Does Gestational Diabetes Always Mean A Big Baby And Induction?

Does Gestational Diabetes always mean a Big Baby and Induction?

July 3, 2012 by Rebecca Dekker, PhD, RN, APRN
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This question was submitted to me by one of my readers, Sarah.
“I have a question about gestational diabetes. It seems like everyone I know who has had it has ended up being induced. Does gestational diabetes automatically mean induction? Does it automatically mean big babies? It seems like people get diagnosed and then give up on a natural childbirth and are treated as a sick person.”
I talked to Dr. Shannon (a family medicine physician), and she echoed Sarah’s perceptions about gestational diabetes:
“I would say that ‘routine care’ in the U.S. is to induce at 38 to 39 weeks for gestational diabetes (leaning towards 39 weeks nowadays) if the mom’s glucose is uncontrolled or if she is controlled on medication. However, women can technically be treated as ‘normal’ if their gestational diabetes is well controlled and baby’s growth looks normal on a 32 week scan. So people just might want to know they will get major push back from their provider if they refuse induction. It’s tough. Many OB’s cite the risk of stillbirth as a reason for induction, because the risk of stillbirth in women with regular diabetes is higher. However, there is no evidence that the risk of stillbirth goes up in gestational diabetes.”
Evidence Based Birth® offers an online course on Big Babies and Gestational Diabetes (3 contact hours)! To learn more, click here!
Dr. Shannon brings up several good points. First, she is talking about “routine care,” whi Continue reading

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Type 2 Diabetes Overview

What Is It?
When you have this disease, your body does a poor job turning the carbohydrates in food into energy. This causes sugar to build up in your blood. Over time it raises your risk for heart disease, blindness, nerve and organ damage, and other serious conditions. It strikes people of all ages, and early symptoms are mild. About 1 out of 3 people with type 2 diabetes don't know they have it.
People with type 2 diabetes often have no symptoms. When they do appear, one of the first may be being thirsty a lot. Others include dry mouth, bigger appetite, peeing a lot -- sometimes as often as every hour -- and unusual weight loss or gain.
In many cases, type 2 diabetes isn't discovered until it takes a serious toll on your health. Some red flags include:
Cuts or sores that are slow to heal
Frequent yeast infections or urinary tract infections
Itchy skin, especially in the groin area
Diabetes can damage blood vessels and nerves in your genitals. This could lead to a loss of feeling and make it hard to have an orgasm. Women are also prone to vaginal dryness. About 1 in 3 who have diabetes will have some form of sexual trouble. Between 35% and 70% of men who have the disease will have at least some degree of impotence in their lifetime.
Some health habits and medical conditions related to your lifestyle can raise your odds of having type 2 diabetes, including:
Being overweight, especially at the waist
A couch potato lifestyle
Smoking
Eating a lot of red meat, processed meat, high-fat dairy products, and sweets
Unhealthy cholesterol and triglyceride levels
Other risk factors a Continue reading

What Causes Type 2 Diabetes?

Insulin resistance and high levels of insulin and lipids all precede the development of metabolic dysfunction. Which metabolic factor is to blame?
Type 2 diabetes is a multifactorial metabolic disease.1 Obesity, elevated levels of lipids and insulin in the blood, and insulin resistance all accompany the elevated blood glucose that defines diabetes. (Diabetes is defined as fasting blood glucose concentrations above 7 millimolar (mM), or above 11 mM two hours after ingestion of 75 grams of glucose.) But while researchers have made much progress in understanding these components of the metabolic dysfunction, one major question remains: What serves as the primary driver of disease?
Lifestyle choices characterized by inactivity have been postulated as one possible cause. Researchers have also pointed the finger at nutrition, postulating that poor food choices can contribute to metabolic disease. However, there is thus far weak support for these hypotheses. Changing to a healthy diet typically does not result in significant weight loss or the resolution of metabolic dysfunction, and it is rare to reverse obesity or diabetes through increased exercise. Furthermore, there does not appear to be a strong relationship between body-mass index (BMI) and activity level, though exercise clearly has many other health benefits.
With such macroscale factors unable to explain most cases of obesity and diabetes, scientists have looked to molecular mechanisms for answers. There are at least 40 genetic mutations known to be associated with type 2 diabetes. These genes tend to be involved in the Continue reading

3.8 million people in England now have diabetes

The new Diabetes Prevalence Model, produced by the Public Health England (PHE) National Cardiovascular Intelligence Network (NCVIN) and launched today at the PHE Conference at Warwick University, estimates the total number of adults with both Type 1 and Type 2 diabetes in England.
Whilst 3.8 million people are estimated to have both types of diabetes, approximately 90% of diabetes cases are Type 2; this is largely preventable or manageable by lifestyle changes and also provides additional benefits for health and wellbeing. The likelihood of developing Type 2 diabetes is increased by being overweight (although family history, ethnicity and age can also increase risk).
The figures reiterate that diabetes is an increasing burden of ill health, underlining the need for urgent action to lessen the impact on individuals, as well as the health and social care system supporting them.
The model suggests that 1 in 4 people with diabetes, an estimated 940,000, are unaware of their condition. The disease can lead to serious complications including foot amputation and kidney disease, and is associated with an increased risk of stroke and heart attack.
John Newton, Chief Knowledge Officer at PHE, said:
The number of people with diabetes has been steadily increasing and tackling it is fundamental to the sustainable future of the NHS. Diabetes can be an extremely serious disease for those that have it and treating it and its complications costs the NHS almost £10 billion a year. Developing Type 2 diabetes is not an inevitable part of aging, we have an opportunity through public health to Continue reading

How Serious Is Prediabetes?

According to the American Diabetes Association (ADA), over 84 million Americans had prediabetes in 2015. But how big a problem is prediabetes?
Is prediabetes a real disease? Or are they just trying to scare people, sell medicines, and get more money for diabetes services? Let’s see.
What is prediabetes?
According to the Centers for Disease Control, prediabetes means blood sugars that are higher than normal, but not high enough to qualify as diabetes. It’s what used to sometimes be called “borderline diabetes.”
Prediabetes is a numbers game. There are no symptoms that define it. The term “prediabetes” classes people with only slightly high sugars as having an illness.
Some experts strongly dislike the term, because it sounds like a stage on the way to diabetes. It can be, but many people never get there. It depends on your life and how you live it.
A person can be classed with prediabetes in three ways:
• Impaired fasting glucose (IFG): A fasting blood glucose between 100–125 mg/dl (5.6–7.0 mmol/l).
• Impaired glucose tolerance (IGT): An oral glucose tolerance test (OGTT) result from 140–199 mg/dl. The person is given a sweet drink and his glucose is tested one and/or two hours later.
An OGTT was the first test used to diagnose prediabetes, but it’s used much less now because of the time, difficulty, and expense involved.
• Hemoglobin A1C: An HbA1c level of 5.7% to 6.4%. HbA1c is a rough measure of a person’s average glucose over the last 2–3 months.
Some of the increased number of people with prediabetes is from the newer tests. More people are Continue reading