Timing Of Delivery In Gestational Diabetes Mellitus: Need For Person-Centered, Shared Decision-Making

Timing of Delivery in Gestational Diabetes Mellitus: Need for Person-Centered, Shared Decision-Making

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Abstract
Gestational diabetes mellitus (GDM) is a medical as well as obstetric challenge, which needs person-centered management. The timing of delivery of women with GDM is discussed by various obstetric professional bodies. We highlight pertinent medical, obstetric, and psychosocial factors which may influence the timing of delivery in women with GDM. This commentary proposes a person-centered approach to decide the delivery timing in GDM and supports shared decision-making based upon the individual’s biopsychosocial characteristics and environmental factors.
Keywords: Antenatal corticosteroid therapy, Cephalopelvic disproportion, Diabetes, Fetomaternal distress, Labor, Macrosomia
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Introduction
The prevalence of gestational diabetes mellitus (GDM) is rapidly increasing across the world and it is a common endocrine complication in obstetric practice today [1–3]. GDM, as a syndrome, is marked by controversy related to virtually every facet, ranging from its nomenclature, screening tools, and diagnosis to management strategies [4, 5]. Most debate on GDM management centers on medical issues, such as appropriateness of oral hypoglycemic agents. In this communication, we discuss the timing of delivery in GDM and emphasize the need for person-centered, shared decision-making in this regard.
Compliance with Ethics Guidelines
This article does not contain any new studies with human or animal subjects performed by any of the authors.
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Expert recommendations suggest that women with uncomplicated GDM take their pregnancies to term, and d Continue reading

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Gestational Diabetes: Causes, Signs, Symptoms & Prevention

Gestational Diabetes (GSD) typically affects women during pregnancy. Due to the many lifestyle issues we are facing, women are more prone to Gestational Diabetes now. Gestational Diabetes can often lead to type 2 diabetes in later stages of life for women. However, it is not necessary that one may become diabetic permanently. Once the baby is born, one may not have diabetes at all.
Even though Gestational Diabetes is not a permanent state, it is important to remember to stick to a healthy diet and regime as your baby might end up getting affected. Gestational Diabetes does not mean that you will have an unhealthy baby, however, it is necessary to keep your sugar levels in check. Similar to other types of diabetes, Gestational Diabetes affects how well your cells use sugar or glucose in your body.
GSD can cause a spike in your blood sugar levels and hence can affect your and your baby's health. GSD occurs when your body cannot produce enough insulin to support you and your baby. Since during pregnancy the needs of your body increase, GSD is a common phenomenon which often subsides with a healthy regime after delivery.
If you do not take proper care during pregnancy, for example, eating outside foods and not exercising, GSD can lead to type 2 diabetes, a permanent state of your body insulin levels dropping frequently.Some studies suggest that if you had GSD in your first pregnancy, you are more likely to get it in your second pregnancy as well. Asian and middle-eastern women are most prone to this type of diabetes. However, if you lead a healthy lifestyle with proper diet and Continue reading

How To Detox The 4 Worst Diabetes-causing Chemicals Today

We used to think diabetes was caused by body fat, sugar, and inactivity. You might be surprised how large of a role environmental toxicants play. Get started on reversing type 2 diabetes, or reversing prediabetes, with this incredibly helpful cleanse for diabetics today.
For years, it seemed that many had assumed that diabetes was simply caused by obesity and inactivity. Recent data, though, has shown that environmental toxicants may play a larger role than just about any other controllable factor when it comes to causing diabetes.
My patients are often shocked to learn that obesity is merely a risk factor when it comes to diabetes, especially when a person has a high burden of environmental toxicants.
Body fat has often been regarded as a large risk factor for diabetes, even independent of body weight. New evidence is even showing that fat itself is less of a danger, rather the toxins that are commonly stored within fat are what is causing damage to our bodies.
A recent study I read talked about the positioning of children in areas of high-pollution, and that they were chemically predisposed to contracting diabetes due to the air around them (1). This is shocking stuff, because it takes what we thought of as the cause of diabetes and basically turns it on its head. It’s no longer simply about what’s going on in our bodies, but the factors outside our bodies as well.
Diabetes is just about one of the most common diseases there is in the United States and the numbers are only growing. A recent study, from 2015, suggested that over half of Americans have either diabetes o Continue reading

25 Facts to Know on Exercise on Type 1 Diabetes

This past month, researchers from more than a dozen leading diabetes and exercise research teams published guidelines on how to exercise with Type 1 diabetes. These guidelines, published in the Lancet, represent the current international consensus of the best methods for maintaining blood sugar control with exercise.
From the report, we’ve pulled out 25 important findings:
Why You Really Should Exercise
1. Some 60 percent of people with Type 1 diabetes are overweight or obese
2. Some 40 percent of people with Type 1 have hypertension, and 60 percent have dyslipidemia, a condition which increases the chance of clogged arteries, heart attacks, and strokes.
Read “JDRF Rolls Out its PEAK Program on Exercise and Type 1.”
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3. Children and young people with Type 1 all see improved cardiorespiratory fitness and blood lipid levels with regular physical activity.
4. Adults with Type 1 diabetes who are physically active had lower rates of retinopathy
Read “5 Tips for Exercise and Type 1.”
5. Regular exercise decreases total daily insulin needs.
How Much Exercise Should You Do
6. Adults with diabetes should aim for a total of 150 minutes of accumulated physical activity each week.
7. Resistance exercise is recommended two to three times a week.
What Happens to Your Blood Sugar Levels During Exercise
8. During aerobic exercise, insulin secretion decreases and glucagon secretion increases.
9. During anaerobic activities and high-intensity interval training, circulating insulin levels do not decrease as much as they do in aerobic activities.
10. Trained athletes with Type Continue reading

Slideshow: Diabetes and Your Mouth

4 Signs You May Have a Problem
Diabetes puts you at risk for dental problems. It hurts your ability to fight bacteria in your mouth. Having high blood sugar encourages bacteria to grow and contributes to gum disease. You may have gum disease if you have:
Gums that are red, sore, bleeding, or swollen, or that pull away from your teeth
Loose teeth
Chronic bad breath
An irregular bite or dentures that don't fit well
Well-controlled diabetes helps keep your mouth healthy. If you have poorly controlled or high blood sugar, you have a higher chance of dry mouth, gum disease, tooth loss, and fungal infections like thrush. Since infections can also make your blood sugar rise, your diabetes may become harder to control. Keeping your mouth healthy can help you manage your blood sugar.
People with diabetes are more likely to have oral infections. You should get dental checkups at least twice a year. Let your dentist know you have diabetes and what medicines you take. Regular checkups and professional cleanings can help keep a mouth healthy. And your dentist can teach you the best ways to care for your teeth and gums at home.
Sticky plaque -- food, saliva, and bacteria -- starts to form on your teeth after you eat, releasing acids that attack tooth enamel. Untreated plaque turns into tartar, which builds under gum lines and is hard to remove with flossing. The longer it stays on your teeth, the more harmful it is. Bacteria in plaque causes inflammation and leads to gum disease. High blood sugar can make gum disease worse.
When you brush your teeth twice a day, it not only keeps your br Continue reading