Gestational Diabetes And PCOS

Gestational Diabetes and PCOS

What is Gestational Diabetes and what does it mean to my unborn baby?
Polycystic Ovarian Syndrome (PCOS) is a common cause of female infertility because it causes many types of menstrual irregularities, including the absence of a period.4 If you don’t ovulate or this process is impaired, then pregnancy is unlikely. So treating PCOS symptoms and addressing a condition called Insulin Resistance, which influences PCOS, is very important for women wishing to conceive.4 If a woman does conceive in spite of Polycystic Ovarian Syndrome it is not all smooth sailing. Unfortunately, there will be a new series of health issues concerning PCOS and pregnancy.3 Women with PCOS have a higher risk of several pregnancy problems, including gestational diabetes, miscarriage, premature delivery, pregnancy-induced hypertension, and babies with high birth weight.8 It is crucial for women with PCOS to work closely with their obstetrician during pregnancy to minimize the risk of these problems.
What is gestational diabetes?
Gestational diabetes happens when a pregnant woman’s body has an impaired ability to process glucose. This results in high blood glucose levels that can cause serious complications for the woman and her growing baby.9 During pregnancy elevated blood sugar can be passed to the baby through the placenta producing a larger baby with potentially immature lungs. A large baby also means a more dangerous birth for both mother and child. Gestational diabetes affects about seven percent of all pregnancies and usually develops after the 20th week.5
Since gestational diabetes can be t Continue reading

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Experiencing the MiniMed 670G System after 43 Years with Diabetes

In March, we shipped the MiniMed 670G systems to customers in the Customer Training Phase. Among them is Laura, Medtronic Clinical Specialist in Phoenix, Arizona, who has been a part of the Medtronic family – both as a Certified Product Trainer and employee – for 26 years. Today, she shares her experience with the new system.
I’ve been on the MiniMed 670G system for a month, and haven’t felt this good in 43 years living with diabetes. I love it!
When the FDA approved the MiniMed 670G system, I cried tears of joy. I couldn’t believe this day had finally come.
Insulin pumps and continuous glucose monitors (CGM) are a huge part of my personal and professional life. Watching and personally experiencing the advancements in pump and sensor technology has been amazing. My first insulin pump in 1980 weighed a whopping 2.7 pounds (in comparison, the MiniMed 670G system is 1/5 pound)!
After 43 years of living with diabetes and 37 years pumping, I’m ecstatic to be on this journey with the world’s first hybrid closed loop system – the MiniMed 670G system!
I live an active lifestyle, and no day is the same. For people with diabetes, this means insulin needs vary each day. I love that the MiniMed 670G system understands this – getting to know my insulin needs more every day, and automatically adjusts and personalizes insulin delivery 24 hours a day.
I’ve struggled with hypoglycemia unawareness for many years, and the new Suspend before low feature – to me – is a miracle! Suspend before low kept me from going low four times in the three days before I turned on Auto Continue reading

Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE)

Abstract
Objective To compare the effectiveness of insulin pumps with multiple daily injections for adults with type 1 diabetes, with both groups receiving equivalent training in flexible insulin treatment.
Design Pragmatic, multicentre, open label, parallel group, cluster randomised controlled trial (Relative Effectiveness of Pumps Over MDI and Structured Education (REPOSE) trial).
Setting Eight secondary care centres in England and Scotland.
Participants Adults with type 1 diabetes who were willing to undertake intensive insulin treatment, with no preference for pumps or multiple daily injections. Participants were allocated a place on established group training courses that taught flexible intensive insulin treatment (“dose adjustment for normal eating,” DAFNE). The course groups (the clusters) were then randomly allocated in pairs to either pump or multiple daily injections.
Interventions Participants attended training in flexible insulin treatment (using insulin analogues) structured around the use of pump or injections, followed for two years.
Main outcome measures The primary outcomes were a change in glycated haemoglobin (HbA1c) values (%) at two years in participants with baseline HbA1c value of ≥7.5% (58 mmol/mol), and the proportion of participants achieving an HbA1c value of <7.5%. Secondary outcomes included body weight, insulin dose, and episodes of moderate and severe hypoglycaemia. Ancillary outcomes included quality of life and treatment satisfaction.
Results 317 participants (46 courses) were randomised (156 pump and 161 injections). 267 attended cou Continue reading

NIHR Signal Insulin pumps not much better than multiple injections for intensive control of type 1 diabetes

People with type 1 diabetes offered insulin pumps did not achieve better blood glucose control compared with those using multiple daily injections. Education remains important.
While both groups saw improvements in blood glucose levels and fewer hypoglycaemic episodes (very low blood sugar) over two years, only one in four participants met NICE blood glucose targets. Insulin pump users showed some modest improvements in satisfaction, dietary freedom and daily hassle.
All participants in this NIHR trial attended a training course on managing their insulin levels before randomisation. This is important because previously observed benefits from pump treatment might actually have been a reflection of the training given to them.
Currently just 10% of adults with type 1 diabetes access these training courses. These results support NICE guidelines around the restricted use of insulin pumps and suggest that training improves self-management of the condition. Efforts should therefore be made to encourage training uptake.
People with type 1 diabetes require lifelong treatment with insulin. Doses are adjusted according to food intake, physical activity, and blood glucose level. High or low blood glucose levels lead to serious short and long term complications, however, many people struggle to maintain blood glucose levels within the target range.
Insulin pumps are small devices, about the size of a mobile phone, that deliver a steady flow of insulin. They offer an alternative to multiple daily injections, and may also help people who are unable to achieve blood glucose control. They a Continue reading

U.S. Diabetes Patients Are About to Get Some High-Tech Relief

User-friendly devices to replace old, ‘barbaric’ tools
‘This is a crossroads for diabetes technology:’ analyst
Diabetes devices may be having their iPhone moment.
For decades, the daily routine of diabetics involved painful needles, finger-pricking lancets and imprecise glucose meters. Now, manufacturers have begun incorporating the slick and consumer-friendly designs of Silicon Valley, linking to phones and other tech devices.
“This is a crossroads for diabetes technology,’’ said Raj Denhoy, an analyst at Jefferies in New York.
September marked a breakthrough in the U.S., as regulators approved the first glucose-monitoring system that doesn’t need a blood sample, the FreeStyle Libre by Abbott Laboratories. The new devices do away with fingerpricks, changing an unpleasant, several-times-a-day routine into quiet monitoring in the background through a sensor worn on the back of the upper arm.
Other companies have been left behind. Johnson & Johnson is closing its insulin-pump unit after failing to keep up with Medtronic Plc. DexCom Inc., the current leader in glucose-monitoring systems, lost a third of its market value on Sept. 28 after Abbott’s Libre got approval.
On DexCom’s earnings conference call Wednesday executives, peppered with questions about the Libre, said the company hopes to introduce its own fingerprick-free device before the end of 2018. The comments about next-generation monitors helped assuage investors’ concerns about DexCom’s prospects, sending the stock up 9.5 percent in the two trading days following the results.
“Companies who Continue reading