Department of Obstetrics and Gynecology at the University Central Hospital of Helsinki. This is the referral center for all pregnant diabetic women in Southern Finland (population 1.5 million). If the diabetes classification was not evident based on the diagnoses established at pediatric or adult endocrinology units, it was confirmed by the undetectable plasma C-peptide levels. All patients were followed-up for an interval of 1–6 weeks during pregnancy and within 1–2 months after delivery. Maternal deaths (during pregnancy or within 42 days after delivery) were recorded, and the causes of death were determined by a forensic medical autopsy or by clinical findings. Of the 972 women Continue reading >>
- Mortality and Cardiovascular Disease in Type 1 and Type 2 Diabetes
- Maternal obesity as a risk factor for early childhood type 1 diabetes: a nationwide, prospective, population-based case–control study
- Type 2 Diabetes and Comorbid Symptoms of Depression and Anxiety: Longitudinal Associations With Mortality Risk
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 >>
- Identification of novel biomarkers to monitor β-cell function and enable early detection of type 2 diabetes risk
- Girls with early first periods become women with greater risk of gestational diabetes
- Women in India with Gestational Diabetes Mellitus Strategy (WINGS): Methodology and development of model of care for gestational diabetes mellitus (WINGS 4)
Diabetes And Pregnancy: Heading Off Complications
P&S Journal: Spring 1997, Vol.17, No.2 Clinical Advances Diagnosing and treating non-insulin dependent diabetes mellitus (NIDDM) before pregnancy may help prevent some severe birth defects, according to results of a pilot study by P&S researchers. Physicians have long known that insulin dependent diabetes (IDDM), if not controlled before and during pregnancy, can lead to serious consequences, says Dr. Robin Goland, the Florence Irving Assistant Professor of Medicine, chief of the diabetes clinic, director of the diabetes and pregnancy program, and leader of the team that conducted the study. "But often they may dismiss NIDDM before and during pregnancy as a 'touch of sugar.' Our results show that NIDDM during pregnancy deserves as much careful monitoring and control as IDDM." Dr. Goland; Dr. Judith Hey-Hadavi, medical resident; and nurse-educator Mary Ann Jonaitis collaborated on the pilot study, which will be presented at the 1997 meeting of the Endocrine Society. The research team compared the management and outcomes of 12 women with pre-gestational NIDDM and six women with pre-gestational IDDM, all of whom were referred to the diabetes and pregnancy program. All of the women were managed with strict glucose control using results of their home glucose monitoring. Both groups of women were able to better control their blood sugar as their pregnancies progressed. None of the babies born to the women were excessively large. (Abnormally large babies, the result of high levels of glucose from the diabetic mother crossing the placenta, are a complication of diabetes during pregnancy.) Despite these promising results, the researchers found that compared with IDDM pregnancies, NIDDM pregnancies resulted in a 25 percent incidence of severe birth defects, including two babies w 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 >>
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 >>
