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Gestational Diabetes Overview

Gestational Diabetes Overview

Gestational Diabetes Overview

Gestational diabetes is a condition characterized by high blood sugar (glucose) levels that is first recognized during pregnancy. The condition occurs in approximately 4% of all pregnancies. What Is Gestational Diabetes? Gestational diabetes -- diabetes that develops during pregnancy -- affects about 4% of pregnant women. With proper prenatal care, gestational diabetes can be detected and treated. Pregnancy and Gestational Diabetes: the Basics Diabetescan affect the developing fetus throughout the pregnancy. In early pregnancy, a mother'sdiabetes can result in birth defects and an increased rate of miscarriage. What Causes Gestational Diabetes? Gestational diabetes is high blood sugar that you get only when you're pregnant. Learn why some women get high blood sugar during pregnancy, and whether you could be at risk. Are You at Risk? If you have any of the health problems that could lead to diabetes -- youre overweight, have high blood pressure, or a family history of the disease -- you could be more likely to get gestational diabetes. Can You Prevent Gestational Diabetes? Learn whether you may be at high risk for gestational diabetes, and how to lower your risk through diet and exercise. Continue reading >>

Diabetes Mellitus And Pregnancy

Diabetes Mellitus And Pregnancy

Initiate testing early enough to avoid significant stillbirth but not so early that a high rate of false-positive test results is encountered. In patients with poor glycemic control, intrauterine growth restriction, or significant hypertension, begin formal biophysical testing as early as 28 weeks. In patients who are at lower risk, most centers begin formal fetal testing by 34 weeks. Fetal movement counting is performed in all pregnancies from 28 weeks onward. There is no consensus regarding antenatal testing in patients with gestational diabetes that is well controlled with diet. Monitoring fetal growth continues to be a challenging and imprecise process. Although currently available tools (serial plotting of fetal growth parameters based on ultrasonographic measurement) are superior to those used previously for clinical estimations, accuracy is still only within 15%. [ 95 ] In the obese fetus, the inaccuracies are further magnified. In 1992, Bernstein and Catalano reported that significant correlation exists between the degree of error in the ultrasonogram-based estimation of fetal weight and the percentage of body fat on the fetus. [ 96 ] Perhaps this is the reason no single formula has proven to be adequate in identifying a macrosomic fetus with certainty. Despite problems with accuracy, ultrasonogram-based estimations of fetal size have become the standard of care. Estimate fetal size once or twice at least 3 weeks apart in order to establish a trend. Time the last examination to be at 36-37 weeks' gestation or as close to the planned delivery date as possible. Select the timing of delivery to minimize morbidity for the mother and fetus. Delaying delivery to as near as possible to the expected date of confinement helps maximize cervical maturity and improves the Continue reading >>

Gestational Diabetes: An Overview

Gestational Diabetes: An Overview

Gestational diabetes is a form of diabetes that occurs only during pregnancy, though it does increase your risk of T2D and gestational diabetes may be the result of a pre-existing undiagnosed diabetes. Gestational diabetes is usually diagnosed in the later parts of pregnancy, and, like the other forms of diabetes, indicates that your blood sugar (blood glucose) is not being adequately regulated. It is important to diagnose and treat gestational diabetes because it can put you and your baby at risk for future diabetes. It also puts your baby at risk for having a condition called macrosomia—where the baby is born with a large body which can make delivery dangerous and difficult. Gestational diabetes also puts your baby at risk for early death, low blood sugar, jaundice (a liver condition) and respiratory distress syndrome. [1] Finally, having untreated gestational diabetes puts you and your baby at a higher risk of obesity. Like other forms of diabetes, gestational diabetes can reflect insulin resistance, not enough insulin or the inability of your body cells to respond properly to the signals from insulin. In addition, the placenta (which connects your baby to your blood supply) can produce hormones which block the action of insulin.[2] Insulin is a hormone produced by the pancreas—insulin signals the cells to take up glucose from the blood. All cells in the body use glucose (sugar) for energy, but as with most things, too much of any substance can be detrimental—and too much glucose in the blood for any length of time can damage the nerves, the kidneys, the eyes and other organs as well as put you at risk for heart disease, stroke and obesity. If you already have diabetes (either T1D or T2D) and are interested in having a baby, this can usually be done as long as Continue reading >>

Gestational Diabetes Diet

Gestational Diabetes Diet

Gestational diabetes, which causes higher-than-normal blood sugar levels to be present, occurs during pregnancy. Gestational diabetes testing usually occurs between 24 and 28 weeks of pregnancy. If you have risk factors for diabetes, your doctor may recommend testing earlier in the pregnancy. If you receive a gestational diabetes diagnosis, you’ll need testing 6 to 12 weeks after giving birth to see whether the diabetes is still present. Gestational diabetes usually resolves after you deliver, although you’re at higher risk for developing type 2 diabetes later in life. According to Johns Hopkins Medicine, gestational diabetes affects 3 to 8 percent of pregnant women in the United States. Gestational diabetes increases the risk of having a large baby, which may cause problems with delivery. It also increases the risk of having a baby born with hypoglycemia (low blood sugar). Respiratory distress, jaundice, and low calcium and magnesium levels are also more common in babies whose mothers have gestational diabetes. There’s a higher risk of your baby developing diabetes later in life as well. Changing your diet is generally the first method of treatment for gestational diabetes. The amount of calories you should consume each day depends on a number of factors, such as your weight and activity level. Pregnant women should generally increase their calorie consumption by 300 calories per day from their prepregnancy diet. Doctors recommend three meals and two to three snacks per day. Eating smaller meals more frequently can help you keep your blood sugar levels stable. Your doctor will likely recommend that you monitor your blood sugar levels to help manage gestational diabetes. Testing your blood sugar after meals tells you how that meal affected your blood sugar. Your d Continue reading >>

Overview Of Gestational Diabetes

Overview Of Gestational Diabetes

ABSTRACT: Gestational diabetes occurs as a result of insulin resistance during pregnancy. Adequate blood glucose control is important in helping prevent complications in the mother, such as preeclampsia, and in the fetus, such as macrosomia and stillbirth. Nonpharmacologic measures, including diet and exercise, are often sufficient for many women to maintain appropriate glycemic control. However, some women may require additional pharmacologic therapy including insulin, metformin, or glyburide. Additionally, women with gestational diabetes should be screened postpartum because they are at increased risk for developing overt diabetes after pregnancy. Gestational diabetes mellitus is defined as diabetes that is first diagnosed in the second or third trimester of pregnancy and is not considered overt type 1 or type 2 diabetes.1 For this reason, it is important that all pregnant women who have risk factors for diabetes be tested in the first trimester to rule out the presence of overt or preexisting diabetes.1 The exact prevalence of gestational diabetes depends on the population and the criteria used for diagnosis, but roughly 4% to 6% of all pregnancies are impacted by gestational diabetes.2,3 In recent years, there has been an increasing incidence of gestational diabetes that mirrors the trend of increasing obesity in the United States.4 It is proposed that gestational diabetes is related to a change in the way a womans body responds to insulin in pregnancy. Insulin is the hormone that allows glucose to move from the bloodstream to the bodys cells so that the glucose can be used for energy. In order to increase nutrientsincluding glucoseavailable to the fetus during pregnancy, the body naturally becomes more resistant to insulin. The body compensates for the resistance Continue reading >>

Gestational Diabetes

Gestational Diabetes

Gestational diabetes is a type of diabetes that starts during pregnancy. If you have diabetes, your body isn’t able to use the sugar (glucose) in your blood as well as it should. This causes the level of sugar in your blood to become higher than normal. Gestational diabetes affects 1% to 3% of all pregnant women. It usually develops in the second trimester (sometimes as early as the 20th week of pregnancy). Most often, gestational diabetes goes away after the baby is born. How can gestational diabetes affect my baby and me? High blood sugar levels can be unhealthy for both you and your baby. If the diabetes isn’t treated, your baby may be more likely to have problems at birth. For example, your baby may have a low blood sugar level or jaundice. Or your baby may weigh much more than normal. Gestational diabetes can also affect your health. For instance, if your baby is very large, you may have a more difficult delivery. You may even need a cesarean section. Gestational diabetes also increases your risk of developing preeclampsia. Preeclampsia is a condition that can be serious if left untreated. Need a link to a handout on preeclampsia or a better description of what this is. Otherwise, sounds ominous and scary for a patient reading this Many times, there are no noticeable symptoms for women who have gestational diabetes. This could be because some of the common symptoms of diabetes are also symptoms of pregnancy. These include: fatigue (being tired) nausea (feeling sick to your stomach). Other symptoms can include: As part of you prenatal care, your doctor will recommend screening for gestational diabetes around 24 weeks of pregnancy. But this could happen sooner if there is reason to believe you are at risk for developing gestational diabetes. If you have elevated Continue reading >>

Gestational Diabetes | Overview

Gestational Diabetes | Overview

You've probably heard of diabetes, and think of it as a lifelong disease. There are several types of diabetes, and most types do last a lifetime. usually goes away after your baby is born Diabetes prevents your body from using food properly. During digestion, most foods are converted to a sugar called glucose. Glucose is your body's main source of energy. Your body's pancreas produces a hormone called insulin to convert the glucose to energy. When you have diabetes, your body has trouble producing enough insulin or using insulin, or both. Type 1 diabetes. The pancreas makes no insulin, and daily injections of insulin are needed to process glucose. Type 2 diabetes. The pancreas may not make enough insulin or the body may not use it properly (called insulin resistance). Gestational diabetes. During pregnancy, important hormones that are needed for the baby's growth interfere with insulin. This happens to all women during pregnancy, but most women can make enough extra insulin to keep their blood glucose levels under control. With gestational diabetes: Your body has trouble producing the extra insulin needed. Your blood glucose levels become higher than normal. The extra glucose is passed on to your baby. About 3 to 8 percent of pregnant women in America develop gestational diabetes. The risk is higher than average if you: have given birth to a baby who weighed more than nine pounds had abnormal blood glucose levels in the past have had a stillbirth or more than one miscarriage However, women sometimes develop gestational diabetes without being in any one of the risk groups. You did not cause this to happen to you and your baby.Gestational diabetes often happens for reasons that can't be explained. Source: Source: Allina Health's Patient Education Department , Gestational Continue reading >>

Gestational Diabetes - Topic Overview

Gestational Diabetes - Topic Overview

If your blood sugar level first becomes too high when you are pregnant, you have gestational diabetes. It usually goes back to normal after the baby is born. High blood sugar can cause problems for you and your baby. Your baby may grow too large, which can cause problems during delivery. Your baby may also be born with low blood sugar. But with treatment, most women who have gestational diabetes are able to control their blood sugar and give birth to healthy babies. Women who have had gestational diabetes are more likely than other women to develop type 2 diabetes later on. You may be able to prevent or reduce the severity of type 2 diabetes by staying at a healthy weight, eating healthy foods, and increasing your physical activity. The pancreas makes a hormone called insulin. Insulin helps your body properly use and store the sugar from the food you eat. This keeps your blood sugar level in a target range. When you are pregnant, the placenta makes hormones that can make it harder for insulin to work. This is called insulin resistance. A pregnant woman can get diabetes when her pancreas cannot make enough insulin to keep her blood sugar levels within a target range. Because gestational diabetes may not cause symptoms, it is important for you to be tested for gestational diabetes. Sometimes a pregnant woman who has symptoms has been living with another type of diabetes without knowing it. If you have symptoms from another type of diabetes, they may include: Increased thirst. Increased urination. Pregnancy causes most women to urinate more often and to feel more hungry. So having these symptoms doesn't always mean that a woman has diabetes. Talk with your doctor if you have these symptoms, so that you can be tested for diabetes at any time during pregnancy. Most women are 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 Mellitus

Gestational Diabetes Mellitus

Develops during pregnancy and is usually diagnosed at 24 to 28 weeks of gestation on the basis of elevated plasma glucose levels on glucose tolerance testing. Goal of therapy is to achieve maternal glucose levels that are as close to normal as possible in order to avoid fetal macrosomia and complications. Initial therapy for gestational diabetes is usually dietary modification. Insulin is started when acceptable glucose levels cannot be maintained with diet alone. Maternal postnatal testing for diabetes or impaired glucose tolerance is performed at least 6 weeks following delivery. The risk for recurrence of GDM in subsequent pregnancies or progression to type 2 diabetes is high. Gestational diabetes mellitus (GDM) has traditionally been defined as any degree of glucose intolerance with onset or first recognition during pregnancy. However, the criteria for diagnosis are controversial, [1] Metzger BE, Buchanan TA, Coustan DR, et al. Summary and recommendations of the Fifth International Workshop-Conference on Gestational Diabetes Mellitus. Diabetes Care. 2007 Jul;30 Suppl 2:S251-60. and some authorities now define it as diabetes diagnosed in the second or third trimester of pregnancy that is clearly not overt diabetes. [2] American Diabetes Association. Standards of medical care in diabetes - 2018. Diabetes Care. 2018 Jan 1;41 Suppl 1:S1-159. It is usually recognized at 24 to 28 weeks of gestation on the basis of abnormal glucose tolerance testing. [2] American Diabetes Association. Standards of medical care in diabetes - 2018. Diabetes Care. 2018 Jan 1;41 Suppl 1:S1-159. one-step test option: 75-gram oral glucose tolerance test (OGTT) two-step test option: 1-hour 50-gram glucose load test (GLT), followed by 3-hour 100-gram OGTT Continue reading >>

Gestational Diabetes: Overview

Gestational Diabetes: Overview

have had gestational diabetes in the past, or Your doctor might already ask you about these factors early in your pregnancy and then advise you to be tested for gestational diabetes . Gestational diabetes usually doesnt have any consequences for the mother and child. Babies born to women who have gestational diabetes have a slightly heavier birth weight on average. But this is not a reason for concern. During the birth of larger babies, the phase after the head has come out often takes longer. If the child's shoulder gets stuck in the mother's pelvis (a situation known as shoulder dystocia), the child may not get enough oxygen . Midwives and doctors then react quickly to be on the safe side. This can lead to small injuries in the child and sometimes in the mother. Although these usually heal well, being in that situation can be distressing for the mother. Shoulder dystocia occurs in about 4 out of 100 children whose mothers had gestational diabetes and didnt have it treated. But emergency situations and more severe injuries are rare. Higher blood sugar levels also increase the risk of a rare problem during pregnancy known as pre-eclampsia. This condition is associated with excess protein in the urine , which causes high blood pressure and water retention in the body. Left untreated, pre-eclampsia can harm both the mother and the child. Women with gestational diabetes are somewhat more likely to develop type 2 diabetes later in life. The best way to diagnose gestational diabetes is by doing a glucose tolerance test. The test measures how the body reacts to a large amount of glucose ( sugar ). It is offered in the sixth or seventh month of pregnancy and involves a shorter initial test (a glucose challenge test) followed by the normal glucose tolerance test. For the short Continue reading >>

Diabetes Overview: Type 1, Type 2, Prediabetes And Gestational Diabetes

Diabetes Overview: Type 1, Type 2, Prediabetes And Gestational Diabetes

The Diabetes Management Center at Alton Memorial Hospital provides prevention, diagnosis, treatment and management services to patients that think they have or have diabetes. Below is an overview for the various types of diabetes. The types of diabetes include type 1, type 2, prediabetes and gestational diabetes. Immune-mediated diabetes is the most common form of type 1 diabetes, and the one generally referred to as type 1 diabetes. Idiopathic type 1 diabetes. This refers to rare forms of the disease with no known cause. Immune-mediated diabetes. An autoimmune disorder in which the body's immune system destroys, or attempts to destroy, the cells in the pancreas that produce insulin. Type 2 diabetes is a metabolic disorder resulting from the body's inability to make enough insulin for the degree of insulin resistance (body's inability to properly use insulin). It used to be called non-insulin-dependent diabetes mellitus, or maturity-onset diabetes mellitus (NIDDM). Without adequate production or utilization of insulin, the body cannot move blood sugar into the cells. It is a chronic disease that has no known cure. It is the most common type of diabetes. Type 2 diabetes is commonly preceded by prediabetes. In prediabetes, blood glucose levels are higher than normal but not high enough to be defined as diabetes. However, many people with prediabetes develop type 2 diabetes within 10 years, states the National Institute of Diabetes and Digestive and Kidney Diseases. Prediabetes also increases the risk of heart disease and stroke. With modest weight loss and moderate physical activity, people with prediabetes can delay or prevent type 2 diabetes. Gestational diabetes is a condition in which the glucose level is elevated and other diabetic symptoms appear during pregnancy i Continue reading >>

Pharmacological Management Of Gestational Diabetes

Pharmacological Management Of Gestational Diabetes

An overview Abstract OBJECTIVE—To provide a review of the background literature regarding the pharmacological management of gestational diabetes. RESEARCH DESIGN AND METHODS—This is a literature review. RESULTS—Information is available regarding the use of some, but not all, oral antidiabetes agents in pregnancy. CONCLUSIONS—Available evidence supports the use of glyburide during pregnancy. Evidence is inadequate to support or refute the use of metformin, an agent that has been shown to cross the placenta and thus could be helpful or harmful to the developing fetus. Because insulin preparations tested to date have been determined not to cross the placenta or to cross minimally, insulin has been the treatment of choice in most parts of the world for patients with gestational diabetes whose circulating glucose levels exceed predetermined thresholds. Although advances have been made in developing insulins that may be administered by alternative routes, insulin is typically injected subcutaneously. This poses a barrier to utilization and has been one of the factors that kindled interest over many years in treating gestational diabetes with oral antidiabetic agents. This and the following presentations describe oral agents that have the potential to be used as alternatives to insulin for the treatment of gestational diabetes. In this overview, I shall outline some guiding principles in determining whether a particular agent is appropriate for use in pregnancy and then apply these principles to the most commonly used oral antidiabetes agents. GUIDING PRINCIPLES— As our understanding of the physiology and pharmacology of both pregnancy and diabetes has increased, some guiding principles have emerged to help us decide which medications are safe and effective for pregn Continue reading >>

Gestational Diabetes

Gestational Diabetes

Gestational diabetes (GDM) is a common medical complication of pregnancy and is defined as diabetes with onset or first recognition during pregnancy. Paul Terranova, in xPharm: The Comprehensive Pharmacology Reference , 2007 While the incidence of gestational diabetes is approximate 0.5%, it affects 4% of pregnant women. It is estimated that 135,000 cases of gestational diabetes are diagnosed in the United States each year. Although gestational diabetes usually dissipates after pregnancy, it typically recurs during subsequent pregnancies. In some cases, pregnancy reveals the patient has type 1 or type 2 diabetes. It is uncertain whether these women have gestational diabetes or whether the diabetes coincidentally began during pregnancy. In either case, they are likely to require treatment after pregnancy. Some women with gestational diabetes develop type 2 diabetes, suggesting a possible link between the two conditions. Peter Hornnes, Jeannet Lauenborg, in Obesity , 2013 Gestational diabetes is an asymptomatic condition associated with adverse outcome for mother and child. Overweight and obesity confer a higher risk of gestational diabetes up to 11-fold. Health care providers of pregnant women should ensure that a strategy for screening gestational diabetes is in place. Either general screening programmes or selective screening programmes may be employed. Women with gestational diabetes should be monitored and treated vigorously. After delivery, glucose metabolism is most often normalised, but women with previous gestational diabetes have an increased risk of developing type-2 diabetes in later years. Therefore, they should be counselled about healthy lifestyles and offered exanimations for diabetes or pre-diabetes with 13 year intervals. Christopher Federico, Gabriella Continue reading >>

Gestational Diabetes

Gestational Diabetes

What Is Gestational Diabetes? Gestational diabetes sometimes develops when a woman is pregnant. It’s when the blood glucose level (blood sugar level) of the mother goes too high during pregnancy. Having an elevated blood glucose level during pregnancy can cause problems for your baby—if it’s left untreated. Fortunately, doctors are vigilant about checking for gestational diabetes so that it can be identified and effectively managed. A pro-active treatment plan helps you have a good pregnancy and protects the health of your baby. Gestational Diabetes Symptoms Gestational diabetes doesn’t often cause noticeable symptoms for the mother. Other types of diabetes (eg, type 1 diabetes or type 2 diabetes) do cause symptoms such as increased thirst, but that is hardly ever noticed in gestational diabetes. Because there aren’t often symptoms, it’s very important to be tested for a high blood glucose level when you’re pregnant. (Your doctor will most likely test you for gestational diabetes sometime between the 24th and 28th week. You can learn more about the diagnostic process here.) Then your doctor will know if you need to be treated for gestational diabetes. Gestational Diabetes Causes and Risk Factors Gestational diabetes develops when your body isn’t able to produce enough of the hormone insulin during pregnancy. Insulin is necessary to transport glucose—what your body uses for energy—into the cells. Without enough insulin, you can build up too much glucose in your blood, leading to a higher-than-normal blood glucose level and perhaps gestational diabetes. The elevated blood glucose level in gestational diabetes is caused by hormones released by the placenta during pregnancy. The placenta produces a hormone called the human placental lactogen (HPL), also Continue reading >>

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