Risks Of Diabetes And Pregnancy
This information is for women who were diagnosed with Type 1 or Type 2 diabetes before they got pregnant. It does not cover gestational diabetes.
Most pregnant women with diabetes will go on to have a healthy baby. But there are some possible complications you should be aware of.
Risks to the baby can include:
- the baby having low blood glucose levels, low calcium or jaundice after delivery – this is common
- having a larger baby – which can cause problems during labour
- having a smaller baby than expected – who might need care in a neonatal unit
- malformation incorrect development of the baby – this is rare
- being stillborn – baby dies before it is delivered – this is also rare
Risks to the mother can include:
- more frequent low blood glucose
- poor hypo awareness of a low glucose
- developing a blood pressure problem
- worsening of existing diabetes kidney or eye problems
Infant Mortality And Birth Defects
There is a slight increase in the risk of infant mortality or birth defects in babys of mother with diabetes than without, however preconception care can reduce this risk by ensuring the mother is as healthy as possible before and through out pregnancy
In addition to this if a woman has diabetes before pregnancy, diabetes related complications can worsen this includes things like hypertensio, kidney disease, nerve damage and retinopathy which is a form of diabetic eye disease.
Blood Glucose Target Levels
You and your care team should agree ideal blood glucose levels that are right for you and are manageable without causing problems with hypoglycaemia.
If you are taking metformin, or you are on insulin, you should be advised to aim for the following target blood glucose levels, unless this leads to difficulties with hypoglycaemia:
fasting: below 5.3 mmol/litreand
1 hour after meals: below 7.8 mmol/litre.
If you are not able to test until 2 hours after a meal, the target glucose level at that time should be below 6.4 mmol/litre.
If you are on insulin, you should also be advised to keep your blood glucose above 4 mmol/litre, because of the risk of hypoglycaemia.
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We Dont Know What Causes Gestational Diabetes
But we know that you are not alone. It happens to millions of women. We do know that the placenta supports the baby as it grows. Sometimes, these hormones also block the action of the mothers insulin to her body and it causes a problem called insulin resistance. This insulin resistance makes it hard for the mothers body to use insulin. And this means that she may need up to three times as much insulin to compensate.
Gestational diabetes can also start when the mothers body is not able to make and use all the insulin it needs for pregnancy. Without enough insulin, glucose cant leave the blood and be changed into energy. When glucose builds up in the blood, its called hyperglycemia.
Whatever the cause, you can work with your doctor to come up with a plan and maintain a healthy pregnancy through birth. Ask questions. Ask for help. There are many ways to combat gestational diabetes.
How Gestational Diabetes Can Affect You
As mentioned above, gestational diabetes often comes with no symptoms, so you probably wont know that you have it until the doctor diagnoses it. However, gestational diabetes can still have an effect on you.
Gestational diabetes can increase your risk of high blood pressure while youre pregnant. Also, you may have a larger baby, which can make delivery difficult or require a C-section.
Gestational diabetes can also put you more at risk for developing type 2 diabetes later in life.
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Eating A Nutritionally Balanced Diet
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Gestational Diabetes Tests And Diagnosis
Gestational diabetes usually happens in the second half of pregnancy. Your doctor will check for it between weeks 24 and 28, or sooner if you’re at high risk.
Your doctor will give you a glucose tolerance test: Youâll drink 50 grams of glucose in a sweet drink, which will raise your blood sugar. An hour later, youâll take a blood glucose test to see how your body handled all that sugar. If the results show that your blood sugar is higher than a certain level, youâll need a 3-hour oral glucose tolerance test, meaning youâll get a blood glucose test 3 hours after you drink a 100-gram glucose drink. Your doctor can also test you by having you fast for 12 hours, then giving you a 75-gram glucose drink and a 2-hour blood glucose test.
If youâre at high risk but your test results are normal, your doctor might test you again later in your pregnancy to make sure you still donât have it.
Diabetic Eye Screening In Pregnancy
You will be offered regular diabetic eye screening during your pregnancy. This is to check for signs of diabetic eye disease .
Checking your eyes during pregnancy is important. The risk of diabetic retinopathy increases in pregnancy.
Diabetic retinopathy is treatable, especially if it is caught early.
If you decide not to have the test, you should tell the doctor looking after your diabetes care.
- other health care professionals
The obstetricians and midwives will have training in diabetes in pregnancy. They will work with you to provide your antenatal care. They will organise visits and ultrasounds to check on your babys development and growth.
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What Should Someone With Gestational Diabetes Do
If you are diagnosed with gestational diabetes, its important to start carefully managing your blood sugar levels. For most women, the aim is to keep blood glucose levels between 63 mg/dL and 140 mg/dL as much as possible they need to work with their healthcare team early and often after diagnosis, and determine their personal glucose targets. Treatments will often include strategic meal plans and exercise, and may incorporate medication and available diabetes technology.
The California Department of Public Health recommends a carbohydrate-controlled diet with meals and snacks spread two to three hours apart and walking after each meal.
For exercise, healthcare professionals suggest 30-60 minutes of moderately intense cardio and strength training three times per week.
Remember that there are many more factors that affect blood sugar, including sleep, stress, and your environment. Talk with a healthcare professional to come up with an individual approach to managing your blood sugar levels which may include meal plans, exercise routines, and insulin .
Some tools and technologies may be able to help you manage glucose. A continuous glucose monitor tracks glucose levels every few minutes throughout the day and night. This information can be exceptionally helpful for staying in your target glucose range, tracking and replicating the factors that create the best environment for mother and child.
What Are Normal Blood Sugar Levels During Pregnancy
As women ages 35 and above the chances of getting affected with gestational diabetes are high and so it is important to know the ideal count of sugar to be present while carrying. If your test result is below 7.8 mmol/L after consumption of 50g glucose and lapse of 60 minutes then the sugar count is normal. There is also another way to know normal blood range by following the oral glucose tolerance test , with a sugared liquid having 75 g glucose and 3 blood tests. In the below 3 tests if minimum 1 out of the 3 blood tests values is greater than or equal to the mentioned readings then your blood count is not normal.
- 5.1 mmol/L fasting
- 10 mmol/L 1 hour after drinking the sugary drinks or the sugary liquid
- 8.5 mmol/L 2 hours after drinking the sugary liquid
Usually when blood sugar level is higher than 200 mg/dl is seen a second evaluation i.e., an oral glucose tolerance test is recommended.
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Risks Of Developing Type 2 Diabetes
While maternal blood glucose levels usually return to normal after birth, there is an increased risk of the woman developing type 2 diabetes in the future. The baby may also be at risk of developing type 2 diabetes later in life.
Depending on your risk factors, you will also need to be tested for type 2 diabetes again every one to three years. Ask your doctor for more information. You can find more information about reducing your risk of type 2 diabetes here.
Blood Glucose Testing And Diagnosis
As a standard practice in our institution, all pregnant women without risk factors for GDM underwent a glucose challenge test at 2428 weeks of gestation. On the other hand, women with risk factors received a screening test at the initial visit and, if negative, were rescreened at 2832 weeks of gestation. Individuals with a GCT result of 140 mg/dL or higher would be scheduled for a diagnostic 100-g OGTT. The diagnosis of GDM was based on the Carpenter and Coustan criteria .
The management of women with GDM included dietary and lifestyle modifications as initial treatment. These women were evaluated for their levels of glycemic control throughout gestation by the measurement of fasting and 2-hour postprandial plasma glucose levels every 24 weeks. Insulin therapy, as determined and prescribed by an endocrinologist, was generally initiated when the FPG was 95 mg/dL and/or 2-hour postprandial glucose was 120 mg/dL. Factors that were also involved in the decision to initiate insulin treatment were the compliance of pregnant women with insulin injections, gestational age at which abnormally high FPG or 2-hour postprandial glucose was detected, and type , magnitude and number of hyperglycemic episodes.
After delivery, all women with a diagnosis of GDM were scheduled for a 75-g, 2-hour OGTT at 6 weeks postpartum.
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Normal Blood Sugar Levels For Gestational Diabetes
05-Sep-2018 | Pennie Solorio
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What Are The Risks Of A Glucose Tolerance Test
I hear that there are no risks associated with a glucose tolerance test.
However, I have personally be affected by a VERY low blood sugar following the 3-hour test. Honestly, so low that I probably should have been in a coma.
SO, I always recommend that on both the 1-hour and the 3-hour test that you bring something that has a nice balance of carbs and protein to eat right after the test is over. I usually take a peanut butter and honey sandwich since its easy to keep in my bag or my car. And can easily be eaten quickly.
NOTE: This snack is for AFTER the test is over. Make sure you follow the instructions for the test during the procedure. It is really important.
If you have any questions or concerns about the test, talk to your doctor or midwife. Theyll be happy to answer any questions you have.
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Your Diabetes Treatment In Pregnancy
Your diabetes team may recommend changing your treatment regime during pregnancy.
If you usually take tablets to manage your diabetes, you’ll normally be advised to stop these medications and switch to insulin injections.
If you already use insulin injections to control your diabetes, you may need to switch to a different type of insulin.
If you use an insulin pump you can continue to do so during pregnancy.
If you take medications for high blood pressure or high cholesterol, these may also need to be changed.
It’s important that you attend all your appointments so that your diabetes and obstetric teams can monitor your condition. They can react to any changes that could affect your or your baby’s health
You will need to check your blood glucose levels more frequently during pregnancy. This is because nausea and vomiting can affect them. Your diabetes team or midwife will be able to advise you on this.
Managing your blood glucose levels tightly may be associated with more episodes of low blood glucose . The diabetes team will help you and those close to you to recognise hypos and how to manage them. Talk to your GP or diabetes team.
If I Have Gestational Diabetes How Will It Be Treated
Treating gestational diabetes comes down to one key factor: controlling your blood sugar. The goal is to manage your blood glucose level so that it doesnt go too high and stay high. This is accomplished by eating wisely, remaining physically active, and if needed taking medication to help keep your blood sugar levels in your target range.
The importance of treating gestational diabetes gained attention following the Hyperglycemia and Adverse Pregnancy Outcomes trial, which demonstrated a direct link between continuous treatment of the maternal glucose levels and reducing negative outcomes.²
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What Is A Glucose Tolerance Test During Pregnancy And Why Is It Done
A glucose tolerance test is usually done during the second trimester of pregnancy, between 24 and 28 weeks. However if you have certain risk factors, like weight, or having a previously large baby they may test you earlier .
The test is used to screen for gestational diabetes, which is a type of diabetes that can develop during pregnancy.
Gestational diabetes happens when your body cant make enough insulin to handle the extra glucose in your blood during pregnancy. Insulin is a hormone that helps your body use or store glucose for energy.
For most women, gestational diabetes doesnt cause any noticeable symptoms. Thats why its important to get screened for the condition with a glucose tolerance test. If Gestational diabetes is not treated, it can lead to high blood sugar levels during pregnancy. This can cause problems for you and your baby, such as:
-Excessive weight gain in your baby
-Increased risk of cesarean delivery
-Breathing problems in your baby after birth
I want to be really clear on the fact that most often there is no way for you to know if you have gestational diabetes. These women dont tend to feel much different than other pregnant women so taking this test is truly the only way!
Hey, did you know that you are also at the perfect spot to take this too?