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Gestational Diabetes Target Numbers

What To Expect With Gestational Diabetes

What To Expect With Gestational Diabetes

Blood glucose control is key to having a healthy baby A diagnosis of gestational diabetes can cast a shadow over the joys of pregnancy. While the vast majority of these cases end with a healthy baby and mom, gestational diabetes (high blood glucose during pregnancy in a woman who has never had type 1 or type 2 diabetes) does increase risks to the health of both baby and mother. Keeping blood glucose under control is crucial for women with gestational diabetes to help safeguard their babies and themselves. Gestational diabetes is caused by issues that arise as part of a normal pregnancy: hormonal changes and weight gain. Women whose bodies can't compensate for these changes by producing enough of the hormone insulin, which ushers glucose from the blood into cells to produce energy, develop high blood glucose and gestational diabetes. Overweight mothers are at a greater risk for the condition. In the United States, gestational diabetes is reported in somewhere between 2 and 10 percent of pregnancies, but it is now believed that the condition affects 18 percent of women in pregnancy. The larger number is the result of new criteria for diagnosis, not just skyrocketing rates. The American Diabetes Association began recommending this year that gestational diabetes be diagnosed with only one abnormal test result rather than two, the previous method, and this is causing more cases to be detected. Gestational diabetes usually appears roughly halfway through pregnancy, as the placenta puts out large amounts of "anti-insulin" hormones. Women without known diabetes should be screened for gestational diabetes 24 to 28 weeks into their pregnancies. (If high blood glucose levels are detected earlier in pregnancy, the mother-to-be may actually have type 2 diabetes, rather than gestati Continue reading >>

Understanding Gestational Diabetes: Glucose Monitoring

Understanding Gestational Diabetes: Glucose Monitoring

Fetal Monitoring, Gestational Diabetes, Integrative Medicine, Pregnancy and Birth, Weight Management What is self blood glucose monitoring? Once you are diagnosed as having gestational diabetes, you and your health care providers will want to know more about your day-to-day blood sugar levels. It is important to know how your exercise habits and eating patterns affect your blood sugars. Also, as your pregnancy progresses, the placenta will release more of the hormones that work against insulin. Testing your blood sugar level at important times during the day will help determine if proper diet and weight gain have kept blood sugar levels normal or if extra insulin is needed to help keep the fetus protected. Self blood glucose monitoring is done by using a special device to obtain a drop of your blood and test it for your blood sugar level. Your doctor or other health care provider will explain the procedure to you. Make sure that you are shown how to do the testing before attempting it on your own. Some items you may use to monitor your blood sugar levels are: Lancet–a disposable, sharp needle-like sticker for pricking the finger to obtain a drop of blood. Lancet device–a springloaded finger sticking device. Test strip–a chemically treated strip to which a drop of blood is applied. Color chart–a chart used to compare against the color on the test strip for blood sugar level. Glucose meter–a device which “reads” the test strip and gives you a digital number value. Your health care provider can advise you where to obtain the self-monitoring equipment in your area. You may want to inquire if any places rent or loan glucose meters, since it is likely you won't be needing it after your baby is born. How often and when should I test? You may need to test your blo Continue reading >>

Gestational Diabetes

Gestational Diabetes

What is gestational diabetes? Gestational diabetes is a type of diabetes that develops only during pregnancy. Diabetes means your blood glucose, also called blood sugar, is too high. Your body uses glucose for energy. Too much glucose in your blood is not good for you or your baby. Gestational diabetes is usually diagnosed during late pregnancy. If you are diagnosed with diabetes earlier in your pregnancy, you may have had diabetes before you became pregnant. Treating gestational diabetes can help both you and your baby stay healthy. You can protect your baby and yourself by taking action right away to control your blood glucose levels. If you have gestational diabetes, a health care team will likely be part of your care. In addition to your obstetrician-gynecologist, or OB/GYN—the doctor who will deliver your baby—your team might include a doctor who treats diabetes, a diabetes educator, and a dietitian to help you plan meals. What causes gestational diabetes? Gestational diabetes happens when your body can't make enough insulin during pregnancy. Insulin is a hormone made in your pancreas, an organ located behind your stomach. Insulin helps your body use glucose for energy and helps control your blood glucose levels. During pregnancy, your body makes more hormones and goes through other changes, such as weight gain. These changes cause your body's cells to use insulin less effectively, a condition called insulin resistance. Insulin resistance increases your body's need for insulin. If your pancreas can't make enough insulin, you will have gestational diabetes. All pregnant women have some insulin resistance during late pregnancy. However, some women have insulin resistance even before they get pregnant, usually because they are overweight. These women start pregnan Continue reading >>

Blood Sugar Levels For Pregnant Women With Diabetes

Blood Sugar Levels For Pregnant Women With Diabetes

Whether you had diabetes before you got pregnant or you developed diabetes during your pregnancy, you'll need to keep a close eye on your blood sugar levels. Tight control will help you avoid complications and long-term health problems for both you and your baby. You're eating differently because your body needs more energy to help your baby grow and be healthy. And your changing hormones affect how your body makes and uses insulin. In the later parts of your pregnancy, you may become more insulin resistant, so blood sugar builds up to higher levels. How often should you check your blood sugar? Pre-existing diabetes: Before and after meals and before bedtime If you are pregnant and have type 1 diabetes, your doctor might sometimes ask you to check your blood sugar in the middle of the night, around 3 a.m. You should check your fasting urine ketones every day, too. For every type of diabetes, if you're pregant you need to see your doctor at least once a month, perhaps as often as once a week. Continue reading >>

Gestational Diabetes: Target Blood Sugar Levels

Gestational Diabetes: Target Blood Sugar Levels

Gestational Diabetes: Target Blood Sugar Levels Gestational Diabetes: Target Blood Sugar Levels It is important to keep your blood sugar levels in a healthy range during your pregnancy. Healthy blood sugar levels for women with gestational diabetes Note: If you have gestational diabetes, you may experience weakness, sweating, and hunger if your blood sugar level drops below 70 mg/dL. These are symptoms of hypoglycemia (low blood sugar), which can be serious if it is not treated. As soon as these symptoms develop, eat some food that contains sugar to raise your blood sugar level. Medical Review: Sarah Marshall, MD - Family Medicine & Alan C. Dalkin, MD - Endocrinology This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use . How this information was developed to help you make better health decisions. 1995-2012 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. NOTICE: This health information was not created by the University of Michigan Health System (UMHS) and may not necessarily reflect specific UMHS practices. For medical advice relating to your personal condition, please consult your doctor. Complete disclaimer Continue reading >>

Management Of Gestational Diabetes Mellitus

Management Of Gestational Diabetes Mellitus

Gestational diabetes mellitus is a common but controversial disorder. While no large randomized controlled trials show that screening for and treating gestational diabetes affect perinatal outcomes, multiple studies have documented an increase in adverse pregnancy outcomes in patients with the disorder. Data on perinatal mortality, however, are inconsistent. In some prospective studies, treatment of gestational diabetes has resulted in a decrease in shoulder dystocia (a frequently discussed perinatal outcome), but cesarean delivery has not been shown to reduce perinatal morbidity. Patients diagnosed with gestational diabetes should monitor their blood glucose levels, exercise, and undergo nutrition counseling for the purpose of maintaining normoglycemia. The commonly accepted treatment goal is to maintain a fasting capillary blood glucose level of less than 95 to 105 mg per dL (5.3 to 5.8 mmol per L); the ambiguity (i.e., the range) is due to imperfect data. The postprandial treatment goal should be a capillary blood glucose level of less than 140 mg per dL (7.8 mmol per L) at one hour and less than 120 mg per dL (6.7 mmol per L) at two hours. Patients not meeting these goals with dietary changes alone should begin insulin therapy. In patients with well-controlled diabetes, there is no need to pursue delivery before 40 weeks of gestation. In patients who require insulin or have other comorbid conditions, it is appropriate to begin antenatal screening with nonstress tests and an amniotic fluid index at 32 weeks of gestation. Screening for gestational diabetes mellitus is widely practiced despite lack of evidence that it prevents adverse perinatal outcomes. Although the disorder affects approximately 2.5 percent of pregnant women1 and has been the subject of extensive res Continue reading >>

Diabetes In Pregnancy

Diabetes In Pregnancy

Gestational diabetes does not increase the risk of birth defects or the risk that the baby will be diabetic at birth. Also called gestational diabetes mellitus (GDM), this type of diabetes affects between 3% and 20% of pregnant women. It presents with a rise in blood glucose (sugar) levels toward the end of the 2nd and 3rd trimester of pregnancy. In 90% if cases, it disappears after the birth, but the mother is at greater risk of developing type 2 diabetes in the future. Cause It occurs when cells become resistant to the action of insulin, which is naturally caused during pregnancy by the hormones of the placenta. In some women, the pancreas is not able to secrete enough insulin to counterbalance the effect of these hormones, causing hyperglycemia, then diabetes. Symptoms Pregnant women generally have no apparent diabetes symptoms. Sometimes, these symptoms occur: Unusual fatigue Excessive thirst Increase in the volume and frequency of urination Headaches Importance of screening These symptoms can go undetected because they are very common in pregnant women. Women at risk Several factors increase the risk of developing gestational diabetes: Being over 35 years of age Being overweight Family members with type 2 diabetes Having previously given birth to a baby weighing more than 4 kg (9 lb) Gestational diabetes in a previous pregnancy Belonging to a high-risk ethnic group (Aboriginal, Latin American, Asian or African) Having had abnormally high blood glucose (sugar) levels in the past, whether a diagnosis of glucose intolerance or prediabetes Regular use of a corticosteroid medication Suffering from ancanthosis nigricans, a discoloration of the skin, often darkened patches on the neck or under the arms Screening The Canadian Diabetes Association 2013 Clinical Practice Gui Continue reading >>

What Are The Ideal Levels Of Blood Sugar?

What Are The Ideal Levels Of Blood Sugar?

A blood sugar or blood glucose chart identifies ideal blood sugar levels throughout the day, including before and after meals. Doctors use blood sugar charts to set target goals and monitor diabetes treatment plans. Blood sugar charts also help those with diabetes assess and self-monitor blood sugar test results. What is a blood sugar chart? Blood sugar charts act as a reference guide for blood sugar test results. As such, blood sugar charts are important tools for diabetes management. Most diabetes treatment plans involve keeping blood sugar levels as close to normal or target goals as possible. This requires frequent at-home and doctor-ordered testing, along with an understanding of how results compare to target levels. To help interpret and assess blood sugar results, the charts outline normal and abnormal blood sugar levels for those with and without diabetes. In the United States, blood sugar charts typically report sugar levels in milligrams per deciliter (mg/dL). In the United Kingdom and many other countries, blood sugar is reported in millimoles per liter (mmol/L). A1C blood sugar recommendations are frequently included in blood sugar charts. A1C results are often described as both a percentage and an average blood sugar level in mg/dL. An A1C test measures the average sugar levels over a 3-month period, which gives a wider insight into a person's overall management of their blood sugar levels. Blood sugar chart guidelines Appropriate blood sugar levels vary throughout the day and from person to person. Blood sugars are often lowest before breakfast and in the lead up to meals. Blood sugars are often highest in the hours following meals. People with diabetes will often have higher blood sugar targets or acceptable ranges than those without the condition. These Continue reading >>

Patient Education: Gestational Diabetes Mellitus (beyond The Basics)

Patient Education: Gestational Diabetes Mellitus (beyond The Basics)

INTRODUCTION Insulin is a hormone whose job is to enable glucose (sugar) in the bloodstream to enter the cells of the body, where sugar is the source of energy. All fetuses (babies) and placentas (afterbirths) produce hormones that make the mother resistant to her own insulin. Most pregnant women produce more insulin to compensate and keep their blood sugar level normal. Some pregnant women cannot produce enough extra insulin and their blood sugar level rises, a condition called gestational diabetes. Gestational diabetes affects between 5 and 18 percent of women during pregnancy, and usually goes away after delivery. It is important to recognize and treat gestational diabetes to minimize the risk of complications to mother and baby. In addition, it is important for women with a history of gestational diabetes to be tested for diabetes after pregnancy because of an increased risk of developing type 2 diabetes in the years following delivery. More detailed information about gestational diabetes is available by subscription. (See "Diabetes mellitus in pregnancy: Screening and diagnosis".) GESTATIONAL DIABETES TESTING We recommend that all pregnant women be tested for gestational diabetes. Identifying and treating gestational diabetes can reduce the risk of pregnancy complications. (See "Diabetes mellitus in pregnancy: Screening and diagnosis".) Complications of gestational diabetes can include: Having a large baby (weighing more than 9 lbs or 4.1 kg), which can increase the risk of injury to the mother or baby during delivery and increase the chance of needing a cesarean section. Stillbirth (a baby who dies before being born), a complication which fortunately is now rare in women with gestational diabetes because of good control of blood sugars and careful monitoring of mo 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 >>

Gestational Diabetes

Gestational Diabetes

PDF Format Gestational Diabetes What is gestational diabetes? Gestational diabetes is diabetes mellitus that develops in women for the first time during pregnancy. Some women found to have gestational diabetes actually may have had mild diabetes before pregnancy that was not diagnosed. What is diabetes mellitus? Diabetes mellitus (also called "diabetes") is a condition that causes high levels of glucose in the blood (see the FAQ Diabetes and Women). Glucose is a sugar that is the body’s main source of energy. Health problems can occur when glucose levels are too high. What causes gestational diabetes? Gestational diabetes is caused by a change in the way a woman’s body responds to insulin during pregnancy. Insulin is a hormone. It moves glucose out of the blood and into the body’s cells where it can be turned into energy. During pregnancy, a woman’s cells naturally become slightly more resistant to insulin’s effects. This change is designed to increase the mother’s blood glucose level to make more nutrients available to the baby. The mother’s body makes more insulin to keep the blood glucose level normal. In a small number of women, even this increase is not enough to keep their blood glucose levels in the normal range. As a result, they develop gestational diabetes. Will I be tested for gestational diabetes? All pregnant women are screened for gestational diabetes. You may be asked about your medical history and risk factors or you may have a blood test to measure the level of glucose in your blood. This test usually is done between 24 weeks and 28 weeks of pregnancy. It may be done earlier if you have risk factors. If I develop gestational diabetes, will I always have diabetes mellitus? For most women, gestational diabetes goes away after childbirth. How Continue reading >>

Healthy Blood Sugar Levels For Pregnant Women

Healthy Blood Sugar Levels For Pregnant Women

Diabetes that begins during pregnancy is called gestational diabetes. This condition affects 5 to 9 percent of all pregnancies in the United States, and it is becoming more common, according to a July 2009 article in "American Family Physician." Pregnancy also aggravates preexisting type 1 and type 2 diabetes. Blood sugar levels that are consistently too high during pregnancy can cause problems for both mother and infant. Video of the Day Diabetes during pregnancy increases the likelihood of congenital malformations, or birth defects, in infants, particularly if your blood glucose is poorly controlled for the first 10 weeks of pregnancy. High blood sugars also contribute to excessive fetal growth, which makes labor and delivery difficult and increases the likelihood of infant fractures or nerve injuries. Large infants are more likely to be delivered via cesarean section. Newborns of diabetic mothers are at risk for respiratory distress, jaundice and dangerously low blood calcium or glucose levels. Gestational diabetes is diagnosed when your blood sugars exceed specified levels following two glucose tolerance tests. The first test, usually performed between the 24th and 28th week of your pregnancy, involves drinking 50 g of a sugar solution and checking your blood glucose one hour later. If your level is above 130 mg/dL, your doctor will probably order a second glucose tolerance test that measures your blood glucose when you are fasting and then each hour for 2 to 3 hours after the test. A fasting glucose higher than 95 mg/dL, a one-hour level above 180 mg/dL, a two-hour level over 155 mg/dL or a three-hour measurement over 140 mg/dL is diagnostic of gestational diabetes. For pregnant women without diabetes, average fasting glucose levels vary between 69 mg/dL and 75 mg/ Continue reading >>

New Thresholds For Diagnosis Of Diabetes In Pregnancy

New Thresholds For Diagnosis Of Diabetes In Pregnancy

Share Midwives should diagnose women with gestational diabetes if they either have a fasting plasma glucose level of 5.6 mmol/litre or above, or a 2-hour plasma glucose level of 7.8 mmol/litre or above, according to NICE. Midwives should diagnose women with gestational diabetes if they either have a fasting plasma glucose level of 5.6 mmol/litre or above, or a 2-hour plasma glucose level of 7.8 mmol/litre or above, according to NICE. Updated guidelines on diabetes in pregnancy lower the fasting plasma glucose thresholds for diagnosis, and include new recommendations on self-management for women with type 1 diabetes. Around 35,000 women have either pre-existing or gestational diabetes each year in England and Wales. Nearly 90 per cent of the women who have diabetes during pregnancy, have gestational diabetes, which may or may not resolve after pregnancy. Rates have increased in recent years to due rising obesity rates among the general population, and increasing number of pregnancies among older women. Of the women with diabetes in pregnancy who do not have gestational diabetes, 7.5 per cent of women have type 1 diabetes, and the remainder have type 2 diabetes, both of which have also increased recently. Following a number of developments, such as new technologies and research on diagnosis and treatment of gestational diabetes, NICE has updated its guidelines on diabetes in pregnancy. Diagnosis Among the new recommendations are that a woman should be diagnosed with gestational diabetes if she has either a fasting plasma glucose level of 5.6 mmol/litre or above, or a 2-hour plasma glucose level of 7.8 mmol/litre or above. NICE says this could help tackle current variation in the number in the glucose levels used for diagnosing gestational diabetes, and may lead to an incr Continue reading >>

Gestational Diabetes: The Numbers Game

Gestational Diabetes: The Numbers Game

Copyright 1998 [email protected] All rightsreserved. DISCLAIMER: The information on this website is notintended and should not be construed as medical advice. Consultyour health provider. This particular web section isdesigned to present more than one view of a controversialsubject, pro and con. It should be re-emphasizedthat nothing herein should be considered medical advice. One thing that is especially confusing in gd is the variousnumbers that are tossed around all the time. It is very common toget confused! For example, 140 mg/dl is a numberyou see a lot, but it means different things in differentcontexts. It is the cutoff for the one-hour glucose challengetest in pregnancy, it used to be the number for diagnosing 'true'diabetes outside of pregnancy, and it is the cutoff for desirableblood glucose levels one hour after a meal in many programs. Whenthe levels for diagnosing diabetes outside pregnancy wererecently revised to lower levels (126 mg/dl), it confused manypregnant women, who wondered if the cutoff for the one-hour testin pregnancy was also going to be lowered or if their target bGfor one hour after eating was going to be lowered too. The answeris that one has nothing to do with the others. They all refer to differentmeasurements; it is just coincidence that they use the samenumber as a cutoff. But even among those who have studied the basics of gd, thevarious reference numbers commonly used in gd discussions can bevery confusing. Kmom knows from experience that when gd comes upfor discussion on mailing lists, people often mix up theirreferences, compare numbers incorrectly, and generally make thediscussion even more confusing. This websection is an attempt toclarify this very confusing issue and discuss thevarious guidelines that gd women are often given. Continue reading >>

Diabetes Management Guidelines

Diabetes Management Guidelines

Source: American Diabetes Association. Standards of medical care in diabetes—2016. Diabetes Care. 2016;39(suppl 1):S1-S106. Available here. Refer to source document for full recommendations, including class of recommendation and level of evidence. Jump to a topic or click back/next at the bottom of each page Diabetes in Pregnancy (Gestational Diabetes) Glycemic Targets in Pregnancy Pregestational diabetes Gestational diabetes mellitus (GDM) Fasting ≤90 mg/dL (5.0 mmol/L) ≤95 mg/dL (5.3 mmol/L) 1-hr postprandial ≤130-140 mg/dL (7.2-7.8 mmol/L) ≤140 mg/dL (7.8 mmol/L) 2-hr postprandial ≤120 mg/dL (6.7 mmol/L) ≤120 mg/dL (6.7 mmol/L) A1C 6.0-6.5% (42-48 mmol/L) recommended <6.0% may be optimal as pregnancy progresses Achieve without hypoglycemia Recommendations for Pregestational Diabetes Pregestational type 1 and type 2 diabetes confer greater maternal and fetal risk than GDM Spontaneous abortion Fetal anomalies Preeclampsia Intrauterine fetal demise Macrosomia Neonatal hypoglycemia Neonatal hyperbilirubinemia Diabetes in pregnancy may increase the risk of obesity and type 2 diabetes in offspring later in life Maintain A1C levels as close to normal as is safely possible Ideally, A1C <6.5% (48 mmol/L) without hypoglycemia Discuss family planning Prescribe effective contraception until woman is prepared to become pregnant Women with preexisting type 1 or type 2 diabetes Counsel on the risk of development and/or progression of diabetic retinopathy Perform eye exams before pregnancy or in first trimester; monitor every trimester and for 1 year postpartum Management of Pregestational Diabetes Insulin is the preferred medication for pregestational type 1 and type 2 diabetes not adequately controlled with diet, exercise, and metformin Insulin* management during pre Continue reading >>

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