S To Controlling Blood Sugar
Most women who have gestational diabetes will give birth to perfectly healthy babies. But, in order to do so, you may need to make changes to your lifestyle to promote a healthy pregnancy and avoid any risks to your baby .
The management of gestational diabetes involves making healthy choices. This involves five key steps:
- Eating a healthy diet
- Knowing your blood sugar level and keeping it under control
- Taking insulin, if needed
Myth #: Im Thin I Cant Possibly Have Gestational Diabetes
Screening for gestational diabetes might seem like another unnecessary test, especially if youre otherwise healthy, but that doesnt mean youre in the clear. Some studies have shown up to 50% of women with gestational diabetes dont have any of the classic risk factors, like being overweight prior to becoming pregnant or a family history of diabetes.
While the screening tests arent perfect , its still worth being proactive given all that we know about mildly elevated blood sugar levels and risks to your baby. Even if youre not interested in the glucose drink, at the very least, using a glucometer to measure your blood sugar levels for a few weeks while you eat your usual diet teaches you a TON about food and your body. And if youre reading this in early pregnancy, ask to have an A1c added to your blood work.
Prediabetes Flies Under The Radar
You can have prediabetes for years but have no clear symptoms, so it often goes undetected until serious health problems show up. Thats why its important to talk to your doctor about getting your blood sugar tested if you have any of the risk factors for prediabetes, which include:
- Being overweight
- Being 45 years or older
- Having a parent, brother, or sister with type 2 diabetes
- Being physically active less than 3 times a week
- Ever having gestational diabetes or giving birth to a baby who weighed more than 9 pounds
Race and ethnicity are also a factor: African Americans, Hispanic/Latino Americans, American Indians, Pacific Islanders, and some Asian Americans are at higher risk.
Ready to find out your risk? Take the 1-minute prediabetes risk test and be sure to share the results with your doctor.
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Screening And Diagnosis Of Gdm
Early screening. Screening for diabetes in the first trimester should be considered for diagnosing overt diabetes in women who are at risk , including those with a history of previous GDM. The ability to predict abnormal results on glucose screening tests at 24 to 28 weeks and risk of continued dysglycemia postpartum are other, but less compelling, reasons cited to screen in the first trimester.
The test of choice for early screening should be based primarily on the ability to predict poor obstetrical outcomes, which may be modifiable by lifestyle or pharmacological intervention. There are 2 strategies for testing glucose levels in early pregnancyusing the nonpregnancy-recommended screening tests or using the typical 24- to 28-week gestational diabetes screening criteria . To apply nonpregnant FPG or A1C criteria in early pregnancy does not take into account that both decrease early in pregnancy and may lead to underdiagnosis in women with pre-existing diabetes. On the other hand, there has been no rigorous validation that criteria accepted for the diagnosis of GDM in the second or third trimester are appropriate for use in the first trimester.
My Struggle With My Fasting Blood Sugar 32 Weeks
I was diagnosed with GD early in pregnancy, around 18 weeks and have been able to control it with diet/exercise up until now. I am almost 33 weeks and my fasting sugar has been 95-97 these past few days. For the past 1.5 months, skipping a bedtime snack worked best for me, but my doctor became concerned that I was going too long without eating for the baby. When I would skip a bedtime snack, my fasting would be 78-88, but recently its been creeping up to mid/high 90s.
I tried all protein/fat snack and my blood is still around 97 when I wake up in the morning. Tonight Im going to try to incorporate a carb.
My stomach always measures normal when I goto the doctor and I’ve only gained around 12lbs. My numbers after meals are perfect, it’s just my damn fasting! I read so much about fasting blood and every doctor has different limits. My doctor would like it under 90, but she said if I average BELOW 95, I shouldn’t need meds, but I see some women on here that are under 100 and are fine.
Im so scared to take medications while pregnant and don’t want to take it if it’s not absolutely necessary. Help!
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Ehealth Medicine: Telehomecare And New Technologies For Glucose Monitoring And Healthy Behaviour Interventions
Use of new technologies and web-based platforms for BG monitoring in pregnant women with diabetes in Canada and worldwide is rapidly increasing. These initiatives allow for 2-way communication with women monitoring and transmitting their BG results in real time to health-care providers for feedback. Studies have demonstrated 38.0% to 82.7% reduction in face-to-face medical visits and decreased insulin use in pregnant women using telehomecare in conjunction with conventional care, without an increase in maternal or perinatal complications. While 4 studies of GDM women have demonstrated comparable glycemic control and pregnancy outcomes , other studies with type 1 diabetes and GDM have shown improved glycemic control and pregnancy outcomes in the group using web-based programs compared to standard care. Enhanced patient empowerment and greater satisfaction with the care received are also reported in groups using new monitoring technology . However, generalizability of those studies is questionable as these studies were small, conducted in very specific settings and used different types of technologies and e-platforms. Furthermore, acceptance of these interventions by marginalized population subgroups and in remote regions would also be important to determine. Finally, studies assessing cost effectiveness of these measures, both direct and indirect are needed.
What Are The Signs And Symptoms When Does It Develop
GD is typically diagnosed in the third trimester, though its not always obvious, experts say. The signs and symptoms arent very helpful, because it is only when blood sugar gets really high that you see excessive thirst and urination, said Gabbay. The majority of women have no symptoms.
According to ACOG, a health care professional will screen you earlier in your pregnancy by asking about your medical history to determine if you have risk factors for GD. If you do, youll get tested to determine your blood sugar levels. If you dont show signs of diabetes , youll undergo the standard glucose screening test.
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What Are The Risks Of Gestational Diabetes
Untreated gestational diabetes can have unfortunate consequences for both mom and baby. Complications related to GD include:
- Preeclampsia, preterm birth, and stillbirth
- Shoulder dystocia
- Permanent changes to babys blood sugar regulation and metabolism
One of the most concerning risks of gestational diabetes is the last bullet point. When a baby is exposed to high blood sugar in the uterus its pancreas has to produce more insulin to compensate. This can cause an accumulation of fat on the body and in the fetal pancreas, according to this HAPO study. This accumulation of fat predisposes the baby to metabolic issues later in life.
So, healthy blood sugar during pregnancy is important for not only a healthy pregnancy and delivery but for babys lifetime health!
Treatment For Gestational Diabetes
Luckily, even conventional treatment suggests a healthy or balanced diet and exercise before resorting to insulin or medications. Unfortunately, the kind of diet conventional healthcare providers recommend may leave some room for improvement.
Conventional wisdom tells us that whole grains and dairy are healthy foods. In reality, both of these provide a large amount of carbohydrates and very little nutrition .
Because carbohydrates are so important during pregnancy many clinicians are wary of restricting pregnant womens carbohydrate intake. Its generally accepted that pregnant women should be no less than 175 carbohydrates each day. This guideline is followed for women with gestational diabetes as well.
The concern is that starvation ketosis or diabetic ketoacidosis can be harmful in pregnancy. However, research published in Diabetes shows that low-level pregnancy ketosis is common and does not carry the same risks including fetal brain development.
This makes sense when you think about the biological reason that women have slight insulin resistance. Pregnancy insulin resistance is the protection against dangerously low blood sugar.
Here is the difference between dangerous ketosis and normal ketosis:
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Tip #: Eat A Nutrient
The cover of Nichols book features two fried eggs with sliced avocado and cherry tomatoes a low-carb high-fat meal. It is the perfect breakfast, or any meal, for gestational diabetes, she says. Her advice: eat nutrient-dense foods over empty calories.
Some low-carb people are just living off fat bombs and bulletproof coffee. You need to have good, common sense with variety in your diet.She recommends having protein like meat, fish, and eggs snacks like nuts and seeds and lots of vegetables with natural fats like olive oil or butter. Nichols suggests eating liver once or twice a week, to help ensure a good natural intake of vitamins, minerals, and antioxidants in your diet.
She further recommends avoiding all highly processed foods, added sugar, refined carbs, as well as high-glycemic fruit and fruit juices. If your blood sugar is still high, consider cutting out all fruit except berries. You do not need to add in bread and cereals to have a healthy pregnancy, says Nichols. Pay attention to how you feel, and monitor your blood sugars. Some pregnant women may feel better eating slightly more carbs, but I think the majority of women with GD, and all pregnant women in general, do better with at least one-half to one-quarter the carbohydrates recommended in conventional nutrition guidelines .31
Are gestational diabetes programs around the globe now registering that message and advising lower carb? Alas, not yet.
Why Are Fasting Levels Important
Fasting levels give an indicator of our baseline blood sugar levels. This shows an picture of what our levels are returning to when they are not complicated by the foods we are eating.
High fasting levels have been associated with increased adverse pregnancy outcomes in many research studies1416
A large Canadian study published in Nov 201915 of 257,547 pregnancies between 2008 -2014 found that those diagnosed with high fasting blood sugar levels following the GTT resulted in the highest rates of adverse pregnancy outcomes .
elevated FPG was significantly associated with a higher risk of LGA and HDP outcomes compared to postload elevation in GDM pregnancies. We also found that the use of pharmacological treatment was highest in pregnancies with elevated FPG and treatment rates increased with increasing dysglycaemia . After adjusting for other maternal factors, FPG was associated with an increased risk of LGA and HDP outcomes in GDM pregnancies with and without pharmacological intervention.
Elevated fasting plasma glucose in women with gestational diabetes is a stronger predictor of largeforgestationalage and hypertensive disorders of pregnancy outcomes than elevated postload glucose
Higher fasting levels in the first trimester has been linked to increased risks of adverse pregnancy outcomes17,18
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How To Monitor And Stabilize Blood Sugar Naturally
There are three main things you need to do to make sure your blood sugar is in a healthy range. The first thing is to monitor your blood sugar in the morning and after each meal. This will give you information to figure out how certain foods affect your blood sugar.
The next is to exercise regularly. Exercise lowers blood sugar, so its especially important for those who are having trouble lowering blood sugar levels. The American Congress of Obstetricians and Gynecologists recommend 30 minutes a day.
Lastly, eating a healthy diet is vital for keeping blood sugar under control.
Minimizing Fasting Glucose With Exercise
So, my fasting blood sugar numbers have been consistently between 93 and 95 mg/DL and while Im not convinced that this number really should even be classified as gestational diabetes, it does technically meet the really aggressive new definitions that have been adopted for gestational diabetes in recent years . And on days when I am up all night long with Samson, my blood sugar can between 100 and 110mg/DL when i Wake up
Whats frustrating is that my post-prandial numbers are totally normal always below 120 at 1 hour and often below 100 or 90, and by 3 or 4 hours by blood sugar is often in the 60s or 70s. So I really dont think taking a long-acting insulin or metformin makes sense, given that Im already running on the low end. Im honestly scared of going hypoglycemic at night.
Anyways, , or anyone else who has knows a lot about how exercise affects blood sugar, Im wondering what is the optimal time to do exercise in the day so that my body is ferrying glycogen into my muscles overnight, thereby reducing my fasting blood sugar?
I am not concerned about my BGs in the immediate aftermath of the exercise as Im not struggling with numbers throughout the day. I just want to keep the fasting numbers in range.
Im wondering what is the optimal time to do exercise in the day so that my body is ferrying glycogen into my muscles overnight, thereby reducing my fasting blood sugar?
There are a lot of interesting things to look at!
OMG, thats the worst definition ever!
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Myth #: The Glucola/glucose Test Is Fail Safe: If You Pass The Glucose Test You Can Eat Whatever You Want
Theres a lot of black and white thinking when it comes to gestational diabetes. You might think that as long as you pass your GD screening test you are fine and can eat whatever you want. On the other hand, if you fail, suddenly the sky is falling! Now youre high risk, will have to be on insulin, will have a large baby that will get stuck during delivery, and then youll be induced or need a C-section, etc, etc.
And full disclosure I entirely understand these fears, especially that your birthing options could be limited because of a label. If your healthcare providers fall into this fear-based thinking and have never seen gestational diabetes well-managed, they dont always understand that there can be another way and they immediately go to worst case scenario.
Its important to understand that blood sugar is on a continuum and the relative risk of complications relies on your blood sugar levels, not a label!
Plus, the glucose tolerance test is not perfect. Some women with an elevated first trimester A1c, indicating prediabetes, will pass the glucola despite clear blood sugar problems .
Others will fail the glucola despite normal blood sugar metabolism, but as a result of eating a healthy, lower-carb diet . I described the pros and cons of different testing methods in this post .
Key Messages For Women With Diabetes Who Are Pregnant Or Planning A Pregnancy
- The key to a healthy pregnancy for a woman with diabetes is keeping blood glucose levels in the target rangeboth before she is pregnant and during her pregnancy.
- Poorly controlled diabetes in a pregnant woman with type 1 or type 2 diabetes increases her risk of miscarrying, having a baby born with a malformation and having a stillborn.
- Women with type 1 or type 2 diabetes should discuss pregnancy plans with their diabetes health-care team to:
- Review blood glucose targets
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Study Design And Participants
All laboratory parameters were measured according to the standard laboratory methods at our certified Department of Medical and Chemical Laboratory Diagnostics . Briefly, the plasma glucose level was measured by the hexokinase method with a coefficient of variation of 1.3%. The levels of insulin and C-peptide were measured by chemiluminescence immune assays with CVs of 4% to 7% and 3% to 4%, respectively. HbA1c was assessed by high performance liquid chromatography .
The study was approved by the Ethics Committee of the Medical University of Vienna and performed in accordance with the Declaration of Helsinki. All participants gave the written informed consent.
How Do You Keep Fasting Numbers Low
I was wondering what worked and didnt work, im still trying to get the hang of it, but i mostly get high numbers in the morning.
I either eat flavored almonds before bed or Fage 0% Greek Yogurt with some frozen mixed berries in it. my fasting will be in the 80’s every time with those two snacks.
I’ve just realized that I need to have a shorter fast rather than longer. My last pregnancy I needed 10 hrs to be in range but now am able to keep it in check with a shorter fast. I have a small glass of milk and a Greek yogurt. Sometimes I will add almonds or peanuts
I tried everything from no snacks to just protein snacks, and nothing worked. Exercise didnt help, so I was put on insulin.
I was very upset about this at first, but since the insulin Ive only had 2 high fasting numbers in 12 weeks!
I’m just not sure if I’m having the snack to early, too late, or if it’s what I’m eating. I don’t have this problem on weekends but I sleep for 9-10 hours whereas I’m up at 5am on weekdays.
Mine today was 120 :/ i have tried snack and no snack after dinner and i still haven’t been able to get good numbers. I just started the diet this week, could that have something to do with it or i should give up and accept the fact that i need medicine? My other numbers throughout the day are always really good.
I’m on my 11th day now and my fasting result has gone down to 84-92. After meals, I get 103-117.
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