Diabetes Medications During Pregnancy And Breastfeeding

Diabetes medications during pregnancy and breastfeeding

In the past, women with diabetes were at high risk for complications during pregnancy. Today, with advancements in treatment and good blood glucose control, women with diabetes can have a safe pregnancy and delivery similar to that of a woman without diabetes.
(Please note: this article focuses on pre-existing diabetes, which refers to women who have diabetes before becoming pregnant. This is different than gestational diabetes, which occurs during pregnancy.)
Planning your pregnancy
For women who have diabetes, obtaining preconception (‘before pregnancy’) care is associated with better birth outcomes. By discussing pregnancy with your healthcare team prior to conception, they can help you reach your blood glucose targets, start folic acid supplementation and discontinue potentially harmful medications to lay the groundwork for a healthy pregnancy.
Blood glucose targets
It is important that woman who are planning a pregnancy get their preconception A1C levels to less than 7%, or as close to normal as can be achieved safely. This will decrease the risk of spontaneous abortion, birth defects and pregnancy-induced high blood pressure (this is known as ‘preeclampsia’). Good blood glucose control in pregnancy is important, because 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.
Women should speak to their healthcare team, as blood glucose targets change in pregnancy; hence, more frequent blood glucose monitoring is recommended to ensure these goals are being met. Continue reading

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Living with Diabetes Teeth and Gum Problems to be Aware of

Comments Off on Living with Diabetes Teeth and Gum Problems to be Aware of
One of the most common sedentary lifestyle diseases affecting very many Americans today is diabetes. When discussing the side effects of diabetes, a lot people often concentrate on the sugar related implications and oversee a very important problem associated with diabetes- dental disease. Unknown to many, diabetes puts patients at a very high risk of getting dental problems. The sugar related problems extend every part of the body and teeth are not an exception. If you are suffering from diabetes therefore, you should be weary of teeth and gum problems. Here are some of the most common teeth and gum problems associated with diabetes and how you can stay clear of the said problems;
Gum diseases
One of the most common problems associated with diabetes is the gum disease. Gum disease takes two forms: gingivitis and periodontitis. Gingivitis is less serious, but can develop into periodontitis if left untreated for a very long period of time. In addition to cutting off blood to the gums, diabetes reduces the body’s resistance to infection, putting the gums at risk for gingivitis, an inflammation caused by the bacteria in the form of plaque. The main symptoms of gingivitis are red, swollen, and bleeding gums. It is important to contact your dentist as soon as these symptoms develop so the problem can be addressed.
Untreated gingivitis can lead to a more serious infection called periodontitis, which affects the tissue and bones that support your teeth. Periodontal disease is a more serious infection and Continue reading

Living With Diabetes: Teeth and Gum Problems to be Aware of

Diabetes can lead to a whole host of health problems, but did you know that it can also put you at risk for dental issues? The implications of high blood sugar extend to every part of the body — including teeth and gums. When it comes to diabetes, teeth and gum problems are something you need to be aware of.
Diabetes: Teeth and Gum Problems to Look Out For
Here are few of the ways diabetes can wreak havoc on your mouth, and how you can prevent this damage from occurring if you are one of the 21.9 million people in the U.S. who suffer from diabetes.
Gum Disease
Diabetes can reduce the blood supply to the gums, which increases the risk for gum disease. This risk is amplified if you had poor dental health prior to being diagnosed with diabetes.
Gum disease takes two forms: gingivitis and periodontitis. Gingivitis is less serious, but can develop into periodontitis if left untreated. In addition to cutting off blood to the gums, diabetes reduces the body’s resistance to infection, putting the gums at risk for gingivitis, an inflammation caused by the bacteria in the form of plaque. The longer plaque remains on your teeth, the more it irritates the gingiva — the part of your gums around the base of your teeth.
The main symptoms of gingivitis are red, swollen, and bleeding gums. It is important to contact your dentist as soon as these symptoms develop so the problem can be addressed.
Untreated gingivitis can lead to a more serious infection called periodontitis, which affects the tissue and bones that support your teeth. In addition to red bleeding gums, other symptoms incl Continue reading

Diabetes Linked to Increased Risk of Tooth Loss

Study of 40-year trend focused on three ethnic groups prone to dental complications.
Diabetes has been increasing in the United States over the years. According to the CDC, diabetes rate have tripled from 1980 to 2014. Diabetics are at risk for multiple complications such as cardiovascular disease, neuropathy, eye damage, hearing impairment, skin disease, and periodontal disease. Researchers have identified a relationship between diabetes and periodontal disease. About half of the U.S. population suffers from periodontal disease and the prevalence for periodontal disease is greater in adults with diabetes.
“One of the many complications of diabetes is a greater risk for periodontal disease,” said Maria E. Ryan, DDS, PhD, Professor of Oral Biology and Pathology, and Director of Clinical Research, School of Dental Medicine, Stony Brook University, New York, in a recent interview. “If you have this oral infection and inflammation, as with any infection, it’s much more difficult to control blood glucose levels.” Intensive periodontitis treatment significantly reduces levels of A1C.
These links between oral and systemic health may start even before clinical diabetes begins. “We have found evidence that the severity of periodontal disease is associated with higher levels of insulin resistance, often a precursor of type 2 diabetes, as well as with higher levels of A1C, a measure of poor glycemic control of diabetes,” she said.
The importance of these findings were emphasized by her colleague, George W. Taylor, DrPH, DMD, Associate Professor of Dentistry, Schools of D Continue reading

Effect of Fructose on Glycemic Control in Diabetes

OBJECTIVE The effect of fructose on cardiometabolic risk in humans is controversial. We conducted a systematic review and meta-analysis of controlled feeding trials to clarify the effect of fructose on glycemic control in individuals with diabetes.
RESEARCH DESIGN AND METHODS We searched MEDLINE, EMBASE, and the Cochrane Library (through 22 March 2012) for relevant trials lasting ≥7 days. Data were aggregated by the generic inverse variance method (random-effects models) and expressed as mean difference (MD) for fasting glucose and insulin and standardized MD (SMD) with 95% CI for glycated hemoglobin (HbA1c) and glycated albumin. Heterogeneity was assessed by the Cochran Q statistic and quantified by the I2 statistic. Trial quality was assessed by the Heyland methodological quality score (MQS).
RESULTS Eighteen trials (n = 209) met the eligibility criteria. Isocaloric exchange of fructose for carbohydrate reduced glycated blood proteins (SMD −0.25 [95% CI −0.46 to −0.04]; P = 0.02) with significant intertrial heterogeneity (I2 = 63%; P = 0.001). This reduction is equivalent to a ∼0.53% reduction in HbA1c. Fructose consumption did not significantly affect fasting glucose or insulin. A priori subgroup analyses showed no evidence of effect modification on any end point.
CONCLUSIONS Isocaloric exchange of fructose for other carbohydrate improves long-term glycemic control, as assessed by glycated blood proteins, without affecting insulin in people with diabetes. Generalizability may be limited because most of the trials were <12 weeks and had relatively low MQS (<8). Continue reading