ACOG Releases Updated Guidance On Gestational Diabetes

ACOG Releases Updated Guidance on Gestational Diabetes

SUMMARY:
ACOG has released updated guidance on gestational diabetes (GDM), which has become increasingly prevalent worldwide. Highlights and changes from the previous practice bulletin include the following:
Fetal Monitoring
Screening for GDM – One or Two Step?
ACOG (based on NIH consensus panel findings) still supports the ‘2 step’ approach (24 – 28 week 1 hour venous glucose measurement following 50g oral glucose solution), followed by a 3 hour oral glucose tolerance test (OGTT) if positive
Note: While the diagnosis of GDM is based on 2 abnormal values on the 3 hour OGTT, ACOG states, due to known adverse events, one abnormal value may be sufficient to make the diagnosis
1 step approach (75 g OGTT) on all women will increase the diagnosis of GDM but sufficient prospective studies demonstrating improved outcomes still lacking
ACOG does acknowledge that some centers may opt for ‘1 step’ if warranted based on their population
Who Should be Screened Early?
ACOG has adopted the NIDDK / ADA guidance on screening for diabetes and prediabetes which takes in to account not only previous pregnancy history but also risk factors associated with type 2 diabetes. Screen early in pregnancy if:
Patient is overweight with BMI of 25 (23 in Asian Americans), and one of the following:
Physical inactivity
Known impaired glucose metabolism
Previous pregnancy history of:
GDM
Macrosomia (≥ 4000 g)
Stillbirth
Hypertension (140/90 mm Hg or being treated for hypertension)
HDL cholesterol ≤ 35 mg/dl (0.90 mmol/L)
Fasting triglyceride ≥ 250 mg/dL (2.82 mmol/L)
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Study suggests link between A1 beta-casein and Type 1 diabetes

RESEARCH: Type 1 diabetes, an autoimmune disease in which the body attacks its own insulin-producing cells, is on the rise globally.
Early evidence of an association between Type 1 diabetes and a protein in cow milk, known as A1 beta-casein, was published in 2003. However, the notion that the statistically strong association could be causal has remained controversial.
As part of a seven-person team, we have reviewed the overall evidence that links A1 beta-casein to type 1 diabetes. Our research brings forward new ways of looking at that evidence.
Different types of diabetes
Type 1 diabetes is the form of diabetes that often manifests during childhood. The key change is an inability of the pancreas to produce insulin, which is essential for transporting glucose across internal cell membranes.
There is common confusion between Type 1 and the much more common Type 2 diabetes. Type 1 diabetes is an autoimmune disease. This means that the immune system attacks the body's own cells. Insulin-producing cells in the pancreas are then destroyed by "friendly fire".
READ MORE:
* A1 or A2 milk? Where's the research?
* What the 'milk devil' could do
* What does A2 milk have to offer?
There is no accepted lifestyle change that will prevent or cure Type 1 diabetes and daily insulin injections are required throughout life.
In contrast, people who develop Type 2 diabetes still produce some insulin, but the liver and muscles become resistant to insulin's ability to move glucose out of the blood and into the tissues. Type 2 diabetes is primarily a disease of middle-aged and older people and is Continue reading

Type 1 diabetes more prevalent in adults than previously believed, prompting doctors to warn against misdiagnosis

Doctors are wrong to assume that type 1 diabetes mainly affects children, according to a new study that shows it is equally prevalent in adults.
The findings, published in the journal Lancet Diabetes & Endocrinology, overturn previous thinking that the form of diabetes, an auto-immune condition, is primarily a childhood illness. Scientists from Exeter University found that in a lot of cases it was actually misdiagnosed among adults.
“Diabetes textbooks for doctors say that type 1 diabetes is a childhood illness. But our study shows that it is prevalent throughout life. The assumption among many doctors is that adults presenting with the symptoms of diabetes will have type 2 but this misconception can lead to misdiagnosis with potentially serious consequences,” said Dr Richard Oram, a senior lecturer at the University of Exeter and consultant physician.
Diabetes textbooks ... say that type 1 diabetes is a childhood illness. But our study shows that it is prevalent throughout life
Dr Richard Oram, University of Exeter
The research, funded by the Wellcome Trust and Diabetes UK, was based on the UK Biobank, a resource which includes data and genetic information from 500,000 people aged between 40 and 69 from across the country. Participants provided blood, urine and saliva samples for future analysis, detailed information about themselves and agreed to have their health followed.
“The key thing we were looking for with this study was whether people presented with type 1 diabetes in adulthood and at what age this occurred. This was only possible because of the unique combi Continue reading

Know the Warning Signs of High Blood Sugar and Diabetes

Did you know that diabetes is known as a “silent killer,” which can attack you without you even knowing?
That’s right because its signs can be confused with other health problems or temporary conditions.
For this reason, in today’s article, we want to tell you about the signs of high blood sugar so that you can pay attention and detect this disease in time.
Be careful with hyperglycemia
An increase in blood sugar can be caused by different changes in your body. Most of them have to do with shifts when processing carbohydrates.
All cells need glucose for energy. For them to receive their “ratio,” certain processes are carried out. When this system fails for some reason, however, your cells require more food to perform its activities.
When this happens, there are no obvious signs that you might consider to be negative. With the passage of time, however, the symptoms could continue to increase.
That’s when you typically consult a doctor who is responsible for identifying an appropriate treatment if you’re in fact suffering from diabetes.
Signs that indicate high blood sugar
When your glucose increases, it weakens your immune system.
As a result, your body is more vulnerable to all types of infections and wounds to both the skin and your mucous membranes. In addition to that, you lose small blood vessels.
That’s why it’s critical to pay attention to the signals your body is sending you.
If you have high blood sugar levels, your body might be trying to tell you through the following:
An excessive appetite
First of all, you need to learn how to distinguish bet Continue reading

Alzheimer’s Disease Is TYPE 3 Diabetes: Natural Treatments That Work

The human body is an exceptionally delicate mechanism. All of its parts are beautifully interconnected, and even the tiniest of details is crucial for the big picture. For example, a single cell can either kill (like during cancer) or save (like during immune responses to infections) you through a series of complex processes. And, in turn, these processes are also intertwined.
One change leads to another. One condition always brings forth something else.
This truth often results in unbelievable findings that shake the scientific world to its very core, and here you will discover one of such breakthrough. A discovery that may change forever the way we see some of the most dreadful conditions of the modern era: Diabetes and Alzheimer’s Disease (AD).
Let’s take a look at the numbers and trends, as they are the best way to illustrate what’s happening.
According to the World Health Organization (WHO), the global prevalence of obesity has more than doubled since 1980. In 2014 more than 1.9 billion adults had excess weight, and 600 million of them were obese.
And don’t get me wrong, this is not a matter of looks, but strictly of health. Innocent (often even cute) at first sight, excess weight takes a terrible toll on the body. It increases the risk of cardiovascular diseases (heart attack and stroke in particular) and certain forms of cancer, but what’s even more important in the light of our discussion today is that, untreated excess weight almost inevitably results in diabetes.
Throughout the last decades, the global prevalence of diabetes in men has increased more tha Continue reading