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2017 Mips Measure #001: Diabetes: Hemoglobin A1c (hba1c) Poor Control (>9%)

2017 Mips Measure #001: Diabetes: Hemoglobin A1c (hba1c) Poor Control (>9%)

Valid Data Submission Method(s) Measure Type High Priority Measure? NQS Domain Specialty Measure Sets Claims, EHR, CMS Web Interface, Registry Intermediate Outcome Yes Effective Clinical Care Internal Medicine, Preventive Medicine, General Practice/Family Medicine Measure Description Percentage of patients 18-75 years of age with diabetes who had hemoglobin A1c > 9.0% during the measurement period Instruction This measure is to be reported a minimum of once per performance period for patients with diabetes seen during the performance period. The most recent quality-data code submitted will be used for performance calculation. This measure may be reported by eligible clinicians who perform the quality actions described in the measure based on the services provided and the measure-specific denominator coding. Denominator Patients 18 – 75 years of age with diabetes with a visit during the measurement period Denominator Criteria (Eligible Cases): Patients 18 through 75 years of age on date of encounter AND Diagnosis for diabetes (ICD-10-CM): E10.10, E10.11, E10.21, E10.22, E10.29, E10.311, E10.319, E10.3211, E10.3212, E10.3213, E10.3219, E10.3291, E10.3292, E10.3293, E10.3299, E10.3311, E10.3312, E10.3313, E10.3319, E10.3391, E10.3392, E10.3393, E10.3399, E10.3411, E10.3412, E10.3413, E10.3419, E10.3491, E10.3492, E10.3493, E10.3499, E10.3511, E10.3512, E10.3513, E10.3519, E10.3521, E10.3522, E10.3523, E10.3529, E10.3531, E10.3532, E10.3533, E10.3539, E10.3541, E10.3542, E10.3543, E10.3549, E10.3551, E10.3552, E10.3553, E10.3559, E10.3591, E10.3592, E10.3593, E10.3599, E10.36, E10.37X1, E10.37X2, E10.37X3, E10.37X9, E10.39, E10.40, E10.41, E10.42, E10.43, E10.44, E10.49, E10.51, E10.52, E10.59, E10.610, E10.618, E10.620, E10.621, E10.622, E10.628, E10.630, E10.638, E10.64 Continue reading >>

Effectiveness Of Cinnamon For Lowering Hemoglobin A1c In Patients With Type 2 Diabetes: A Randomized, Controlled Trial

Effectiveness Of Cinnamon For Lowering Hemoglobin A1c In Patients With Type 2 Diabetes: A Randomized, Controlled Trial

Abstract Purpose: Multiple trials in the past have shown conflicting results of whether cinnamon lowers glucose or hemoglobin A1C (HbA1C). The purpose of this study was to determine whether cinnamon lowers HbA1C in patients with type 2 diabetes. I performed a randomized, controlled trial to evaluate whether daily cinnamon plus usual care versus usual care alone lowers HbA1c. Methods: I randomized 109 type 2 diabetics (HbA1C >7.0) from 3 primary care clinics caring for pediatric, adult, and geriatric patients at a United States military base. Participants were randomly allocated to either usual care with management changes by their primary care physician or usual care with management changes plus cinnamon capsules, 1g daily for 90 days. HbA1c was drawn at baseline and 90 days and compared with intention-to-treat analysis. This study was approved by an institutional review board. Results: Cinnamon lowered HbA1C 0.83% (95% CI, 0.46–1.20) compared with usual care alone lowering HbA1C 0.37% (95% CI, 0.15–0.59). Conclusions: Taking cinnamon could be useful for lowering serum HbA1C in type 2 diabetics with HbA1C >7.0 in addition to usual care. As the worldwide incidence of diabetes increases, the search for dietary adjuncts to treat this life-altering disease has become far ranging. Cinnamon is purported to be a natural insulin sensitizer, with adverse events of perioral dermatitis and stomatitis reported uncommonly with high intake.1 Both in vitro and in vivo animal studies have shown that cinnamon is an insulin sensitizer.2,3 Kim et al3 showed that intestinal glucosidase activity in rats was increased by cinnamon. Polyphenols within cinnamon have been identified as upregulators of mouse adipocyte insulin receptors.4 Peng et al5 found that polyphenols from cinnamon inhibi Continue reading >>

Understanding Your A1c

Understanding Your A1c

The A1C is a blood test that helps determine if your diabetes management plan is working well. (Both Type 1 and Type 2 take this test.) It’s done every 2-3 months to find out what your average blood sugar has been. (You may also hear this test called glycosylated hemoglobin, glycohemoglobin, hemoglobin A1c, and HbA1c.) A1c is the most common name for it though. How the test works Essentially, the test can tell how much sugar is in the blood stream by looking for proteins (hemoglobins). When glucose (sugar) enters the blood, it binds to the protein in the red blood cells. This binding creates “glycated hemoglobin”. The more sugar in the blood, the more glycated hemoglobin. It’s important to test your blood sugar levels (BGLs) throughout the day; however, an A1C test gives you a bigger picture with a long-term average of those blood sugar levels. What do these numbers mean? The A1c is an average of what your blood sugar levels have been over the 3-month period. In general, the higher your A1C number, the higher your likelihood of diabetes complications. (You don’t want a high A1C; it means there is too much sugar in your blood and your body isn’t absorbing it.) A1C number 4.6 – 6.0 Normal (does not have diabetes) 5.7 – 6.4 Pre-diabetes (warning that someone may develop Type 2 or have the beginning onset of Type 1) 6.7+ Diabetes (someone diagnosed with diabetes) <7.0 – 7.5 Target range (for adults diagnosed with diabetes – children diagnosed with diabetes) This target range varies between individuals, some people naturally run a little higher, some lower. It is important to note that especially in children a higher A1C (of 7.5) is recommended. The A1C number will help you and your doctor determine though if your diabetes management plan is working well. Continue reading >>

A1c Calculator*

A1c Calculator*

Average blood glucose and the A1C test Your A1C test result (also known as HbA1c or glycated hemoglobin) can be a good general gauge of your diabetes control, because it provides an average blood glucose level over the past few months. Unlike daily blood glucose test results, which are reported as mg/dL, A1C is reported as a percentage. This can make it difficult to understand the relationship between the two. For example, if you check blood glucose 100 times in a month, and your average result is 190 mg/dL this would lead to an A1C of approximately 8.2%, which is above the target of 7% or lower recommended by the American Diabetes Association (ADA) for many adults who are not pregnant. For some people, a tighter goal of 6.5% may be appropriate, and for others, a less stringent goal such as 8% may be better.1 Talk to your doctor about the right goal for you. GET YOURS FREE The calculation below is provided to illustrate the relationship between A1C and average blood glucose levels. This calculation is not meant to replace an actual lab A1C result, but to help you better understand the relationship between your test results and your A1C. Use this information to become more familiar with the relationship between average blood glucose levels and A1C—never as a basis for changing your disease management. See how average daily blood sugar may correlate to A1C levels.2 Enter your average blood sugar reading and click Calculate. *Please discuss this additional information with your healthcare provider to gain a better understanding of your overall diabetes management plan. The calculation should not be used to make therapy decisions or changes. What is A1C? Performed by your doctor during your regular visits, your A1C test measures your average blood sugar levels by taking a Continue reading >>

Understanding Your Hba1c

Understanding Your Hba1c

You’ve heard about a diabetes test called a hemoglobin A1C. It’s sometimes shortened to HgbA1c or HbA1c or just A1C. Hopefully, you know what yours is. But do you know what it means and what to do with the information? Hemoglobin is what makes red blood cells red. It consists of several proteins wrapped around an iron-based molecule called heme. Heme attaches to oxygen and carries it to the cells. That’s why iron is important in our diets. We need iron to make heme to carry oxygen, so our cells can breathe. Glucose (sugar) molecules are also floating along in our blood. Glucose attaches itself to all kinds of proteins, including the hemoglobin in red blood cells (RBCs). When glucose levels are high, many more of them will attach. Hemoglobin coated with glucose is called “glycated” or “glycosylated” hemoglobin. Glycation (“sugar-coating”) may not harm an RBC, but it does tell us if the cell has encountered much glucose during its lifetime. The more glucose has been in the blood, the more RBCs will be glycated. This is what an HbA1c test measures. A1C isn’t measuring what your blood glucose level is at the moment. It measures how high glucose has been over the last two months or so. RBCs only live about 100–120 days in the bloodstream. Once they become glycated, they stay glycated for life, so the number of glycated RBCs (HbA1c) gives a good picture of how much glucose has been in the blood recently. The A1C test has several advantages over other tests such as a fasting blood sugar (FBS). You don’t have to fast for an A1C. It can be taken at any time of day. It doesn’t matter what you ate the day before or on the day of the test, because it’s not measuring your current sugar. Normally, between 4.2% and 5.6% of RBCs will be glycated. The America Continue reading >>

Hemoglobin A1c

Hemoglobin A1c

On This Site Tests: Glucose Tests; Urine Albumin; Urine Albumin/Creatinine Ratio; Fructosamine Conditions: Diabetes In the News: Screening, Diet and Exercise Key Factors in Task Force's New Diabetes Guidelines (2015), Task Force Updates Recommendations for Screening for Pre-Diabetes and Diabetes in Adults (2014), New Report Finds that Diabetes is on the Rise (2014) Elsewhere On The Web American Diabetes Association: Diabetes Basics American Diabetes Association: Risk Test American Association of Diabetes Educators Centers for Disease Control and Prevention: Diabetes Public Health Resource National Diabetes Information Clearinghouse: Prevent diabetes problems - Keep your diabetes under control National Institute of Diabetes and Digestive and Kidney Diseases: Diabetes A to Z National Glycohemoglobin Standardization Program American Diabetes Association – DiabetesPro, estimated Average Glucose, eAG Ask a Laboratory Scientist Your questions will be answered by a laboratory scientist as part of a voluntary service provided by one of our partners, the American Society for Clinical Laboratory Science (ASCLS). Click on the Contact a Scientist button below to be re-directed to the ASCLS site to complete a request form. If your question relates to this web site and not to a specific lab test, please submit it via our Contact Us page instead. Thank you. Continue reading >>

Hemoglobin A1c Test

Hemoglobin A1c Test

A REPORT CARD FOR DIABETES CONTROL THE HEMOGLOBIN A1C TEST AND THE OPTIMAL CONTROL OF DIABETES By keeping your diabetes under tight control, you significantly reduce the risk of losing your vision to diabetic eye disease. The hemoglobin A1C test can tell you just how well you are controlling your diabetes. You can think of the hemoglobin A1C test as if it were an averaging of all your blood sugar readings from the previous three months. An A1C reading of 7.0 or less indicates that your blood sugar control is probably quite good. Patients who maintain their hemoglobin AIC levels below 7.0 are less at risk for developing the complications of diabetes and are more likely to retain their vision. Hemoglobin AIC readings above 8.0 are not as good. When the readings are 9.0, 10.0, 11.0, 12.0 and above, the risk and severity of diabetic complications increases proportionately. Your doctor will probably draw a hemoglobin A1C; blood test three or four times a year. You should be interested and you should always know what your latest hemoglobin A1C results are. Keep these results in your wallet so that when you visit the Rand Eye Institute, we will be able to know what your latest numbers are. The hemoglobin A1C test is in reality, your report card on how well you and your physician are managing your diabetes. If you depend upon insulin injections to control your diabetes, a strategy of more frequent blood glucose measurements may improve the quality of your control considerably. The best diabetes control usually requires that you test your blood sugar four times a day or more. You need to have a general idea of what your blood sugar measurement would be at any given time, and you should test yourself whenever you are not sure. With a little practice, you can learn how each food y Continue reading >>

Why Doesn’t My Average Blood Glucose Match My A1c?!

Why Doesn’t My Average Blood Glucose Match My A1c?!

So, you test your meter for accuracy and everything looks good. You take your average BG and convert it to A1C using a table, calculator, or equation you find online. Then, you get your blood work done and learn that your actual A1C is… Not even close! What’s the deal? As it turns out, the relationship between average BG and A1C isn’t as clear as most of us think. After doing some research, I came across a couple reasons why someone’s actual A1C may be higher or lower than expected… But before we get into that, let’s briefly go over why A1C is used to approximate average glucose over ~3 months: As glucose enters your blood, it attaches to a protein in your red blood cells called “hemoglobin.” Hemoglobin is the same protein that carries oxygen in your bloodstream, and it is what gives blood its red color A1C measures the total amount of glucose that has attached to your hemoglobin over the lifespan of your red blood cells (typically ~3 months). OK, now that we’ve got the science down, here’s why your average BG and lab-measured A1C values might not match up: 1. BG meter average does not usually reflect the average over a full 24 hours This reason is pretty obvious. If you are not on a CGM, it’s tough to get a full picture of your average blood glucose throughout the day. We generally test much more during the day than at night, and nighttime glucose values may be very different from daytime values. We also tend to test more often before eating (when glucose is typically lower), and less often after meals (when glucose is typically higher). So, for most people, BG meter average doesn’t accurately reflect average blood glucose over a full 24 hours. A1C, on the other hand, does. If you want your BG meter average to better reflect your A1C values, che Continue reading >>

Combining Glycosylated Hemoglobin A1c And Fasting Plasma Glucose For Diagnosis Of Type 2 Diabetes In Chinese Adults

Combining Glycosylated Hemoglobin A1c And Fasting Plasma Glucose For Diagnosis Of Type 2 Diabetes In Chinese Adults

Abstract Glycosylated hemoglobin A1c (HbA1c) has been applied to identify type 2 diabetes (T2DM) in the U.S. and European countries. It has not been used in China mainly due to lack of a standardized approach to measure HbA1c, short of knowledge about racial-specific standard and deficiency of an optimal cut-off point. To evaluate combination of HbA1c and fasting plasma glucose (FPG) in diagnosing T2DM in Chinese adults, a multistage sampling cross-sectional study was conducted in Shanghai, China, in 2009. The FPG measurement, HbA1c assay, and oral glucose tolerance test (OGTT) were performed in 6,661 Chinese adults (3057 men, 3604 women) who had no prior history of diabetes to identify the unrecognized T2DM. A total of 454 participants were identified as T2DM based on the 1999 World Health Organization (WHO) diagnostic criteria. Of these patients, 239 were detected using an FPG ≥ 7.0 mmol/l and 141 were further identified using an HbA1c ≥ 43 mmol/mol (6.1%), achieving a sensitivity of 83.7% and a specificity of 89.3% for combining use of FPG and HbA1c. In subjects at high risk of diabetes, the combining use of FPG and HbA1c produced a higher sensitivity and an improved positive predictive value (PPV), and had a satisfactory specificity and negative predictive value (NPV). The combining use of FPG and HbA1c is a potential screening and diagnosis approach for T2DM in Chinese adults, especially among those at high risk of the disease. Background Type 2 diabetes mellitus (T2DM) is a common disease reflecting metabolic disorders characterized with hyperglycemia, which may lead to specific long-term complications affecting heart, brain, eyes, kidneys and nervous system [1]. Currently, diagnosis of T2DM in Chinese adults is principally according to the 1999 World Health O Continue reading >>

New Guidelines For Diabetes In Seniors

New Guidelines For Diabetes In Seniors

Mom is 82, a diabetic, and her sugars often drop below 100 and she feels lightheaded. She’s been told that she should keep her sugars between 70 and 120 but we’ve noticed she often feels better if they are higher. What is a good range of finger-stick sugars for her? The guidelines for blood sugar control in seniors have changed recently. The Choosing Wisely Campaign from the AGS [American Geriatrics Society] I referenced in previous articles, now recommends that lower sugars are not good for seniors (as contrasted with younger adults, where tighter control is better). The new advice is: Avoid using medications to achieve hemoglobin A1c less than 7.5% in most adults age 65 and older; moderate control is generally better. What is the ‘A1c’? The ‘A1c’ is a protein—the hemoglobin A1c—produced in your blood in response to the level of sugar. As the sugar increases, the A1c rises, and reflects the average sugar over the preceding three months. Diabetics should have their A1c measured every 3-6 months. An A1c of 7% indicates an average blood sugar of 154; 7.5% means it’s been 168; 8.0%, it’s 182; for 9.0%, it’s 211. The AGS found no evidence that tight control in older adults with type 2 diabetes is beneficial. ‘Tight control’ means an A1c less than 7% which usually translates into finger-stick sugars under 100 before breakfast and under 200 the rest of the day. Compared with ‘looser control’, tight control in seniors results in more harm: higher death rates, and particularly higher rates of hypoglycemia—blood sugars that are too low, meaning less than 70-80, which increases the risk of dizziness, falling, injury, and generally just not feeling as well. Since it takes years for the benefits of ‘tight control’ to really be seen, the AGS recom Continue reading >>

Could Slightly High Blood Sugar Cause Neuropathy?

Could Slightly High Blood Sugar Cause Neuropathy?

My glucose levels usually run between 120 and 135 with a nonfasting blood test, though do not have a diagnosis of diabetes. I suffer greatly with my feet and been told by a podiatrist that it is neuropathy. Is it possible that my high glucose levels are causing the neuropathy? Dear Terry, Thanks for your question. I like to think of blood glucose values as a spectrum of numbers with no clear cutoff between nondiabetic and diabetic. In similar manner there is a gray area of blood glucose that defines pre-diabetes. Many people use blood sugar and blood glucose interchangeably. The definition of diabetes has changed over time. The numbers you quote might very well be considered diagnostic of diabetes today whereas they were not 20 years ago. In 1997, the American Diabetes Association definition of normal blood glucose decreased from 120 to 110 mg/dL (6.1 mmol/L). In 2002, the American Diabetes Association defined a normal fasting blood glucose as less than 100 mg/dL (5.6 mmol/L). Today we consider fasting blood sugars of 100 mg/dl to 125mg/dl to be in the realm of glucose intolerance which is sometimes called pre-diabetes. These patients are at increased risk for developing frank diabetes. Several fasting glucose levels over 125 or a single random glucose over 200 mg are considered diagnostic of diabetes. There are other tests used to make the diagnosis of pre-diabetes or diabetes. Pre-diabetes is defined as a blood sugar of 140 to 199 mg/dL (7.8 to 11.0 mmol/L) two-hour after drinking 75 grams of an oral glucose solution. The diagnosis of diabetes is confirmed with a blood sugar of 200 mg/dL or greater, two hours after ingestion of the glucose solution. Hemoglobin A1C is a blood test that gives an estimate of blood sugar levels over the previous three months. Persons with Continue reading >>

A1c-it’s Just A Number

A1c-it’s Just A Number

Yesterday, I had my endocrinologist appointment where I found out what my A1C was from blood work I had done last week. I’ve been trying sooooooooooo hard to get my A1C not only Below-Seven but below 6.5 because my hubby and I are planning on trying to get pregnant soon. I was so confident in my blood sugars over the last few weeks and months that I was positive I was going to have an amazing A1C, so positive that my husband and I made the decision for me to get off of my birth control pills so we could actually begin trying to get pregnant within the next few months. The last A1C I had done was 7.3 back in June. However, that was done a few weeks after we went to beach week, where my blood sugars stayed high the majority of the week thanks to grazing and alcohol. It was also after extensive basal testing in March and April, where I purposely kept my blood sugars in the high 200’s because I knew my basal rates were too high. I would drop drastically, more than 100 mg/dls during the tests until I tweaked them enough to stop the dramatic declines. So, my A1C in June of 7.3 made sense because I did have some highs. I was still disappointed though, because I felt that after I had completed the basal testing, my blood sugars were pretty solid, minus the high beach week. After getting the June result, I was more determined than ever to get my A1C Below-Seven. I have done all sorts of things to make that happen. I did a clean eating challenge back in September which resulted in a few changes in my eating habits overall such as limiting my carb intake and for the most part cutting out Diet Cokes. I have been working hard to pre-bolus before meals. I have been running a TON, at least four times per week. I’ve been getting used to lower blood sugar numbers and I’ve been t Continue reading >>

Hemoglobin A1c

Hemoglobin A1c

This report is not a substitute for the regular medical care of your physician. If you have questions resulting from this information, please contact the staff at Meeker Memorial Hospital Laboratory. You must visit your regular physician for any treatment that you may need. MCMH Laboratory does not send your physician a copy of these results. Hemoglobin A1C Hemoglobin A1C is an indicator of how well you have controlled your diabetes over the last few months. This test measures the amount of hemoglobin (the red protein that carries oxygen in your red blood cells) that has attached to glucose (blood sugar) molecules. The amount of hemoglobin A1C formed is directly related to the amount of glucose in your blood. If your diabetes is not well controlled, your blood glucose levels are high, causing higher hemoglobin A1C levels. Hemoglobin A1C levels do not change quickly since red cells can live for 2-3 months. A healthy person without diabetes will have an A1C between 4% and 6%. If you are diabetic, the closer your A1C is to 6%, the better your diabetes is in control. For every 1% increase in A1C, blood increases approximately 30 mg/dL and the risk of complications increases. The American Diabetes Association recommends the goal of therapy should be hemoglobin A1C values of <7.0% and that physicians should reevaluate the treatment regimens in patients with A1C values consistently > 8.0%. The American Diabetes Association recommends testing your A1C: 4 times each year if you have type 1 or type 2 diabetes and use insulin: or 2 times each year if you have type 2 diabetes and do not use insulin. Once again, this report is not a substitute for the regular medical care of your physician. If you have any questions or concerns, please schedule an appointment with your regular physi Continue reading >>

Measure #1 (nqf 0059): Diabetes: Hemoglobin A1c (hba1c) Poor Control (>9%) €“ National Quality Strategy Domain: Effective Clinical Care

Measure #1 (nqf 0059): Diabetes: Hemoglobin A1c (hba1c) Poor Control (>9%) €“ National Quality Strategy Domain: Effective Clinical Care

2017 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY MEASURE TYPE: Intermediate Outcome DESCRIPTION: Percentage of patients 18-75 years of age with diabetes who had hemoglobin A1c > 9.0% during the measurement period INSTRUCTIONS: This measure is to be reported a minimum of once per performance period for patients with diabetes seen during the performance period. The most recent quality-data code submitted will be used for performance calculation. This measure may be reported by eligible clinicians who perform the quality actions described in the measure based on the services provided and the measure-specific denominator coding. Measure Reporting: The listed denominator criteria is used to identify the intended patient population. The numerator options included in this specification are used to submit the quality actions allowed by the measure. The quality-data codes listed do not need to be submitted for registry-based submissions; however, these codes may be submitted for those registries that utilize claims data. DENOMINATOR: Patients 18 - 75 years of age with diabetes with a visit during the measurement period Denominator Criteria (Eligible Cases): Patients 18 through 75 years of age on date of encounter AND Diagnosis for diabetes (ICD-10-CM): E10.10, E10.11, E10.21, E10.22, E10.29, E10.311, E10.319, E10.3211, E10.3212, E10.3213, E10.3219, E10.3291, E10.3292, E10.3293, E10.3299, E10.3311, E10.3312, E10.3313, E10.3319, E10.3391, E10.3392, E10.3393, E10.3399, E10.3411, E10.3412, E10.3413, E10.3419, E10.3491, E10.3492, E10.3493, E10.3499, E10.3511, E10.3512, E10.3513, E10.3519, E10.3521, E10.3522, E10.3523, E10.3529, E10.3531, E10.3532, E10.3533, E10.3539, E10.3541, E10.3542, E10.3543, E10.3549, E10.3551, E10.3552, E10.3553, E10.3559, E10.3591, E10.3592, E10.3593, E10.3 Continue reading >>

Pregnancy In Women With Type 1 Or Type 2 Diabetes

Pregnancy In Women With Type 1 Or Type 2 Diabetes

Being well-prepared for pregnancy can help reduce the risk of complications, keep you healthy throughout your pregnancy, and give your baby a good start in life. Blood glucose (sugar) control is a daily challenge for people with diabetes. Hormonal changes during pregnancy make diabetes even more challenging. The majority of women who properly control their diabetes before and during pregnancy have successful pregnancies, and give birth to beautiful, healthy babies. Risks and potential complications Women with diabetes have a higher risk of miscarriage and of having a baby with birth defects (heart and kidney defects, for example). This risk significantly increases if blood glucose (sugar) control is not optimal, especially at conception and during the first 3 months of pregnancy, when the baby's organs are forming. If your blood glucose (sugar) levels are poorly controlled, you should avoid becoming pregnant until your healthcare team has helped you improve your blood sugar control. Risks for the mother: Miscarriage Rapidly worsening retinopathy (damage to the retina caused by diabetes) Rapidly worsening nephropathy (kidney damage caused by diabetes) and kidney failure A more difficult vaginal delivery (because of the baby’s weight) requiring special maneuvers by the obstetrician or the use of forceps or suction Caesarean delivery Gestational hypertension and pre-eclampsia (a pregnancy complication characterized by high blood pressure and significant swelling) Excess amniotic fluid, which can cause premature labour Risks for the baby: Defects (especially if the diabetes is poorly controlled in the first 3 months of pregnancy) of the heart, kidneys, urogenital tract, brain, spinal cord and backbone Higher-than-average birth weight (more than 4 kg or 9 lbs.) or, convers Continue reading >>

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