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Gestational Diabetes Medication

Gestational Diabetes

Gestational Diabetes

Home » About Diabetes » Pregnancy » Gestational Diabetes Gestational Diabetes Gestational diabetes is the type of diabetes that occurs during pregnancy. Like other forms od diabetes, gestational diabetes affects the way the body uses the glucose [sugar] in the blood and as a result the blood sugars rise too high. The glucose in the blood is the body’s main source of energy. If gestational diabetes is untreated or uncontrolled, it can result in a variety of health problems for both that mother and baby. So it is important that a treatment plan is worked out to keep blood sugars within the normal range. The good news is that controlling blood sugars can help to ensure a healthy pregnancy and a healthy baby. Signs and Symptoms Most women do not have any signs or symptoms of gestational diabetes but your healthcare professional will check for gestational diabetes as part of your prenatal care. When signs and symptoms do occur they include: Excessive thirst Increased urination. About 3 to 5% of all pregnant women develop gestational diabetes. The Causes of Gestational Diabetes Normal metabolism Normally during digestion the body breaks down the carbohydrates you eat into simple sugars [glucose] and this glucose is absorbed into the blood and transported around the body by the blood vessel system to provide the energy needed for all our activities. This process cannot take place without insulin. Insulin is produced in the pancreas, a gland behind the stomach, and helps the glucose to pass into the cells to provide energy and maintains normal levels of glucose in the blood. The liver also plays a part in maintaining normal blood glucose levels. When there is more glucose in the cells than your body needs for energy, it is removed from the blood and stored it in the liver 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 >>

Taking Medication And Insulin For Gestational Diabetes

Taking Medication And Insulin For Gestational Diabetes

Depending on the levels of glucose in your blood when you are diagnosed, you may be given the option of reducing your levels through dietary changes and exercise alone. If your levels are still high after a week or two though, you will be offered metformin tablets. If your fasting blood glucose levels are high and you have particular complications such as macrosomia (where the baby is very large) or hydramnios (excessive amniotic fluid), your team may recommend that you start immediate insulin treatment, with or without metformin (as well as dietary and exercise changes). "If I’d understood more about it, I’d have stuck with the diet and found ways to lower my blood glucose levels. Having insulin is not just a quick fix so that you can eat what you want." Kiera, mum of one There are two different types of diabetes medication suitable for women with gestational diabetes: tablets and injection. Tablets - metformin and glibenclamide In pregnancy, there are two types of tablet that you may be offered to help keep your blood glucose at a healthy level: metformin and glibenclamide. Metformin reduces the amount of glucose made by the liver and helps your body respond better to the insulin you produce naturally Glibenclamide lowers blood glucose by stimulating your pancreas to produce more insulin. Like all medication, they carry a risk of side effects, so check the patient information leaflet and talk to your doctor about any possible side effects. Although the patient information leaflet will say that these medications are not to be used during pregnancy, there is strong evidence in the UK for their safety and effectiveness in treating diabetes during pregnancy. Talk to your healthcare team if you have any concerns. Insulin injections If tablets are not suitable for you, Continue reading >>

Gestational Diabetes - Medications

Gestational Diabetes - Medications

Most women can treat gestational diabetes by changing the way they eat and exercising more often. If these changes do not keep your blood sugar level within a target range , you may need to take diabetes medicine, for example glyburide , insulin , or metformin . You may also need to take insulin if your doctor thinks that your baby is getting too large. If you need to take insulin , you will learn how to give yourself an insulin shot. Gestational Diabetes: Giving Yourself Insulin Shots Insulin is the primary medicine used to treat gestational diabetes. Insulin is only used if you cannot control your blood sugar level by eating well and exercising regularly. How much insulin you need depends on how much you weigh and on how close you are to your due date . Some women need more insulin as they get closer to their delivery date, because the placenta makes more and more hormones that make it harder and harder for insulin to do its job. In rare cases, a woman with gestational diabetes has to stay in the hospital for a short time to get her blood sugar level within a target range. This information is not intended to replace the advice of a doctor.Healthwise disclaims any liability for the decisions you make based on thisinformation. 1995-2015 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. Continue reading >>

Anyone Refused Insulin/medication?

Anyone Refused Insulin/medication?

I was diagnosed a little over a week ago. The doctors cant get me in for another week, but I met with a nurse for my meter and diet instructions. All of my (after 2hrs) numbers are well below the 120 mark, but all this week my fasting number has been around 100. Ive tried a different snack every night and just cant get it to go down. BUT, since its only 10pts higher than what the cut off should be is it significant enough to put my body and baby on a new med? Especially since by the time they get me on meds Ill only have 5 weeks left before the 40week mark? Im not trying to be non-compliment and really do want whats best for my baby!! But, I cant see the benefit of adding medication to my body so late in the game. Suggestions? Advice? Fasting is actually one of the most important numbers to try to get down as it's showing what your body is doing on its own without the influence of food. And five weeks is a long time in the diabetes world! I prefer insulin since it's something your body naturally makes and so my understanding and how my mfm felt was that it's best for mom and baby. If your doctor suggests meds I would question them with anything you want to know as far as pros vs cons but if they still feel it's best for you and babe I wouldn't fight it. Express your concerns (out of curiosity what are they?) and see what they have to say Part of my frustration is I have no idea what my midwifes intentions are. She waited 2.5 weeks to tell me I failed my 1hr test, and then called me up to say I had 2 high #s (one of course was the fasting) on the 3hr test. She didnt even give me my #s. She just said she wanted me to see a nutritionist and check my blood 4x/day and that shed see me at my 36week apt. Im only assuming that based on my high fasting #s she will want me to ta Continue reading >>

Drugs For Gestational Diabetes

Drugs For Gestational Diabetes

Aust Prescr 2010;33:141-41 Oct 2010DOI: 10.18773/austprescr.2010.066 The prevalence of gestational diabetes is increasing in Australia. Non-pharmacological intervention with dietary measures and exercise is the mainstay of therapy in most cases, but insulin is increasingly necessary to achieve adequate glycaemic control in some women. Basal-bolus insulin is the optimal management strategy, but therapy needs to be individualised. Although there is mounting evidence for the efficacy and safety of metformin, the lack of long-term follow-up data has prevented it from being recommended by most experts in the field. Women with gestational diabetes need long-term follow-up because of their increased risk of type 2 diabetes. Gestational diabetes is defined as an intolerance to glucose that is first diagnosed or has its onset during pregnancy. It is estimated to affect almost 5% of pregnancies in Australia and between 3% and 9% worldwide. Its prevalence increases with age, from 1% in women aged 1519 years to 13% in those aged 4449 years. 1 Other risk factors for developing gestational diabetes include being overweight or obese, having a family history of type 2 diabetes or a personal or family history of gestational diabetes or glucose intolerance, being from an Aboriginal or Torres Strait Islander background or belonging to certain ethnic groups (for example Polynesian, Middle Eastern, Indian or other Asian origin). 2 Although gestational diabetes does not affect perinatal mortality, it does increase morbidity, including the risk of shoulder dystocia, nerve palsies and neonatal hypoglycaemia. Maternal outcomes are also affected, with a higher incidence of pre-eclampsia and caesarean section (particularly with poor glycaemic control) in mothers who develop gestational diabetes. Continue reading >>

Pharmacological Management Of Gestational Diabetes

Pharmacological Management Of Gestational Diabetes

An overview Abstract OBJECTIVE—To provide a review of the background literature regarding the pharmacological management of gestational diabetes. RESEARCH DESIGN AND METHODS—This is a literature review. RESULTS—Information is available regarding the use of some, but not all, oral antidiabetes agents in pregnancy. CONCLUSIONS—Available evidence supports the use of glyburide during pregnancy. Evidence is inadequate to support or refute the use of metformin, an agent that has been shown to cross the placenta and thus could be helpful or harmful to the developing fetus. Because insulin preparations tested to date have been determined not to cross the placenta or to cross minimally, insulin has been the treatment of choice in most parts of the world for patients with gestational diabetes whose circulating glucose levels exceed predetermined thresholds. Although advances have been made in developing insulins that may be administered by alternative routes, insulin is typically injected subcutaneously. This poses a barrier to utilization and has been one of the factors that kindled interest over many years in treating gestational diabetes with oral antidiabetic agents. This and the following presentations describe oral agents that have the potential to be used as alternatives to insulin for the treatment of gestational diabetes. In this overview, I shall outline some guiding principles in determining whether a particular agent is appropriate for use in pregnancy and then apply these principles to the most commonly used oral antidiabetes agents. GUIDING PRINCIPLES— As our understanding of the physiology and pharmacology of both pregnancy and diabetes has increased, some guiding principles have emerged to help us decide which medications are safe and effective for pregn Continue reading >>

Current Management Of Gestational Diabetes Mellitus

Current Management Of Gestational Diabetes Mellitus

Current Management of Gestational Diabetes Mellitus Guido Menato; Simona Bo; Anna Signorile; Marie-Laure Gallo; Ilenia Cotrino; Chiara Botto Poala; Marco Massobrio Expert Rev of Obstet Gynecol.2008;3(1):73-91. Traditionally, insulin therapy has been considered the gold standard for management because of its efficacy in achieving tight glucose control and the fact that it does not cross the placenta. Insulin is, however, an expensive and invasive treatment. Insulin therapy involves daily injections, and patient compliance is often suboptimal. Women would prefer tablets rather then multiple injections.[ 63 ] A less invasive, more acceptable alternative that could enhance patient compliance while achieving similar perinatal outcome, would be a welcome replacement. Since GDM and Type 2 diabetes are characterized by insulin resistance and relatively decreased insulin secretion, a treatment with oral hypoglycemic agents could be of potential interest. The use of oral agents is a pragmatic alternative to insulin therapy in pregnancy because of easy administration and patient's satisfaction due to a noninvasive treatment. However, even taking into account these considerations, the introduction of a new drug is unjustified if improvements in pregnancy outcomes and cost-effectiveness are not definitively demonstrated. Different oral hypoglycemic and anti-hyperglycemic agents act upon diverse mechanisms of action. These drug characteristics provide an enhanced physiological approach to the treatment of Type 2 diabetes and GDM in comparison to insulin. In Europe and in South Africa, glyburide and metformin have been used for years without reported adverse side-effects to the fetus. The main restraint to their use in pregnancy is the risk of developing congenital anomalies, fetal c Continue reading >>

Treatment

Treatment

If you have gestational diabetes, the chances of having problems with the pregnancy can be reduced by controlling your blood sugar (glucose) levels. You'll also need to be more closely monitored during pregnancy and labour to check if treatment is working and to check for any problems. Checking your blood sugar level You'll be given a testing kit that you can use to check your blood sugar level. This involves using a finger-pricking device and putting a drop of blood on a testing strip. You'll be advised: how to test your blood sugar level correctly when and how often to test your blood sugar – most women with gestational diabetes are advised to test before breakfast and one hour after each meal what level you should be aiming for – this will be a measurement given in millimoles of glucose per litre of blood (mmol/l) Diabetes UK has more information about monitoring your glucose levels. Diet Making changes to your diet can help control your blood sugar level. You should be offered a referral to a dietitian, who can give you advice about your diet, and you may be given a leaflet to help you plan your meals. You may be advised to: eat regularly – usually three meals a day – and avoid skipping meals eat starchy and low glycaemic index (GI) foods that release sugar slowly – such as wholewheat pasta, brown rice, granary bread, all-bran cereals, pulses, beans, lentils, muesli and porridge eat plenty of fruit and vegetables – aim for at least five portions a day avoid sugary foods – you don't need a completely sugar-free diet, but try to swap snacks such as cakes and biscuits for healthier alternatives such as fruit, nuts and seeds avoid sugary drinks – sugar-free or diet drinks are better than sugary versions; be aware that fruit juices and smoothies contain s Continue reading >>

Medications For Gestational Diabetes

Medications For Gestational Diabetes

This medication may not be approved by the FDA for the treatment of this condition. Prescription Only / Over the Counter Rx Prescription Only OTC Over the Counter Rx/OTC Prescription or Over the Counter Pregnancy A Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters). B Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women. C Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use in pregnant women despite potential risks. D There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use in pregnant women despite potential risks. X Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use in pregnant women clearly outweigh potential benefits. N FDA has not classified the drug. Controlled Substances Act Schedule N Is not subject to the Controlled Substances Act. 1 Has a high potential for abuse. Has no currently accepted medical use in treatment in the United States. There is a lack of accepted safety for use under medical supervision. 2 Has a high potential for abuse. Has a currently accepted medical use in treatment in the United States or a currently accepted medical use with severe restrictions. Abuse may lead to severe psychological or physical dependence Continue reading >>

Medication For Gestational Diabetes...

Medication For Gestational Diabetes... "but I Wanted To Stay Diet Controlled"

The words, "but I wanted..." or "was hoping to stay diet controlled" come up in our Facebook support group very often and my answer is always the same; "of course you did. Not one member in the group WANTS to be taking medication for gestational diabetes or injecting insulin. But there is only so much you can do with diet and exercise alone." Many women feel like a failure when they need to start medication or insulin to help lower and stabilise blood sugar levels. If you're a failure then so am I and so are all of us that ended up on medication or insulin! So stop saying you're a failure - how exactly have you failed??? Just because you need to start medication to help control your blood sugar levels does not mean you've failed! If that's the case, I failed in all 3 of my pregnancies! Yep a failure at 13 weeks in my second pregnancy and from the word go in my most recent pregnancy, in fact my whole Facebook admin team are failures! Please remember that many ladies who are diagnosed may need to go straight onto medication and/or insulin and are not even given a chance to try diet control. Does that make them failures from the word go? NO. Many mothers diagnosed with gestational diabetes will need help with medication to achieve lower levels. Diet controlled gestational diabetics are not trying harder, or doing better because they have managed to control the condition by making changes to diet and exercise alone. They simply do not have insulin resistance 'as bad'. Going on metformin or insulin does not mean that you can eat whatever you like. It means you should be able to eat the same diet as a diet controlled mother. QUESTION. Would you feel you failed if you needed to take medication for other illnesses and ailments? e.g. antibiotics for an infection that you can't g Continue reading >>

Injected And Oral Medications Equally Safe For Gestational Diabetes

Injected And Oral Medications Equally Safe For Gestational Diabetes

Injected and Oral Medications Equally Safe for Gestational Diabetes Injected and Oral Medications Equally Safe for Gestational Diabetes Gestational diabetes mellitus can lead to complications for mother and baby if glycemic control not managed optimally. For women with gestational diabetes and their babies, there is little evidence demonstrating the superiority of injected insulin over oral medications and nonpharmacologic interventions with regard to short-term outcomes and complications, according to findings published in the Cochrane Database of Systematic Reviews. The investigators of this review identified 53 randomized controlled trials that included 7381 mothers with gestational diabetes . Additionally, researchers found another 46 studies that provided outcomes data for 6435 infants born to mothers who had gestational diabetes during pregnancy. Insulin therapy correlated with a higher rate of hypertension during pregnancy (risk ratio (RR) 1.89; 95% CI, 1.14-3.12); however, the researchers found no difference between insulin and oral medications with regard to risk for preeclampsia (RR 1.14; 95% CI, 0.86-1.52), type 2 diabetes development (RR 1.39; 95% CI, 0.80-2.44), or birth by caesarean section (RR 1.03; 95% CI, 0.93-1.14). A pooled analysis of the studies did appear to demonstrate a potential association between insulin injections and an increase in labor induction compared with oral medications. No differences were observed between women receiving oral medications or insulin in relation to risk for infant mortality following birth (RR 0.85; 95% CI, 0.29-2.49), infant hypoglycemia (average RR 1.14; 95% CI, 0.85-1.52), or childhood adiposity (mean difference 0.5%; 95% CI, -0.49 to 1.49) at 18 months. Because current evidence suggests there is no difference be Continue reading >>

Oral Medication For The Treatment Of Women With Gestational Diabetes

Oral Medication For The Treatment Of Women With Gestational Diabetes

What is the issue? Globally the number of women being diagnosed with gestational diabetes mellitus (GDM) is increasing. GDM is an intolerance to glucose leading to high blood sugars, first recognised during pregnancy and usually resolving after birth. Standard care involves lifestyle advice on diet and exercise. Treatment for some women includes oral anti-diabetic medications, such as metformin and glibenclamide, which are an alternative to, or can be used alongside, insulin to control the blood sugar. This review aimed to investigate benefits of taking oral medication to treat GDM in pregnant women. Another Cochrane Review compares the effects of insulin with oral anti-diabetic pharmacological therapies ( Brown 2016). Why is this important? Women diagnosed with GDM are at a greater risk of experiencing complications such as high blood pressure during pregnancy and at birth. They have an increased risk of developing diabetes later in life. The babies of women who have been diagnosed with GDM can be larger than normal and this can cause injuries to the mother and the baby at birth. The birth is more likely to be induced or the baby born by caesarean section. These babies are at risk of developing diabetes as children or young adults. Finding the best medications to treat the women and prevent the complications that are linked to GDM is therefore important. What evidence did we find? We searched for studies on 14 May 2016. We included 11 randomised controlled trials involving 1487 mothers and their babies (but only eight trials contributed data to our analyses). The evidence was limited by the quality and number of studies and we advise caution when looking at the results. The criteria for diagnosis of GDM and treatment targets varied between studies, and each outcome is Continue reading >>

Gestational Diabetes Education And Management

Gestational Diabetes Education And Management

Click here to view upcoming classes Gestational Diabetes Class: It is important to reach and maintain good blood sugar control throughout your pregnancy for you and your baby's health. Your physician recognizes the necessity for this education to be included in your prenatal care. This class includes: Nutrition counseling Individualized meal plan Blood glucose monitoring Diabetes etiology and risk factors for maternal and fetal complications The importance and effects of exercise Medications used for treatment A1c test at initial visit *By providing your pharmacy or durable medical equipment supplier contact information, a Diabetes Center representative will assist you with obtaining your blood glucose meter and testing supplies prior to class. Please check with your insurance provider to determine which glucose meter is covered under your insurance plan. Please refer to Blood Glucose Meter Options for information on durable medical equipment suppliers. A one week follow-up visit will be scheduled after completing the class to review your blood sugar, food diaries and answer any questions. (Follow up visit is required to evaluate effectiveness of education and is an American Diabetes Association Certification requirement.) Diabetes and Pregnancy Management Program In addition to attending the class and one-week follow-up visit listed above, a physician may choose for the diabetes clinicians to monitor and manage your blood sugars throughout your pregnancy. The diabetes clinicians will work with you to reach your target blood sugar until delivery or until you have been released by your referring physician. Monthly visits will be necessary should medication or insulin be required during your pregnancy. Continue reading >>

Medication For Gestational Diabetes

Medication For Gestational Diabetes

What medication do I take for gestational diabetes? You many not need to take medication for gestational diabetes. It's possible to manage the condition by following a special diet and exercise plan. However, about 15 percent of women won't be able to control blood sugar with diet and exercise alone. If that's the case for you, your healthcare provider will prescribe oral medication or insulin to lower your blood sugar. Insulin is a hormone that the pancreas produces naturally. The insulin taken to treat diabetes is a synthetic version. Insulin treatment aims to bring down your blood sugar so it's at the same level as a woman who doesn't have gestational diabetes. Insulin is given through an injection, and you may need several injections each day. Your provider will teach you how to give yourself insulin injections. (Insulin doesn't cross the placenta, so it's considered safe to take during pregnancy.) Even if you take insulin, you still need to follow a balanced, healthy diet. This means monitoring your intake of carbohydrates and eating foods that make blood sugar rise and fall slowly. This includes whole grains, vegetables, beans, and lentils. How can I be sure I'm taking my medication correctly? Insulin is an effective treatment, but it requires careful attention. You'll need to test your blood sugar at least four times a day (using a kit your provider gives you), and write down the results. You'll also need to record how much insulin you've taken. Your provider will review this information with you at your prenatal appointments, and adjust your dosage if necessary. Overall, your need for insulin will increase as your pregnancy progresses. If your blood sugar levels are consistently within the normal range, it means your medication is working well. Blood sugar can c Continue reading >>

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