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Uncontrolled Type 1 Diabetes And Pregnancy

Unplanned Pregnancy Type 1 With High Sugars

Unplanned Pregnancy Type 1 With High Sugars

unplanned pregnancy type 1 with high sugars D.D. Family T1 since 1982, pumping with Animas on 10/20/08 I had an unplanned pregnancy, my numbers where all over as well. My daughter is now 7. Pregnancy is a strange thing, we are at higher risk for lots of things however they can happen to anyone at anytime. Lossing a child is difficult but aborting is as well. I had one and still think about it to this day. There is no mistaking it was the right thing for me to do but as a mom I can't help but think what that child whould have been and how it would have effect my daughters and my life. It is normal to worry and question things. We can't prepare for what is to happen as we never know what that is. Take life one step and one day at a time and try to make the best decision based on what you have to work with at the time. Good luck and Congrats. Regardless of our situation we are living with diabetes and this is our life. I had a hba1c of 16 when I found out I was pregnant!!!! And now I have a healthy gorgeous 9 yr old daughter!!! Before that pregnancy I did miscarry but lots of non diabetics experience this and then after I had my daughter I got pregnant again ( I was always on contraception) and I was advised by everyone under the son that I must terminate the pregnancy...long story... me and baby would most probably not survive and now I had a 1yr old daughter to consider....In the end I felt pressured into doing it, I made the biggest mistake of my life. It haunts me to this day and I wish I had gone through with it because when I was pregnant with Abi my daughter I was warned of all these horrible things that would happen and she is very healthy..I do add though that she was born at 25 wks...so a very prem baby. Try and get the best control you can for yourself now..tha Continue reading >>

Diabetes And Pregnancy: Twice As Important

Diabetes And Pregnancy: Twice As Important

Pregnancy is a wondrous and exciting time. It’s a time of change, both physically and emotionally. With the proper attention and prenatal medical care, most women with diabetes can enjoy their pregnancies and welcome a healthy baby into their lives. Why Tight Blood Sugar Control Is Critically Important Blood sugar control is important from the first week of pregnancy all the way until delivery. Organogenesis takes place in the first trimester. Uncontrolled blood sugar during the early weeks of pregnancy increases the risk of miscarriage, and birth defects. (Women don’t develop gestational diabetes until later in pregnancy, which means they don’t share these early pregnancy risks.) Later in the pregnancy, uncontrolled blood sugar levels can cause fetal macrosomia, which may lead to shoulder dystocia, fractures, and the need for Cesarean section deliveries. Very high blood sugar levels can increase the risk of stillbirth. Maternal hyperglycemia can stimulate fetal hyperinsulinemia, and lead to neonatal hypoglycemia when the glucose supply (umbilical cord) is cut. Because of all these increased risks, home deliveries are not typically recommended for women with any form of diabetes. As many as two thirds of all women with diabetes have unplanned pregnancies and most women don’t realize that they’re pregnant until six or more weeks into the pregnancy. That’s why it’s critically important for women who have diabetes to use contraception and achieve tight blood sugar control prior to conception. Many health-care providers suggest at least three to six months of stable blood sugar control prior to attempting to conceive. Hemoglobin A1c should be within 1 percentage point above the lab normal, which means striving for a HbA1c of less than 7 percent. Women using or Continue reading >>

Diabetes And Pregnancy

Diabetes And Pregnancy

Women who have diabetes before they get pregnant have special health concerns. In addition to the new demands that a pregnancy will put on your body, it will also affect your blood sugar levels and diabetes medications. If you're thinking about having a baby, take steps to lessen the risks for both you and your child. A pre-conception counseling appointment will help you be physically and emotionally prepared for pregnancy. Meet with your doctor to find out if your diabetes is controlled well enough for you to stop your birth control method. A blood test called the glycosylated hemoglobin test (HbA1c, or just A1c) can show how well it's been going over the past 8 to 12 weeks. Other medical tests can help prevent complications during pregnancy: Eye exam to see if you have glaucoma, cataracts, or retinopathy Blood work to make sure your kidneys and liver are working Foot exam High blood sugar levels early in the pregnancy (before 13 weeks) can cause birth defects. They also can increase the risks of miscarriage and diabetes-related complications. But many women don't know they're pregnant until the baby has been growing for 2 to 4 weeks. That's why you should have good control of your blood sugar before you start trying to conceive. Keep blood glucose levels within the ideal range: 70 to 100 mg/dL before meals Less than 120 mg/dL 2 hours after eating 100-140 mg/dL before your bedtime snack Use your meals, exercise, and diabetes medications to keep a healthy balance. Continue reading >>

What Happens When You Have Untreated Diabetes During Pregnancy?

What Happens When You Have Untreated Diabetes During Pregnancy?

Before Delivery High blood glucose -- the result of uncontrolled diabetes -- exerts profound effects on a mother and her developing fetus. Infants of women who have diabetes at the outset of pregnancy are 5 times more likely to have heart defects and twice as likely to have neural tube defects and urinary tract abnormalities as babies born to nondiabetic mothers. The rate of miscarriage, premature birth and stillbirth among diabetic mothers is similarly elevated, and the infants of diabetic mothers are often larger than normal. For mothers with pre-existing diabetes, the risk for diabetic eye and kidney damage increases during pregnancy, particularly if their diabetes is not controlled. Untreated diabetes -- whether it was present before pregnancy or developed during pregnancy -- significantly increases your risk for high blood pressure, preeclampsia, toxemia and cesarean section. The Northern Diabetic Pregnancy Audit, a British study completed during the 1990s, showed that women whose diabetes is poorly controlled during pregnancy have a 5 times higher death rate than their nondiabetic counterparts. Labor and Delivery In addition to an increased risk for stillbirth and cesarean section, women with uncontrolled diabetes are more likely to encounter difficulties during labor and delivery than nondiabetic women or women whose diabetes has been well controlled. For mothers, large birth-weight infants -- the most common fetal side effect of maternal diabetes -- are associated with difficult or arrested labor and excessive bleeding. Larger birth-weight infants are more likely to experience birth trauma and are at risk for respiratory distress, heart failure and jaundice and other severe metabolic disorders following delivery. Long-Term Effects The problems associated with un Continue reading >>

Pregnancy With Type 1 Diabetes

Pregnancy With Type 1 Diabetes

Forty five years ago when I was diagnosed with type 1 diabetes I was clearly told I couldn’t have children. I didn’t. Today, thankfully that advice is no longer given. And while a woman with Type 1 diabetes needs to take precautions, she can absolutely, and safely, have a healthy baby. I sat down for an interview with Ginger Vieira, co-author,with Jennifer Smith, of the recent book, Pregnancy with Type 1 Diabetes: Your Month-to-Month Guide to Blood Sugar Management. What will people find in the book? As much information as you possibly need to understand why your blood sugars fluctuate during pregnancy and how to adjust your insulin management to keep your blood sugars as close to non-diabetic levels as possible. Also the book covers preparing for pregnancy, months one through nine of your pregnancy, delivery, and postpartum, including the challenges of breastfeeding for a woman with type 1 diabetes. My co-author Jenny is also my diabetes pregnancy coach. As a certified diabetes educator, woman with type 1 diabetes and mother, she knows this journey inside and out. What makes pregnancy for a woman with type 1 diabetes challenging? Let’s face it, a normal day with type 1 diabetes is challenging, balancing an autonomic system your body ought to balance on its own. And we’re only given insulin to do the job, while a non-diabetic body uses several different hormones to balance blood sugar. Add pregnancy to that mix and you add the insane pressure of, “Every decision you make impacts the human life growing inside of you!!!” And now you have to balance your blood sugars with constantly shifting pregnancy hormones. Plus those hormones impact your insulin needs in ways that are constantly changing and evolving. Also, there is never a break. Even when you’re sleepi 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 >>

11 Tips To Surviving Early Pregnancy With Type 1 Diabetes

11 Tips To Surviving Early Pregnancy With Type 1 Diabetes

Congratulations – you’re pregnant! (Or, alternatively: uh oh – you’re pregnant!) Either way, this is where your adventures in pregnant blood sugar management will truly begin. You have a challenging road ahead of you, but the good news is that there’s a lot you can do to increase your chances of a healthy pregnancy and a healthy baby. (For preconception tips see here). 1. (Keep up the) work on your A1c: Hopefully by this point your HbA1c is at the target level that you and your doctor agreed upon before conception. This is important because very high blood sugar over time is associated with an increased risk of birth defects and miscarriage. (Though, on the more optimistic flip side, the closer your blood sugar is to normal, the lower the chance of problems.) If your A1c was extremely high in the months before conception, you need to have a frank conversation with your doctor about what impact these levels may have had on your developing embryo, and what this might determine about whether to continue the pregnancy (or what your risk is of losing it). If it’s a go, you need to immediately start working on bringing your blood sugar under control. 2. Test, test, test. In order to come anywhere close to the super-human blood glucose targets of pregnancy (60-99 mg/dl fasting, a peak of 100-129 mg/dl after meals, an average daily blood glucose of 110 mg/dl, and an A1c of less than 6.0%[1] ), you need to be testing your blood glucose a lot. As in, probably more than a dozen times a day. As noted in our pre-conception tips, a Continuous Glucose Monitoring System (CGMS) can be enormously helpful in tracking your pregnancy blood sugars, since it gives you a nearly real-time graph of where your blood glucose has been and where it’s heading — and having advance warn Continue reading >>

The Role Of Diabetes In Miscarriage And Stillbirth

The Role Of Diabetes In Miscarriage And Stillbirth

When humans eat, foods are broken down in the digestive tract into the simplest elements, including glucose (a type of sugar). Glucose is a needed fuel for almost every process in the human body, including brain function. For the body to use glucose as energy, it requires a hormone known as insulin, which is produced by an organ called the pancreas. In diabetes, a persons insulin supply is not sufficient, making it impossible for the body to get and use the energy it needs from glucose. Type 1 Type 1 diabetes (sometimes called insulin-dependent diabetes mellitus, or IDDM) is a chronic, often life-long condition, in which the pancreas does not produce insulin. The exact causes of the disease are unknown, but it is clear that the immune system is somehow triggered to begin attacking the pancreas. It is usually diagnosed in childhood. The common symptoms are fatigue, extreme thirst and hunger, excessive urination, and weight loss. This type of diabetes requires a person to receive insulin, either through multiple injections each day, or a continuous pump. There is no cure for type 1 Diabetes. Type 2 In type 2 diabetes the cells of the body develop a resistance to insulin, even when the pancreas is able to produce enough insulin. Type 2 diabetes (also called non-insulin dependent diabetes mellitus, or NIDDM) is most common in adults, but it can develop in children. It is usually triggered by obesity, a sedentary lifestyle, age, and genetic predisposition. here is an increased risk of type 2 diabetes for people with a family history of the disease, people of African-American, Native American, Asian-American, Latino, and Pacific Islander heritage, and women who have had gestational diabetes. The symptoms are similar to type 1 diabetes. Treatment can vary from nutritional cha Continue reading >>

Having A Healthy Pregnancy With Type 1 Diabetes

Having A Healthy Pregnancy With Type 1 Diabetes

Kerri Sparling was 7 years old when she was diagnosed with type 1 diabetes. She grew up believing that she'd never be able to have children of her own. But by the time she became an adult, significant technological advances in managing the illness gave her hope. With two decades of blood sugar control under her belt, Sparling eventually looked around for models of a healthy pregnancy with type 1 diabetes. Aside from Julia Robert’s character in the movie Steel Magnolia, she didn’t find much. Roberts’ character had type 1 diabetes and successfully carried a child to term, only to die soon after from diabetes complications. “It wasn’t a positive image,” Sparling said. Undaunted by the Hollywood dramatization, Sparling did her own research and, in preparation for pregnancy and with the help of her endocrinologist, worked for more than a year to get her A1C — a standard test to find out average blood sugar levels over several months — below seven. Sparling, now 34, has a 3-year-old daughter and confirms that while type 1 diabetes and pregnancy might be a challenging mix, a healthy pregnancy and a healthy baby are both possible. That said, pregnancy demanded a lot more insulin than she was used to taking, and she had to spend the last month of her pregnancy in the hospital with pre-eclampsia (high blood pressure in pregnancy) before her 6-pound, 13-ounce baby girl was delivered by Caesarean section. “Pregnancy has a definitive end,” Sparling said. “I felt I could make it through to the end of that. But diabetes goes on and on.” Like Sparling, other diabetic women can get pregnant. But without proper monitoring and extra precautions, the chronic illness puts both the mother and the baby at risk for various complications. Here are some of the important m Continue reading >>

Type 1 Diabetes And Pregnancy – Symptoms, Risks And Management

Type 1 Diabetes And Pregnancy – Symptoms, Risks And Management

Type 1 Diabetes and Pregnancy This article will cover everything you need to know about Type 1 diabetes and pregnancy. Deciding to have a baby is a big decision for most people, and for women with Type 1 diabetes, it’s one which means a lot of thought and planning. Taking care of your health and that of your baby is important, as it is for all pregnant women, and if you have Type 1 diabetes it’s crucial. Type 1 diabetes can be difficult to manage on its own, and a pregnancy can complicate it further. Yet many women have successfully met the challenges of diabetes during pregnancy, and have enjoyed healthy pregnancies and healthy babies. What Is Type 1 Diabetes? Previously known as insulin-dependent or juvenile diabetes, Type 1 diabetes is an autoimmune disease. The body’s immune system attacks and destroys the cells in the pancreas that produce insulin. Insulin helps the body to process a type of sugar (glucose) to create energy. In Type 1 diabetes, the body doesn’t produce insulin, and without it the body’s cells can’t convert glucose (sugar) into energy. Science doesn’t know what causes this autoimmune condition, and there is no prevention or cure. Symptoms of Type 1 diabetes include: Excessive thirst Passing more urine Feeling tired and lethargic Constant hunger Slow healing of wounds and cuts Skin infections Blurred vision Unexplained weight loss Mood swings Headaches Feeling dizzy Leg cramps These symptoms can occur suddenly, and usually first affect people under the age of 30. People with Type 1 diabetes need to replace the insulin their bodies can’t make every day. To manage the condition, they must test their blood glucose levels several times daily, and maintain a healthy lifestyle. Getting Pregnant With Type 1 Diabetes Research has shown those Continue reading >>

Pre-existing Diabetes And Pregnancy

Pre-existing Diabetes And Pregnancy

When Joy contacted TheDiabetesCouncil, she wanted to know if she would ever be able to get pregnant and have a healthy baby with her Type 1 diabetes. She had previously heard that there were risks that came with being pregnant and she needed some guidance. We decided to put together a comprehensive guide which would shed light on pregnancy with pre-existing diabetes. We hope Joy and others who have similar questions concerns will benefit from the information provided here, as they work to get the strict diabetes control that is needed. Let’s take a look at what it takes to have a healthy pregnancy and baby despite having diabetes. What this article is about In this article, we will look at how you can manage your diabetes during pregnancy for your health and the health of your baby. We will learn about the guidelines for managing diabetes during pregnancy, and provide you with a detailed instruction. We will explore what women with pre-existing diabetes need to know before they get pregnant, and what they need to know in order to experience a healthy pregnancy with diabetes. What this article is not about Gestational diabetes, or diabetes acquired after pregnancy. I want to stress that this article is not about gestational diabetes. We have already covered the topic of Gestational Diabetes for which the in-depth article can be found here: How opinions on pre-existing diabetes and pregnancy have changed over time Back in the 1980’s, I strongly urged all my teenage patients with diabetes to stay on birth control and prevent pregnancy with diabetes. The outcome was never too good when they got pregnant, had out of control diabetes, and the complications that would arise from the pregnancy. Outcomes are still grave if tight control is not achieved before and during the Continue reading >>

Diabetes During Pregnancy Can Be Deadly For Your Child

Diabetes During Pregnancy Can Be Deadly For Your Child

WEDNESDAY, Nov. 27, 2013 — Diabetes can raise your risk for heart disease, kidney disease, blindness, and more, but did you know it can also affect your children's health? Babies are are more likely to die in the womb or shortly after birth when its mother has diabetes, according to a new study published in the journal Diabetologia, and experts say the findings show the importance of managing your blood sugar during pregnancy. Researchers from Newcastle University in the UK looked at data on more than 1,500 women with either type 1 or type 2 diabetes who gave birth in 1996, and compared them to healthy women who gave birth during the same year. They found that babies were nearly 5 times more likely to die in the womb and nearly 2 times as likely to die within their first year of life when born to diabetic mothers compared to babies born to healthy mothers, even when researchers excluded the increased risk of death from birth defects. Uncontrolled blood sugar during pregnancy can lead to a host of congenital issues and birth defects, according to the study, such as cleft lip, cleft palate, kidney defects and limb deficiencies, which greatly increase a baby’s risk of death. However, researchers excluded deaths from these defects, finding that simply having high blood sugar can be deadly for your child. “It’s not uncommon for infants born to diabetic mothers to have breathing problems,” said Scott Drab, PharmD, a diabetes specialist and associate professor of pharmacy and therapeutics at the University of Pittsburgh School of Pharmacy. “Oftentimes women with diabetes will go into premature labor and will deliver early, which raises the risk for death.” In addition, insulin can pass through the placenta, which can be deadly for newborns. “Some infants will h Continue reading >>

Type 1 Pregnancy Risks And How To Minimize Them

Type 1 Pregnancy Risks And How To Minimize Them

There’s a lot to consider when trying to get pregnant or being pregnant as a Type 1 woman. There’s of course, the maternal desire to do everything you can for your unborn child so that he or she may have the best life possible. An ideal pregnancy is a full-term and uneventful one, the outcome a healthy, happy baby. Having Type 1 diabetes doesn’t mean you can’t have that; it just means that you have to be more vigilant, more prepared because of the heightened risks involved. But you’re a Type 1, so you already know how to do that. In fact, you’ve been doing it ever since “D-day,” so take a deep breath and trust yourself. All pregnancies have the chance for complications, but having Type 1 makes you more susceptible to specific ones. Here are the most important things to do in order to lower those risks: Pregnancy Advice for lowering risks for complications 1. Keep your blood glucose levels in range The most important thing you can do as a Type 1 mother-to-be is to try and get your blood glucose levels in a healthy range. Check your number and check often. This will decrease the chance of excessive sugars being given to your baby. Excessive sugars for your baby may cause them to grow quickly as if being “over fed” (Macrosomia) or can do harm to the early development of organs (fully developed by week seven). This is not just vital for your baby’s health during pregnancy but also before conception. Doctors recommend having your blood glucose levels in range three to six months before you become pregnant. Target blood glucose range pre-pregnancy (NIH) – 80-110 mg/dl before eating 100-155 mg/dl 1-2 hours after eating Target blood glucose range during pregnancy (NIH) – 60-99 mg/dl before eating 100-129 mg/dl 1-2 hours after eating Be sure to set goal Continue reading >>

Adverse Pregnancy Outcomes In Women With Diabetes

Adverse Pregnancy Outcomes In Women With Diabetes

Abstract Pregnancy affects both the maternal and fetal metabolism and even in nondiabetic women exerts a diabetogenic effect. Among pregnant women, 2 to 17.8% develop gestational diabetes. Pregnancy can also occur in women with preexisting diabetes, that can predispose the fetus to many alterations in organogenesis, growth restriction and the mother to some diabetes-related complications like retinopathy and nephropathy or accelerate the course of these complications if they are already present. Women with gestational diabetes generally start their treatment with diet and lifestyle modification; when these changes fail in keeping an optimal glycemic control, then insulin therapy must be considered. Women with type 2 diabetes in use of oral hypoglycemic agents are advised to change to insulin therapy. Those with preexisting type 1 diabetes must start an intensive glycemic control, preferably before conception. All these procedures are performed aiming to keep glycemic levels normal or near-normal as possible to avoid the occurrence of adverse perinatal outcomes to the mother and to the fetus. The aim of this review is to reinforce the need to improve the knowledge on reproductive health of women with diabetes during gestation and to understand what are the reasons for them failing to attend for prepregnancy care programs, and to understand the underlying mechanisms of adverse fetal and maternal outcomes, which in turn may lead to strategies for its prevention. Background Pregnancy affects both the maternal and fetal metabolism and even in nondiabetic women exerts a diabetogenic effect. As normal pregnancy progresses insulin resistance increases and pancreatic β-cells reserve is stressed aiming to maintain glycemia within normal ranges; gestational diabetes results when Continue reading >>

Type 1 Diabetes Mellitus And Pregnancy

Type 1 Diabetes Mellitus And Pregnancy

Go to: Pathophysiology T1DM is caused by an immune-mediated destruction of insulin-producing β cells, located in the pancreatic islets of Langerhans. Although the exact cause of this disease still eludes scientists, it is known that a general inflammatory state, termed insulitis, precedes overt diabetes. During this state of inflammation, macrophages, B lymphocytes, CD4+, and CD8+ T lymphocytes can be seen to infiltrate the islets of Langerhans. A complex cycle of antigen presentation and propagation leads to an eventual accumulation of CD8+ lymphocytes, and gradual destruction of insulin-producing β cells.5 This decline in β-cell mass eventually leads to an insulin-deficient state, causing hyperglycemia in the affected patient. Pregnancy itself is usually regarded as a diabetogenic state in which postprandial glucose levels are elevated and insulin sensitivity is decreased.4 Classically, the decreased response to insulin activity observed in pregnancy has been attributed to increases in hormones such as cortisol, progesterone, estrogen, prolactin, and human placental lactogen.6 Most recently, new molecules such as leptin, tumor necrosis factor-α (TNF-α), and resistin have been implicated in this matter. Kirwan and colleagues7 showed that TNF-α is the strongest independent predictor of insulin sensitivity during the late gestational period. In vitro studies showed that TNF-α disrupted insulin signaling and inhibited glucose uptake.7 This study attributed the rise of TNF-α to increased placental production with advancing gestational age (Table 2). Fluctuations in insulin sensitivity during pregnancy, mostly due to changing hormone levels, complicate insulin replacement in gravid Type 1 patients with diabetes. In 1984, Weiss and Hofmann8 presented data showing a 1 Continue reading >>

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