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Type 2 Diabetes And Pregnancy Risks

Pregnancy If You Have Diabetes

Pregnancy If You Have Diabetes

If you have diabetes and plan to have a baby, you should try to get your blood glucose levels close to your target range before you get pregnant. Staying in your target range during pregnancy, which may be different than when you aren’t pregnant, is also important. High blood glucose, also called blood sugar, can harm your baby during the first weeks of pregnancy, even before you know you are pregnant. If you have diabetes and are already pregnant, see your doctor as soon as possible to make a plan to manage your diabetes. Working with your health care team and following your diabetes management plan can help you have a healthy pregnancy and a healthy baby. If you develop diabetes for the first time while you are pregnant, you have gestational diabetes. How can diabetes affect my baby? A baby’s organs, such as the brain, heart, kidneys, and lungs, start forming during the first 8 weeks of pregnancy. High blood glucose levels can be harmful during this early stage and can increase the chance that your baby will have birth defects, such as heart defects or defects of the brain or spine. High blood glucose levels during pregnancy can also increase the chance that your baby will be born too early, weigh too much, or have breathing problems or low blood glucose right after birth. High blood glucose also can increase the chance that you will have a miscarriage or a stillborn baby.1 Stillborn means the baby dies in the womb during the second half of pregnancy. How can my diabetes affect me during pregnancy? Hormonal and other changes in your body during pregnancy affect your blood glucose levels, so you might need to change how you manage your diabetes. Even if you’ve had diabetes for years, you may need to change your meal plan, physical activity routine, and medicines. Continue reading >>

Patient Education: Care During Pregnancy For Women With Type 1 Or 2 Diabetes Mellitus (beyond The Basics)

Patient Education: Care During Pregnancy For Women With Type 1 Or 2 Diabetes Mellitus (beyond The Basics)

INTRODUCTION Before insulin became available in 1922, women with diabetes mellitus were at very high risk of complications of pregnancy. Today, most women with diabetes can have a safe pregnancy and delivery, similar to that of women without diabetes. This improvement is largely due to good blood glucose (sugar) control, which requires adherence to diet, frequent daily blood glucose monitoring, and frequent insulin adjustment. This topic review discusses care of women with type 1 or 2 diabetes during pregnancy, as well as fetal and newborn issues. It does not address gestational diabetes, which is diabetes that is first diagnosed during pregnancy. (See "Patient education: Gestational diabetes mellitus (Beyond the Basics)".) IMPORTANCE OF BLOOD GLUCOSE CONTROL Glucose in the mother's blood crosses the placenta to provide energy for the baby; thus, high blood glucose levels in the mother lead to high blood glucose levels in the developing baby as well. High blood glucose levels can cause several problems: Early in pregnancy, high glucose levels increase the risk of miscarriage and birth defects. These risks are highest when glycated hemoglobin (hemoglobin A1C or A1C) is >8 percent or the average blood glucose is >180 mg/dL (10 mmol/L). In the last half of pregnancy and near delivery, high blood glucose levels can cause the baby's size and weight to be larger than average and increase the risk of complications during and after delivery (see 'Newborn issues' below). In particular, women with large babies are more likely to have difficulty with a vaginal birth and have a higher chance of needing a cesarean delivery. In the last half of pregnancy, women with diabetes are more prone to developing pregnancy-induced hypertension (preeclampsia) and an excessive amount of amniotic Continue reading >>

Have A Safe Pregnancy With Type 2 Diabetes

Have A Safe Pregnancy With Type 2 Diabetes

It used to be that women with type 2 diabetes were discouraged from becoming pregnant. These days, with careful pregnancy planning and monitoring of blood glucose levels, you can have a safe pregnancy and a healthy baby. Diabetes and Pregnancy: Your Prenatal Care Team If you have type 2 diabetes and you want to become pregnant, the first step would ideally be to speak with both your endocrinologist and your obstetrician. They can help you be at your healthiest to conceive. Both before you become pregnant and during your pregnancy (and beyond), it will be important for you to keep your blood sugar levels under control and to follow all the other guidelines to minimize all health risks to you and your baby. Fortunately, different diabetes practitioners can work with you on all the aspects of pregnancy, including exercise and nutrition. Your medical team might include: Your obstetrician. The ob-gyn you choose should care for patients with type 2 diabetes or have experience with high-risk pregnancies. Your dietitian. This professional can outline a pre-pregnancy and pregnancy diet that will keep blood glucose under control. Your diabetes educator. This specialist can help you learn about your body’s changing needs throughout your pregnancy. Your future pediatrician. Your baby’s doctor should have experience treating infants of mothers with diabetes. Diabetes and Pregnancy: Control Blood Glucose First While every woman is urged to get her body into baby-ready shape before conceiving, this is especially important if you have diabetes. According to the American Diabetes Association, your blood glucose levels should be in the suggested range for three to six months before you try to conceive and, of course, during your entire pregnancy. This may involve more doctor visits, Continue reading >>

Long Term Effects Of Type 1/2 Diabetes In Pregnancy

Long Term Effects Of Type 1/2 Diabetes In Pregnancy

Both type 1 and 2 diabetes have genetic links, and for type 2 diabetes lifestyle factors can increase the risk further More than 85% of type 1 diabetes occurs in people without diabetes in their immediate family. But the risk for people who do have diabetes in their immediate family is about 15 times higher than normal. On average: if a mother has the condition, the risk of developing it is about 2–4% if a father has the condition, the risk of developing it is about 6–9% if both parents have the condition, the risk of developing it is up to 30% if a brother or sister develops the condition, the risk of developing it is 10% (rising to 10–19% for a non-identical twin and 30–70 % for an identical twin) Genetic and environmental factors determine the risk with type 2 diabetes. It tends to cluster in families. People who have diabetes in the family are two to six times more likely to have diabetes than people without diabetes in the family. Top tips for reducing your family’s risk of type 2 diabetes Eat a healthy diet Keep your weight at a healthy level If you drink alcohol, do so in moderation Stay active and get regular exercise Stop smoking Read more Continue reading >>

Women’s Top Diabetes Concerns

Women’s Top Diabetes Concerns

Managing type 2 diabetes means being good to yourself. “Diabetes requires self-care to do it well,” says Robin Goland, MD, diabetes research director at New York-Presbyterian Hospital. “While many women are comfortable at taking care of others, it can be hard for them to take care of themselves.” Your first line of defense is a healthy diet and exercise plan, so talk to your doctor about creating one that will likely include: Getting at least 30 minutes of physical activity on most days. Anything that gets your heart rate up and causes you to sweat a little is beneficial, even if it’s gardening, walking, or cleaning your house. Eating foods that will keep your blood sugar levels in check. That means choosing high-fiber foods, swapping out white starchy foods for whole grains, putting lots of vegetables on your plate, and steering clear of sweetened beverages, including fruit juice. Ask your doctor who else can help you, like a nutritionist or a diabetes specialist. Having diabetes makes heart disease more likely. That's all the more reason to follow your doctor's guidelines about diet and exercise. Also, track your blood pressure, says OB/GYN and diabetes educator Cassandra Henderson, MD, of New York’s Lincoln Hospital and Albert Einstein College of Medicine. Keeping your cholesterol levels in check will also help protect your heart. Continue reading >>

Pre-existing Diabetes And Pregnancy

Pre-existing Diabetes And Pregnancy

If you have type 1 or type 2 diabetes and are planning a family, you should plan your pregnancy as much as possible. Controlling your blood sugars before conception and throughout pregnancy gives you the best chance of having a trouble-free pregnancy and birth and a healthy baby. If you have diabetes and your pregnancy is unplanned, there’s still plenty you can do to give your baby the best start in life. The information on this page is for women who have diabetes before becoming pregnant. If you develop diabetes during pregnancy, it is called gestational diabetes. Planned pregnancy Visit your doctor or diabetes educator at least 6 months before you start trying to fall pregnant, if you can. You will be given advice and guidance on controlling your blood sugars as tightly as possible, and taking necessary supplements like folate. You may also be advised to change medications. If you are healthy and your diabetes is well controlled when you become pregnant, you have a good a chance of having a normal pregnancy and birth. Diabetes that is not well controlled during pregnancy can affect your health long-term and can also be risky for your baby. Unplanned pregnancy Not everybody can plan their pregnancy. If you have diabetes and think you might be pregnant, see your doctor as soon as you can. Your healthcare team You may be cared for by a team of health professionals including: an obstetrician who can handle high risk pregnancies a specialist experienced in diabetes care during pregnancy, who may be an endocrinologist or who may be a general physician a diabetes educator to help you manage your diabetes a dietician who can provide dietary advice at all the different stages - before conception, while pregnant and after the birth a midwife who is experienced in all aspects Continue reading >>

Labour And Birth With Type 1 Or 2 Diabetes

Labour And Birth With Type 1 Or 2 Diabetes

Your birth experience may be different to the one that you had expected, and this can be hard to come to terms with. Finding out what might happen could help you feel mentally prepared for what may lie ahead. It can help to remember that although the birth itself is important, it is just one step in the journey towards having your baby. Where to give birth with type 1 or 2 diabetes If you have diabetes, it is recommended that you give birth in a hospital with the support of a consultant-led maternity team. It is not unusual for babies of mothers with diabetes to be larger than normal, which could lead to birth difficulties such as shoulder dystocia (in which the baby’s shoulder gets stuck during the birth). This means that options such as home birth are unlikely to be recommended. When to give birth with type 1 or 2 diabetes You will be advised to give birth early if you have diabetes. This is to reduce the risk of stillbirth. It is recommended by NICE that women with type 1 or type 2 diabetes and no other complications should give birth between 37 weeks and 38 weeks +6 days – either by being induced or having a planned caesarean. If you have any complications that pose a risk to you or the baby, you might be offered an even earlier delivery. 'I had always been aware that I would be on the ward for high-risk cases. I am so grateful to be pregnant, I’m not going to complain about stuff like that. If there is an issue, I would rather be ready for it.' Svenja, mum-to-be How to give birth with type 1 or 2 diabetes As the recommendation is to give birth by 38+6 weeks, you are likely to be offered an induction or a caesarean section. Diabetes is not in itself a reason that you cannot have vaginal birth. Unless there are other complications there is no reason this should 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 >>

Type 2 Diabetes May Lead To Pregnancy Complications Independent Of Obesity

Type 2 Diabetes May Lead To Pregnancy Complications Independent Of Obesity

Obesity is a well-established risk factor for pregnancy complications, but what happens when the mother-to-be also has type 2 diabetes? New research suggests that the metabolic condition dramatically compounds the chances of experiencing potentially serious complications. The University of Rochester researchers said that their findings are extremely important today, given the skyrocketing obesity and diabetes rates among women of child-bearing age. More than 35 percent of adult women in the U.S. are obese and 11 percent of those over the age of 20 have type 2 diabetes. Obesity is well known to increase the risk of pregnancy complications, including preterm birth, large birth weight, blood loss during delivery and birth trauma. However, the effects of a mother's type 2 diabetes were less understood. To investigate the matter, the researchers analyzed the medical records of 213 pairs of women who gave birth between 2000 and 2008. Each pair was matched based on their body mass index and one member of each unit had type 2 diabetes. The majority of participants, regardless of whether or not they had diabetes, were overweight or obese. The findings were published in the Journal of Maternal-Fetal and Neonatal Medicine. As expected, the women who were overweight or obese experienced a higher rate of birth complications than those who had healthier BMIs. However, the women who had type 2 diabetes experienced significantly more problems during delivery than their BMI-matched counterparts. Women with type 2 diabetes had much higher rates of preeclampsia, cesarean delivery, shoulder dystocia, preterm delivery, large-for-gestational-age infant, fetal anomaly and admission to the neonatal intensive care unit. Kristin Knight, MD, who participated in the research, said that the finding Continue reading >>

Diabetes And Fertility: How Diabetes Can Affect Your Fertility

Diabetes And Fertility: How Diabetes Can Affect Your Fertility

You’ve have been trying with no luck to get pregnant and have not been able to a find a reason for your infertility. You may have tried a fertility cleanse, begun eating a fertility diet, and are taking all the right supplements and herbs, but are still having trouble conceiving. It may be time to have a simple blood test to determine if your glucose levels are too high. With the rates of Type II diabetes rising every year in the U.S., more and more infertility specialists are looking toward this health issue as a main cause of some otherwise unexplained infertility cases they see. According to the American Diabetes Association, there are more than 200,000 new cases of Type II diabetes diagnosed every year, with another 2.4% of the general childbearing population suffering from the disease but not knowing it. When it comes to diabetes and infertility the answer is clear: there is a connection. No, in many cases (especially among women), diabetes alone does not keep them from getting pregnant, but it oftentimes keeps them from staying pregnant. In many cases, say fertility doctors, “a woman with higher than normal glucose levels does get pregnant month after month. Unfortunately her diabetes status prevents that embryo from implanting in the uterus, causing a miscarriage before she ever realizes she is pregnant.” In this case, the diabetes isn’t preventing conception, but is preventing an ongoing pregnancy. High glucose levels are reported to increase a woman’s chances of miscarriage by 30-60% according to statistics released by the American Diabetes Association. Even when implantation does occur, there are other risks to consider, including: An increased risk of birth defects due to damage caused to embryonic cells form the high levels of glucose in the blood Continue reading >>

Risks Of Type 1 Or 2 Diabetes On Pregnancy

Risks Of Type 1 Or 2 Diabetes On Pregnancy

Risks of type 1 or 2 diabetes in pregnancy Risks of type 1 or 2 diabetes on pregnancy Women with type 1 or 2 diabetes are at higher risk of some complications but the majority have normal pregnancies and healthy babies. There is much you can do to reduce the risks, for you and baby. When you are pregnant, the pregnancy hormones interfere with the way your body works, which makes it more difficult to control your blood glucose levels. This means that during the pregnancy you have an increased risk of some health problems, such askidney or eye problems, neuropathy (nerve damage) and vascular disease (problems with the blood vessels). If you already have complications such as eye or kidney problems, these may get worse during the pregnancy.You are also more likely to have low or high blood pressure levels and hypos or hypers, with the extra risks that these carry. Retinopathy and nephropathy and pregnancy There are two particular medical conditions associated with diabetes that can worsen during pregnancy: retinopathy (eye problems) and nephropathy (kidney problems). Both are caused by damage to tiny blood vessels that can be affected by high blood glucose levels and high blood pressure. You will be checked at regular intervals before and through your pregnancy to make sure you are not developing these conditions. Ideally, you will checked before pregnancy to check your level and followed-up during pregnancy to make sure there arent any signs of changes that are a concern. If there are concerns, you may be referred to a specialist team. Eye problems (Retinopathy): Is a condition that affects the blood vessels in your eyes, damaging the retina. It can worsen as a result of high blood glucose levels in early pregnancy and high blood pressure. If left untreated, it can cause Continue reading >>

Poor Pregnancy Outcome In Women With Type 2 Diabetes

Poor Pregnancy Outcome In Women With Type 2 Diabetes

Abstract OBJECTIVE— To evaluate the perinatal outcome and the frequency of maternal complications in pregnancies of women with type 2 diabetes during 1996–2001. RESEARCH DESIGN AND METHODS— Medical records of 61 consecutive singleton pregnancies in women with type 2 diabetes from 1996 to 2001 were studied. Pregnancy outcome was compared with that of pregnant women with type 1 diabetes during 1996–2000, the background population, and pregnant women with type 2 diabetes during 1980–1992 from the same department. RESULTS— The perinatal mortality in pregnancies complicated by type 2 diabetes (4/61, 6.6%) was increased four- and ninefold, respectively, and the rate of major congenital malformations (4/60, 6.7%) was more than doubled, although not statistically significant, compared with type 1 diabetic pregnancies and the background population. The glycemic control was similar or better in women with type 2 diabetes compared with women with type 1 diabetes. Multivariate logistic regression analysis in the pooled group of pregnancies with pregestational diabetes from 1996 to 2001 showed that high HbA1c at admission and type 2 diabetes were independently associated with a serious adverse fetal outcome (perinatal mortality and/or major congenital malformations). The perinatal mortality and the rate of major congenital malformations in type 2 diabetic pregnancies have increased during the last decade. CONCLUSIONS— The perinatal outcome of pregnancies in women with type 2 diabetes during 1996–2001 is poor. It is worse than the outcome of pregnancies in women with type 1 diabetes and the background population in the same period, as well as in women with type 2 diabetes studied during 1982–1990. The prevalence of type 2 diabetes is increasing rapidly in all age-gr Continue reading >>

Type 1 Or Type 2 Diabetes And Pregnancy

Type 1 Or Type 2 Diabetes And Pregnancy

Problems of Diabetes in Pregnancy Blood sugar that is not well controlled in a pregnant woman with Type 1 or Type 2 diabetes could lead to problems for the woman and the baby: Birth Defects The organs of the baby form during the first two months of pregnancy, often before a woman knows that she is pregnant. Blood sugar that is not in control can affect those organs while they are being formed and cause serious birth defects in the developing baby, such as those of the brain, spine, and heart. Download Chart[PDF – 167KB] 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 a surgery 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 the woman and her unborn baby. It might lead to the baby being born early and also could cause seizures or a stroke (a blood clot or a bleed in the brain that ca Continue reading >>

Pregnancy

Pregnancy

Pregnancy in women with type 1 or type 2 diabetes usually results in a normal delivery with no effects on the mother’s or the child’s long-term health. However, poorly controlled blood glucose levels during pregnancy can have long term effects for mum and baby, as well as complications during delivery. You can have a healthy pregnancy and a good outcome with planning, multidisciplinary care and excellent control of blood glucose levels. If you develop diabetes during pregnancy, it is called gestational diabetes. Learn more about gestational diabetes. Pre-pregnancy care for people with diabetes First talk to your doctor, credentialled diabetes educator and obstetrician for pre-pregnancy planning and care. You can receive advice and guidance on blood glucose management, a review of all self care skills and knowledge, an assessment of diabetes equipment and management of hypoglycaemia and hyperglycaemia. High blood glucose levels can increase the risk of having a baby with a birth defect. However this can be minimised by ensuring excellent blood glucose control at the time of conception and during the first eight weeks of pregnancy. Careful attention to nutrition is essential, not only for good diabetes control, but to meet the body’s increased nutritional requirements during pregnancy. Exercise is also helpful in maintaining general fitness and good blood glucose control. Breast-feeding There is no reason why women with diabetes should not breast-feed. Insulin requirements are generally slightly lower during this time. Insulin does not pass into the breast milk and is not harmful to the baby. Hypoglycaemia can be an issue. You should discuss with your doctor or credentialled diabetes educator about strategies to minimise hypoglycaemia. Resources Type 1 Diabetes and Continue reading >>

Type 2 Diabetes During Pregnancy

Type 2 Diabetes During Pregnancy

There’s lots of good news these days for pregnant women with type 2 diabetes (a condition in which the body doesn’t respond as it should to insulin). In fact, with the right medical help and diligent self-care, you have about the same excellent chances of having a successful pregnancy and a healthy baby as any other expectant mom. The key to managing type 2 diabetes during pregnancy? Achieving normal blood glucose levels six months before conception and maintaining those levels throughout the nine months following it. So if you’ve been on top of keeping your diabetes under control, it’s more important than ever to continue your routine now that there are two of you on board. Here's what to think about if you're heading into pregnancy with type 2 diabetes: Your care team How does diabetes affect babies during pregnancy? If you have type 2 diabetes, you already have higher levels of glucose circulating in your blood; issues can come up if your blood sugar levels aren’t well monitored and managed. That’s because extra sugar can be transferred to baby while you're expecting — and a fetus that’s served too much glucose reacts by producing an increased supply of insulin (which can result in a too-large baby and other complications). READ MORE: Gestational Diabetes Finding your pregnancy and diabetes care team Be prepared: You’ll have a lot more prenatal visits than other expectant moms and will probably be given more doctors’ orders to follow (all for a good cause). So it’s a good idea to get your medical team in place as soon as you think you might want to get pregnant. The OB or midwife who supervises your pregnancy should have plenty of experience caring for diabetic moms-to-be, and he or she should work together with the doctor who has been in charge Continue reading >>

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