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Gestational Diabetes Treatments

Testing And Treatment For Gestational Diabetes

Testing And Treatment For Gestational Diabetes

Save for later When you’re diagnosed with gestational diabetes, you should be given equipment so that you can regularly test your blood glucose levels at home. It’s extremely important that you check your blood glucose levels regularly when you have gestational diabetes. If you haven’t been given a blood glucose meter yet, you should go and speak to your diabetes healthcare team as soon as possible and ask them to give you one. Medication Do I need to take medication? Depending on your blood glucose levels when you were diagnosed with gestational diabetes, your diabetes healthcare team may advise you how to control diabetes with changes to your diet and physical activity levels without the need for medication. If changes in diet and physical activity don’t help you to stay within your blood glucose target range within one to two weeks, your healthcare team will offer medication and will talk you through the options. In some cases, your team may discuss medications with you at the time of diagnosis, without trialling dietary and physical activity changes first. Even when medications are needed, changes to diet and physical activity are essential in helping to control your blood glucose levels. Metformin This is a medication that helps to reduce the amount of glucose produced by the liver and make your insulin work properly. It is taken with or after a meal. Glibenclamide This tablet works by stimulating your pancreas to make more insulin. It is taken with or immediately after food. Insulin Insulin is a hormone that allows glucose – the body’s main fuel – to enter the cells and to be used for energy. It can’t be taken orally, otherwise the stomach will digest it. It is usually given as an injection using a small needle. If you need insulin to treat your di Continue reading >>

Treatments For Gestational Diabetes

Treatments For Gestational Diabetes

Maintaining a normal blood sugar level is vital to the health of both the mother and the baby. Treatments for gestational diabetes work to achieve and maintain normal blood sugar until the condition resolves after labor. Depending on the patient’s health, age, tolerance for medications and preference, doctors at Florida Hospital may recommend different or specialized treatments for gestational diabetes. These are some of the ways our team helps patients maintain a healthy blood sugar level and monitor the fetal development: Specialized dietary recommendations that reduce carbohydrates Exercise routine that is safe for the mother and fetus Monitoring of the blood glucose levels periodically Insulin injections if necessary Monitoring of fetal growth and well-being through: Ultrasound Fetal movement counting Biophysical profile Doppler flow study Nonstress testing Especially when the fetus is larger than normal (a potential complication of diabetes during pregnancy), delivery may be required a few weeks early to prevent injury and difficulty during labor. While these are the most common treatments for gestational diabetes, each patient has different needs. Schedule an appointment at Florida Hospital to speak to our specialists. We provide comprehensive, individualized care for patients throughout their pregnancy and after delivery. Our goal is to help mothers, babies and families maintain their highest level of health through holistic, comprehensive, compassionate care. 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 >>

Treatments For Gestational Diabetes

Treatments For Gestational Diabetes

Abstract Background Gestational diabetes (GDM) affects 3% to 6% of all pregnancies. Women are often intensively managed with increased obstetric monitoring, dietary regulation, and insulin. However, there has been no sound evidence base to support intensive treatment. The key issue for clinicians and consumers is whether treatment of GDM improves perinatal outcome. Objectives To compare the effect of alternative treatment policies for GDM on both maternal and infant outcomes. Search methods We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (January 2009) and bibliographies of relevant papers. We updated this search on 1 July 2011 and added the results to the awaiting classification section of the review. Selection criteria Randomised controlled trials comparing alternative management strategies for women with GDM and impaired glucose tolerance in pregnancy. Data collection and analysis Two authors and a member of the Cochrane Pregnancy and Childbirth Group's editorial team extracted and checked data independently. Disagreements were resolved through discussion with the third author. Main results Eight randomised controlled trials (1418 women) were included. Caesarean section rate was not significantly different when comparing any specific treatment with routine antenatal care (ANC) including data from five trials with 1255 participants (risk ratio (RR) 0.94, 95% confidence interval (CI) 0.80 to 1.12). However, when comparing oral hypoglycaemics with insulin as treatment for GDM, there was a significant reduction (RR 0.46, 95% CI 0.27 to 0.77, two trials, 90 participants). There was a reduction in the risk of pre-eclampsia with intensive treatment (including dietary advice and insulin) compared to routine ANC (RR 0.65, 95% CI 0.48 to 0.88, one tri Continue reading >>

Gestational Diabetes - Treatment Overview

Gestational Diabetes - Treatment Overview

Most women who have gestational diabetes give birth to healthy babies. You are the most important person in promoting a healthy pregnancy. Treatment for gestational diabetes involves making healthy choices. Most women who make changes in the way that they eat and how often they exercise are able to keep their blood sugar level within a target range. Controlling your blood sugar is the key to preventing problems during pregnancy or birth. You, your doctor, and other health professionals will work together to develop a treatment plan just for you. You do not need to eat strange or special foods. But you may need to change what, when, and how much you eat. And walking several times a week can really help your blood sugar. The lifestyle changes you make now will help you have a healthy pregnancy and prevent diabetes in the future. As you start making these changes, you will learn more about your body and how it reacts to food and exercise. You may also notice that you feel better and have more energy. During pregnancy Treatment for gestational diabetes during pregnancy includes: Eating balanced meals. After you find out that you have gestational diabetes, you will meet with a registered dietitian to create a healthy eating plan. You will learn how to limit the amount of carbohydrate you eat as a way to control your blood sugar. You may also be asked to write down everything you eat and to keep track of your weight. You will learn more about the range of weight gain that is good for you and your baby. Going on a diet during pregnancy is NOT recommended. Getting regular exercise. Try to do at least 2½ hours a week of moderate exercise.3, 4 One way to do this is to be active 30 minutes a day, at least 5 days a week. It's fine to be active in blocks of 10 minutes or more throu Continue reading >>

How To Treat Gestational Diabetes

How To Treat Gestational Diabetes

One of the most common complications during pregnancy, gestational diabetes (GD) is a condition that develops during the second trimester. According to Lisa Weston, registered midwife and vice president of the Association of Ontario Midwives, 3 to 4 percent of pregnant women develop this condition. Diagnosis of gestational diabetes During pregnancy, the placenta produces hormones that block the effects of insulin, making the mother insulin resistant. This insulin resistance is usually noticeable around the 20 to 24 weeks of pregnancy when the high blood sugar in the mother’s blood stimulates the baby to make more insulin. Extra sugar is then absorbed by the baby, causing extra weight gain. Testing The risk of gestational diabetes is greater in women who have a body mass index over 30, are over 30 years of age, have a history of gestational diabetes or large babies, or have a family history of diabetes. According to Weston, women of aboriginal, Hispanic, Asian, South Asian, and African descent also have a higher risk of developing GD. ‘There is also a greater chance for women who have had it in a previous pregnancy or have had a very large baby,’ says Weston. She recommends that women with more than one risk factor be tested for GD during the first three months of pregnancy and reassessed in the next two trimesters. Women can be screened for GD between 24 and 28 weeks’ gestation using a gestational diabetes test called the oral glucose tolerance test. The test itself is simple ‘ oral glucose is ingested and an hour later, a woman’s blood sugar levels are measured. If the blood sugar is above the recommended range, the test will be administered again with a large amount of oral glucose. If the blood sugar levels are still above the recommended range, a diagnos Continue reading >>

Gestational Diabetes Treatments....

Gestational Diabetes Treatments....

Amy Geraets I am 20 weeks into my 7th pregnancy and finding myself incredibly discouraged with my care providers approach to gestational diabetes. In my first 5 pregnancies, I passed the one-hour glucose test, but failed it by one-point in my sixth pregnancy. So, being the compliant patient I was at the time, I took the 3-hour test and failed miserably (course, I also just sat in the waiting room from one draw to the next not knowing it would be smart to be active instead). There is diabetes on both sides of my family, I was 38 at the time and I have a history of larger babies (8 pounds 6 ounces, 8 pounds 15 ounces and 9 pounds 1 ounce were my three largest). So, I continued to be a compliant patient and I followed all of their directions regarding diet, exercise and eventually, insulin. My son was born weighing 8 pounds 4 ounces. His initial blood sugar level was 40 and they climbed up from there. He was considered jaundiced and they sent us home with a biliblanket. Because of the gestational diabetes in his pregnancy, I was told I had to take the one-hour glucose test at 14 weeks. Unfortunately, it never occured to me to refuse it. I drank the glucola, went to my pre-natal appointment and returned to the lab one-hour later for my draw. It took the tech three pokes and 30 minutes to get blood out of me (finally succeeded in my hand). I failed the test by several points, but refused to take the 3-hour so they turned me over to the Diabetes and Pregnancy Care team whom I have been working with for the past 5 weeks (it took a week before I had test results and an appointment). Before meeting with them, I started keeping a food log and testing my glucose levels 4 times a day. For the past 3 weeks, they have been pressuring me to start insulin because my fasting levels are Continue reading >>

Gestational Diabetes And Pregnancy

Gestational Diabetes And Pregnancy

Gestational diabetes is a type of diabetes that is first seen in a pregnant woman who did not have diabetes before she was pregnant. Some women have more than one pregnancy affected by gestational diabetes. Gestational diabetes usually shows up in the middle of pregnancy. Doctors most often test for it between 24 and 28 weeks of pregnancy. Often gestational diabetes can be controlled through eating healthy foods and regular exercise. Sometimes a woman with gestational diabetes must also take insulin. Problems of Gestational Diabetes in Pregnancy Blood sugar that is not well controlled in a woman with gestational diabetes can lead to problems for the pregnant woman and the baby: 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 an operation 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 Continue reading >>

Gestational Diabetes Mellitus—right Person, Right Treatment, Right Time?

Gestational Diabetes Mellitus—right Person, Right Treatment, Right Time?

Abstract Personalised treatment that is uniquely tailored to an individual’s phenotype has become a key goal of clinical and pharmaceutical development across many, particularly chronic, diseases. For type 2 diabetes, the importance of the underlying clinical heterogeneity of the condition is emphasised and a range of treatments are now available, with personalised approaches being developed. While a close connection between risk factors for type 2 diabetes and gestational diabetes has long been acknowledged, stratification of screening, treatment and obstetric intervention remains in its infancy. Although there have been major advances in our understanding of glucose tolerance in pregnancy and of the benefits of treatment of gestational diabetes, we argue that far more vigorous approaches are needed to enable development of companion diagnostics, and to ensure the efficacious and safe use of novel therapeutic agents and strategies to improve outcomes in this common condition. Background May 2018 will mark 10 years since the publication of the seminal Hyperglycemia and Adverse Pregnancy Outcomes Study (HAPO) [1] and 8 years since new criteria and pathway for diagnosis of gestational diabetes (GDM) were proposed by the International Association of Diabetes and Pregnancy Study Groups (IADPSG) [2]. Landmark studies of the treatment of 'mild' GDM had been published before this in 2005 [3] and 2009 [4]. The IADPSG criteria have been largely adopted by several national and international societies, notably by the World Health Organisation (WHO) [5] and International Federation of Gynecology and Obstetrics (FIGO) [6], but others, most influentially the American College of Obstetricians and Gynecologists (ACOG) [7] and the National Institute for Health and Care Excellence (NIC Continue reading >>

Treatment Of Gestational Diabetes: Oral Hypoglycemic Agents Or Insulin?

Treatment Of Gestational Diabetes: Oral Hypoglycemic Agents Or Insulin?

Go to: Our report aims to verify whether perinatal maternal glycemic control in gestational diabetes can only be achieved with insulin or with oral hypoglycaemic agents. Then we want to evaluate the efficacy and safety of oral hypoglycemic agents in the treatment of gestational diabetes and then to compare these results with those associated with the use of insulin. Keywords: gestational diabetes, fetal hyperinsulinemia, fetal macrosomia, Insulin, oral hypoglycemic Go to: Introduction Gestational diabetes (GDM) is one of the most common medical conditions complicating pregnancy and its prevalence increases proportional to woman obesity in the childbearing age (1). In pregnant women suffering from gestational diabetes, despite a significant reduction in perinatal mortality observed in the last decade, the morbidity remained essentially unchanged (10-50%) (2). Fetal hyperinsulinemia and achieving macrosomia, accompanied by the increase of operative deliveries, shoulder dystocia and birth trauma, are a clear marker of the degree of metabolic control achieved during pregnancy (3) because we find them in approximately 40% of the children of untreated mothers suffering from this pregnancy disease (4). If the diet, which is the first-line therapy, fails (glycemia is higher than 130 mg / dl one hour after eating and 120 mg / dl two hours after eating and / or on an empty stomach glycemia is higher than 95 mg / dl) it is indicated application of insulin therapy that is used approximately 30% of pregnant women suffering from GDM. Subcutaneous insulin therapy has been the mainstay of treatment of women with gestational diabetes not controlled by modification diet. In reality the use of insulin is often associated with hypoglycaemia and increased weight. Moreover, this treatment is 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 >>

Metformin Versus Insulin For The Treatment Of Gestational Diabetes

Metformin Versus Insulin For The Treatment Of Gestational Diabetes

Metformin is a logical treatment for women with gestational diabetes mellitus, but randomized trials to assess the efficacy and safety of its use for this condition are lacking. We randomly assigned 751 women with gestational diabetes mellitus at 20 to 33 weeks of gestation to open treatment with metformin (with supplemental insulin if required) or insulin. The primary outcome was a composite of neonatal hypoglycemia, respiratory distress, need for phototherapy, birth trauma, 5-minute Apgar score less than 7, or prematurity. The trial was designed to rule out a 33% increase (from 30% to 40%) in this composite outcome in infants of women treated with metformin as compared with those treated with insulin. Secondary outcomes included neonatal anthropometric measurements, maternal glycemic control, maternal hypertensive complications, postpartum glucose tolerance, and acceptability of treatment. Of the 363 women assigned to metformin, 92.6% continued to receive metformin until delivery and 46.3% received supplemental insulin. The rate of the primary composite outcome was 32.0% in the group assigned to metformin and 32.2% in the insulin group (relative risk, 1.00; 95% confidence interval, 0.90 to 1.10). More women in the metformin group than in the insulin group stated that they would choose to receive their assigned treatment again (76.6% vs. 27.2%, P<0.001). The rates of other secondary outcomes did not differ significantly between the groups. There were no serious adverse events associated with the use of metformin. In women with gestational diabetes mellitus, metformin (alone or with supplemental insulin) is not associated with increased perinatal complications as compared with insulin. The women preferred metformin to insulin treatment. (Australian New Zealand Clinical 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 >>

Gestational Diabetes

Gestational Diabetes

If you have , you'll need to get your blood sugar under control, and keep it that way, to protect your health and your baby's. You’ll have to make some lifestyle changes for that to happen. Your doctor might suggest you meet with a registered dietitian to help you make a diet plan you can stick with. It will need to address the gestational diabetes, but still provide your growing baby enough calories and nutrients. Your dietitian will recommend the number of total daily calories a woman your height and weight should get. About 2,200 to 2,500 calories per day is the norm for women of average weight. If you’re overweight, you may need to lower that to about 1,800 calories per day. The dietitian can teach you how to balance your diet. She’ll probably suggest you get: 10% to 20% of your calories from protein sources like meats, cheeses, eggs, seafood, and legumes Less than 30% of your calories from fats Less than 10% of your fat calories from saturated fats The remaining 40% or so of your calories from carbohydrates like breads, cereals, pasta, rice, fruits, and vegetables Your doctor may tell you to you add exercise to your weekly routine if it’s OK for you and the baby. Try to do some kind of mild to moderate activity for 15 minutes or half an hour on most days. This will help your body use insulin better, and that helps control blood sugar levels. Follow your doctor's instructions about how much exercise is right for you. Make sure the diet changes and added exercise get your blood sugar levels under control. Test your levels regularly, before meals and 1 or 2 hours after meals. If you don’t already have a blood glucose meter to use at home, your doctor will probably give you one and teach you how to use it. If your blood sugar remains high despite these change Continue reading >>

Gestational Diabetes

Gestational Diabetes

What is gestational diabetes? Gestational diabetes is first diagnosed during pregnancy. Like type 1 and type 2 diabetes, gestational diabetes causes blood sugar levels to become too high. When you eat, your digestive system breaks down most of the food into a sugar called glucose. Glucose enters your bloodstream so your cells can use it as fuel. With the help of insulin (a hormone made by your pancreas), muscle, fat, and other cells absorb glucose from your blood. But if your body doesn't produce enough insulin, or if the cells have a problem responding to it, too much glucose remains in your blood instead of moving into cells and getting converted to energy. When you're pregnant, your body naturally becomes more resistant to insulin so that more glucose is available to nourish your baby. For most moms-to-be, this isn't a problem: When your body needs additional insulin to process excess glucose in blood, the pancreas secretes more. But if the pancreas can't keep up with the increased demand for insulin during pregnancy, blood sugar levels rise too high because the cells aren't using the glucose. This results in gestational diabetes. Gestational diabetes needs to be recognized and treated quickly because it can cause health problems for mother and baby. Unlike other types of diabetes, gestational diabetes isn't permanent. Once a baby is born, blood sugar will most likely return to normal quickly. However, having gestational diabetes does make developing diabetes in the future more likely. Am I at risk of developing gestational diabetes? Anyone can develop gestational diabetes, and not all women who develop the condition have known risk factors. About 5 to 10 percent of all pregnant women get gestational diabetes. You're more likely to develop gestational diabetes if you Continue reading >>

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