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Diagnosis Of Gestational Diabetes In Pregnancy

Gestational Diabetes: What You Need To Know

Gestational Diabetes: What You Need To Know

This pregnancy complication is more common than you might think. Learn who's at risk for it, how it's detected, and what can be done to treat it. For years, doctors believed that gestational diabetes affected three to five percent of all pregnancies, but new, more rigorous diagnostic criteria puts the number closer to 18 percent. The condition, which can strike any pregnant woman, usually develops in the second trimester, between weeks 24 and 28, and typically resolves after baby is born. If gestational diabetes is treated and well-managed throughout your pregnancy, "There's no reason you can't deliver a very healthy baby," says Patricia Devine, M.D., perinatologist at New York-Presbyterian Hospital in New York City. But gestational diabetes that goes untreated, or isn't carefully monitored, can be harmful for both mother and baby. Consult our guide for risk factors, signs of gestational diabetes, and treatment options. What is gestational diabetes? Gestational diabetes, or diabetes that is diagnosed during pregnancy in a woman who previously did not have diabetes, occurs when the pancreas fails to produce enough insulin to regulate blood sugar efficiently. "A hormone produced by the placenta makes a woman essentially resistant to her own insulin," Dr. Devine explains. How does gestational diabetes differ from type 1 or 2 diabetes? Gestational diabetes affects only pregnant women. People who have type 1 diabetes, sometimes referred to as juvenile diabetes, are generally born with it. Type 2 diabetes accounts for 95 percent of all cases of diabetes in the U.S.; it occurs in adulthood, and is triggered by lifestyle factors such as obesity and lack of physical activity. What causes it? It's unclear why some women develop gestational diabetes while others do not. Doctors th Continue reading >>

Gestational Diabetes Mellitus

Gestational Diabetes Mellitus

Alison Nankervis Background Recommendations to change the diagnostic criteria for gestational diabetes mellitus (GDM) are controversial. Two sets of criteria are currently in use in Australia, which has led to considerable confusion. Objective/s This article discusses the rationale behind the proposed changes to the diagnostic criteria, and aims to clarify the current approach to the testing for and diagnosis of GDM in Australia. Discussion Gestational diabetes mellitus has adverse effects on pregnancy outcomes and implications for the long term wellbeing of mother and infant. New information about the relationship between hyperglycaemia in pregnancy and fetal outcomes has led to the formulation of revised recommendations for testing and diagnosis of GDM. The changes to the diagnostic threshold will increase the numbers of women diagnosed with GDM by up to 50%. Evidence that management of GDM improves neonatal outcomes mandates a proactive approach to diagnosis and management. General practitioners will have an increasing role in managing GDM. Gestational diabetes mellitus (GDM) is associated with short and long term risks to mother and infant. Yet, there is considerable controversy as to how to diagnose GDM and provide optimal management during and after pregnancy. This article will try to make some sense of the current debate regarding ‘old’ versus ‘new’ diagnostic criteria, and provide practical guidance for the management and follow up of GDM in general practice. What is GDM? GDM is defined as ‘any degree of glucose intolerance with onset or first recognition during pregnancy’. GDM affects approximately 8–10% of pregnancies in Australia.1 It includes previously unrecognised type 2 diabetes mellitus (DM) and, rarely, type 1 DM arising in pregnancy. In m Continue reading >>

Gestational Diabetes

Gestational Diabetes

What is gestational diabetes? Gestational diabetes is a condition marked by high blood glucose (sugar) levels that are discovered during pregnancy. It is defined as carbohydrate intolerance. About two to 10 percent of all pregnant women in the U.S. are diagnosed with gestational diabetes. Am I at risk for gestational diabetes? These factors increase your risk of developing diabetes during pregnancy: Being overweight before becoming pregnant (if you are 20% or more over your ideal body weight) Family history of diabetes (if your parents or siblings have diabetes) Being over age 25 Previously giving birth to a baby that weighed more than 9 pounds Previously giving birth to a stillborn baby Having gestational diabetes with an earlier pregnancy Being diagnosed with pre-diabetes Having polycystic ovary syndrome Being African-American, Hispanic/Latino, Asian-American, American Indian, or Pacific Islander American Keep in mind that half of women who develop gestational diabetes have no known risk factors. What causes gestational diabetes? Gestational diabetes is caused by some hormonal changes that occur in all women during pregnancy. The placenta is the organ that connects the baby (by the umbilical cord) to the uterus and transfers nutrients from the mother to the baby. Increased levels of certain hormones made in the placenta can prevent insulin—a hormone that controls blood sugar—from managing glucose properly. This condition is called "insulin resistance." As the placenta grows larger during pregnancy, it produces more hormones and increases this insulin resistance. Usually, the mother’s pancreas is able to produce more insulin (about three times the normal amount) to overcome the insulin resistance. If it cannot, sugar levels will rise, resulting in gestational dia Continue reading >>

Gestational Diabetes - Symptoms, Diagnosis, Treatment

Gestational Diabetes - Symptoms, Diagnosis, Treatment

Diabetes is diagnosed when a person has too much glucose (sugar) in the blood. Gestational diabetes is a variation of the disease that occurs during pregnancy, and is the result of the mother not being able to produce enough insulin. Gestational diabetes may not present obvious symptoms but may be diagnosed during routine pregnancy screening. The condition can adversely affect the pregnancy and health of the baby but can be managed with diet modification and exercise and, if necessary, medication. General information Diabetes mellitus (commonly known as diabetes) is a group of diseases characterised by high blood glucose levels over a prolonged period of time. This page deals with gestational diabetes. Other variations of diabetes include: Type 1 diabetes – usually diagnosed in childhood or adolescence. Type 2 diabetes – associated with a person being overweight. Gestational diabetes accounts for 90% of cases of diabetes in pregnancy, while pre-existing type 2 diabetes accounts for 8% of such cases. It usually develops during the second half of pregnancy but can occur as early as the 20th week. Gestational diabetes is common, with 3000–4000 women being diagnosed with the condition or its recurrence each year in New Zealand. The prevalence of gestational diabetes is increasing (8–9% per year) and is higher in Māori (5–10%), Pacific peoples (4–8%), and Asian Indians (4%) than in New Zealand Europeans (3%). The increasing rate of gestational diabetes appears to be related to increasing rates of obesity. Causes The exact cause of gestational diabetes is not known. However, pregnancy does affect how the body metabolises (breaks down) glucose. Glucose is absorbed into the bloodstream following a meal. The body then uses insulin (a hormone produced by the pancreas Continue reading >>

Gestational Diabetes

Gestational Diabetes

Gestational diabetes is a condition in which a woman without diabetes develops high blood sugar levels during pregnancy.[2] Gestational diabetes generally results in few symptoms;[2] however, it does increase the risk of pre-eclampsia, depression, and requiring a Caesarean section.[2] Babies born to mothers with poorly treated gestational diabetes are at increased risk of being too large, having low blood sugar after birth, and jaundice.[2] If untreated, it can also result in a stillbirth.[2] Long term, children are at higher risk of being overweight and developing type 2 diabetes.[2] Gestational diabetes is caused by not enough insulin in the setting of insulin resistance.[2] Risk factors include being overweight, previously having gestational diabetes, a family history of type 2 diabetes, and having polycystic ovarian syndrome.[2] Diagnosis is by blood tests.[2] For those at normal risk screening is recommended between 24 and 28 weeks gestation.[2][3] For those at high risk testing may occur at the first prenatal visit.[2] Prevention is by maintaining a healthy weight and exercising before pregnancy.[2] Gestational diabetes is a treated with a diabetic diet, exercise, and possibly insulin injections.[2] Most women are able to manage their blood sugar with a diet and exercise.[3] Blood sugar testing among those who are affected is often recommended four times a day.[3] Breastfeeding is recommended as soon as possible after birth.[2] Gestational diabetes affects 3–9% of pregnancies, depending on the population studied.[3] It is especially common during the last three months of pregnancy.[2] It affects 1% of those under the age of 20 and 13% of those over the age of 44.[3] A number of ethnic groups including Asians, American Indians, Indigenous Australians, and Pacific Continue reading >>

Diagnosis

Diagnosis

Print Medical experts haven't agreed on a single set of screening guidelines for gestational diabetes. Some question whether gestational diabetes screening is needed if you're younger than 25 and have no risk factors. Others say that screening all pregnant women is the best way to identify all cases of gestational diabetes. When to screen Your doctor will likely evaluate your risk factors for gestational diabetes early in your pregnancy. If you're at high risk of gestational diabetes — for example, your body mass index (BMI) before pregnancy was 30 or higher or you have a mother, father, sibling or child with diabetes — your doctor may test for diabetes at your first prenatal visit. If you're at average risk of gestational diabetes, you'll likely have a screening test during your second trimester — between 24 and 28 weeks of pregnancy. Routine screening for gestational diabetes Initial glucose challenge test. You'll drink a syrupy glucose solution. One hour later, you'll have a blood test to measure your blood sugar level. A blood sugar level below 130 to 140 milligrams per deciliter (mg/dL), or 7.2 to 7.8 millimoles per liter (mmol/L), is usually considered normal on a glucose challenge test, although this may vary by clinic or lab. If your blood sugar level is higher than normal, it only means you have a higher risk of gestational diabetes. You'll need a glucose tolerance test to determine if you have the condition. Follow-up glucose tolerance testing. You'll fast overnight, then have your blood sugar level measured. Then you'll drink another sweet solution — this one containing a higher concentration of glucose — and your blood sugar level will be checked every hour for three hours. If at least two of the blood sugar readings are higher than normal, you'll Continue reading >>

Gestational Diabetes

Gestational Diabetes

Gestational diabetes definition and facts Risk factors for gestational diabetes include a history of gestational diabetes in a previous pregnancy, There are typically no noticeable signs or symptoms associated with gestational diabetes. Gestational diabetes can cause the fetus to be larger than normal. Delivery of the baby may be more complicated as a result. The baby is also at risk for developing low blood glucose (hypoglycemia) immediately after birth. Following a nutrition plan is the typical treatment for gestational diabetes. Maintaining a healthy weight and following a healthy eating plan may be able to help prevent or minimize the risks of gestational diabetes. Women with gestational diabetes have an increased risk of developing type 2 diabetes after the pregnancy What is gestational diabetes? Gestational diabetes is diabetes, or high blood sugar levels, that develops during pregnancy. It occurs in about 4% of all pregnancies. It is usually diagnosed in the later stages of pregnancy and often occurs in women who have no prior history of diabetes. What causes gestational diabetes? Gestational diabetes is thought to arise because the many changes, hormonal and otherwise, that occur in the body during pregnancy predispose some women to become resistant to insulin. Insulin is a hormone made by specialized cells in the pancreas that allows the body to effectively metabolize glucose for later usage as fuel (energy). When levels of insulin are low, or the body cannot effectively use insulin (i.e., insulin resistance), blood glucose levels rise. What are the screening guidelines for gestational diabetes? All pregnant women should be screened for gestational diabetes during their pregnancy. Most pregnant women are tested between the 24th and 28th weeks of pregnancy (see Continue reading >>

Late Diagnosis Of Gestational Diabetes…

Late Diagnosis Of Gestational Diabetes…

Well: this gestational diabetes thing has thrown a right spanner in the old works, I can tell you! (Photo above taken in last pregnancy, by the way, after I had polished off two whole desserts. I thought it was brilliantly inappropriate.) I just feel as though I’ve been diagnosed (my blood sugar readings, though not horrific, definitely indicate GD) and then left just to get on with things. No real advice, no explanations as to how the condition could affect the baby, or (more my concern) how my rampantly out-of-control blood sugar levels prior to diagnosis might have affected the baby… So it has been a crazy week or so of intense Google research, and speaking to my Dad and Uncle about how they keep their Type 2 Diabetes in check, and chatting to my oldest friend Tasha about how she coped during her two pregnancies with her Type 1 Diabetes. I’d like to say that it has all been very interesting, and it has to a certain extent, but overall my one word to describe the situation would be: STRESSFUL. Mainly, I think, because the diagnosis has been made so late. (I’m 38 weeks.) And wouldn’t have been made at all had I not sought a second opinion about baby size from a private obstetrician. (Always trust your instincts, people.) So I’m slightly consumed with low-level fury about the fact that I wasn’t given a fasting blood sugar test, despite the fact that my last baby was big and I have an immediate relative with diabetes, but I’m also frustrated and confused because keeping blood sugar under control is actually quite the learning curve, and I’ve been given approximately 14 days altogether to achieve it. In case you are wondering what the hell I’m on about, Gestational Diabetes is a specific kind of diabetes that affects pregnant women only and it usually Continue reading >>

Gestational Diabetes

Gestational Diabetes

Gestational diabetes now includes both gestational impaired glucose tolerance and gestational diabetes mellitus (1). approximately 700,000 women give birth in England and Wales each year, and up to 5% of these women have either pre-existing diabetes or gestational diabetes of women who have diabetes during pregnancy estimated that 87.5% have gestational diabetes - which is defined as the development of diabetes during pregnancy (which may or may not resolve after pregnancy), 7.5% have type 1 diabetes the remaining 5% have type 2 diabetes prevalence of type 1 diabetes, and especially type 2 diabetes, has increased in recent years incidence of gestational diabetes is also increasing as a result of higher rates of obesity in the general population and more pregnancies in older women diabetes in pregnancy is associated with risks to the woman and to the developing fetus. Miscarriage, pre-eclampsia and preterm labour are more common in women with pre-existing diabetes. In addition, diabetic retinopathy can worsen rapidly during pregnancy. Stillbirth, congenital malformations, macrosomia, birth injury, perinatal mortality and postnatal adaptation problems (such as hypoglycaemia) are more common in babies born to women with pre-existing diabetes NICE (2) suggest testing criteria for gestational diabetes as: use the 2-hour 75 g oral glucose tolerance test (OGTT) to test for gestational diabetes in women with risk factors (see below) offer women who have had gestational diabetes in a previous pregnancy: early self-monitoring of blood glucose or a 75 g 2-hour OGTT as soon as possible after booking (whether in the first or second trimester), and a further 75 g 2-hour OGTT at 24-28 weeks if the results of the first OGTT are normal offer women with any of the other risk factors for Continue reading >>

Gestational Diabetes: Towards New Diagnostic Criteria

Gestational Diabetes: Towards New Diagnostic Criteria

Full Text: PDF Go to CPD Abstract The Australasian Diabetes in Pregnancy Society (ADIPS) has been revising its consensus guidelines for the testing and diagnosis of gestational diabetes but these have not yet been translated into a unified approach to the condition in Australia. Controversy over the diagnosis of gestational diabetes persists internationally. Key practice points for general practitioners arising from the revised guidelines are reviewed. Key Points The Australasian Diabetes in Pregnancy Society has been revising its guidelines for the testing and diagnosis of gestational diabetes. Ongoing controversy over diagnostic criteria is delaying a unified approach to the condition within Australia. Gestational diabetes is associated with adverse maternal and neonatal outcomes at even lower blood glucose levels than previously recognised. Universal testing with a one-step 75 g two-hour oral glucose tolerance test at 24 to 28 weeks of gestation is recommended. Treatment ideally involves a multidisciplinary approach focusing on patient education, dietary modification and lifestyle intervention. Medication should be initiated when treatment targets are not achieved by diet alone. General practitioners play a crucial role in detecting undiagnosed pre-existing diabetes in high-risk women before or in early pregnancy, and ensuring timely postpartum follow up and risk factor modification to reduce the risk of future diabetes. Continue reading >>

Diabetes Mellitus In Pregnancy: Screening And Diagnosis

Diabetes Mellitus In Pregnancy: Screening And Diagnosis

INTRODUCTION Pregnancy is accompanied by insulin resistance, mediated primarily by placental secretion of diabetogenic hormones including growth hormone, corticotropin-releasing hormone, placental lactogen, and progesterone. These and other metabolic changes ensure that the fetus has an ample supply of nutrients. (See "Maternal adaptations to pregnancy: Endocrine and metabolic changes".) Gestational diabetes develops during pregnancy in women whose pancreatic function is insufficient to overcome the insulin resistance associated with the pregnant state. Among the main consequences are increased risks of preeclampsia, macrosomia, and cesarean delivery, and their associated morbidities. The approach to screening for and diagnosis of diabetes in pregnant women will be reviewed here. Management and prognosis are discussed separately: 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 >>

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 >>

Tests & Diagnosis For Gestational Diabetes

Tests & Diagnosis For Gestational Diabetes

When will I be tested for gestational diabetes? Testing for gestational diabetes usually occurs between 24 and 28 weeks of pregnancy. If you have an increased chance of developing gestational diabetes, your doctor may test for diabetes during the first visit after you become pregnant. How do doctors diagnose gestational diabetes? Doctors use blood tests to diagnose gestational diabetes. You may have the glucose challenge test, the oral glucose tolerance test, or both. These tests show how well your body uses glucose. Glucose Challenge Test You may have the glucose challenge test first. Another name for this blood test is the glucose screening test. In this test, a health care professional will draw your blood 1 hour after you drink a sweet liquid containing glucose. You do not need to fast for this test. Fasting means having nothing to eat or drink except water. If your blood glucose is too high—140 or more—you may need to return for an oral glucose tolerance test while fasting. If your blood glucose is 200 or more, you may have type 2 diabetes. Oral Glucose Tolerance Test (OGTT) The OGTT measures blood glucose after you fast for at least 8 hours. First, a health care professional will draw your blood. Then you will drink the liquid containing glucose. You will need your blood drawn every hour for 2 to 3 hours for a doctor to diagnose gestational diabetes. High blood glucose levels at any two or more blood test times—fasting, 1 hour, 2 hours, or 3 hours—mean you have gestational diabetes. Your health care team will explain what your OGTT results mean. Your health care professional may recommend an OGTT without first having the glucose challenge test. Continue reading >>

Managing Gestational Diabetes

Managing Gestational Diabetes

Gestational diabetes is diagnosed during pregnancy when your body cannot cope with the extra demand for insulin production resulting in high blood glucose levels. Gestational diabetes is managed by monitoring blood glucose levels, adopting a healthy eating plan and performing regular physical activity. Effective management of gestational diabetes will reduce the risk of complications during pregnancy and the birth of your baby. Your healthcare team including your doctor, specialist, dietician and Credential Diabetes Educator, can help you with blood glucose monitoring, healthy eating and physical activity. There are three basic components in effectively managing gestational diabetes: monitoring blood glucose levels adopting a healthy eating pattern physical activity. Gestational diabetes can often initially be managed with healthy eating and regular physical activity. However, for some women with gestational diabetes, insulin injections will be necessary for the rest of the pregnancy. Approximately 10 – 20% of women will need insulin; however, once the baby is born insulin is no longer needed. This is safe for both you and your baby. After the baby is born, gestational diabetes usually disappears. A special blood glucose test (Oral Glucose Tolerance Test) (OGTT) is performed six weeks after delivery to ensure that blood glucose levels have returned to normal. However, women who have had gestational diabetes have an increased risk of developing type 2 diabetes later in life and should be tested for diabetes at least every 2 – 3 years. If gestational diabetes is not well looked after (blood glucose levels remain high) it may result in problems such as a large baby, miscarriage and stillbirth. A large baby can create the risk of injury at delivery, caesarean delivery, Continue reading >>

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