Low Blood Sugar Early Pregnancy

What Is Considered Low Blood Sugar During Pregnancy

Hypoglycemia can occur during pregnancywhen blood sugar levels drop below 70 mg/dl in those without diabetes but more often in diabetic women. Hypoglycemic episodes mainly occur from an imbalance of food intake, exercise and insulin maladjustments.

Maintaining optimal blood sugar is essential during pregnancy, as excessive levels can lead to gestational diabetes and its associated problems. In turn, low blood sugar can cause hypoglycemia and, if persistent, can cause further complications for both mother and fetus.

How Is Diabetes During Pregnancy Treated

Treatment will depend on your symptoms, your age, and your general health. It will also depend on how severe the condition is.

Treatment focuses on keeping blood glucose levels in the normal range, and may include:

• A careful diet with low amounts of carbohydrate foods and drinks

• Oral medicines for hypoglycemia

What Causes Gestational Diabetes Mellitus

Although the cause of GDM is not known, there are some theories as to why the condition occurs.

The placenta supplies a growing fetus with nutrients and water, and also produces a variety of hormones to maintain the pregnancy. Some of these hormones can have a blocking effect on insulin. This is called contra-insulin effect, which usually begins about 20 to 24 weeks into the pregnancy.

As the placenta grows, more of these hormones are produced, and the risk of insulin resistance becomes greater. Normally, the pancreas is able to make additional insulin to overcome insulin resistance, but when the production of insulin is not enough to overcome the effect of the placental hormones, gestational diabetes results.

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Work With Your Health Care Team

Regular visits with members of a health care team who are experts in diabetes and pregnancy will ensure that you and your baby get the best care. Your health care team may include

• a medical doctor who specializes in diabetes care, such as an endocrinologist or a diabetologist
• an obstetrician with experience treating women with diabetes
• a diabetes educator who can help you manage your diabetes
• a nurse practitioner who provides prenatal care during your pregnancy
• a registered dietitian to help with meal planning
• specialists who diagnose and treat diabetes-related problems, such as vision problems, kidney disease, and heart disease
• a social worker or psychologist to help you cope with stress, worry, and the extra demands of pregnancy

You are the most important member of the team. Your health care team can give you expert advice, but you are the one who must manage your diabetes every day.

What Do I Need To Know About Blood Glucose Testing Before And During Pregnancy

How often you check your blood glucose levels may change during pregnancy. You may need to check them more often than you do now. If you didnt need to check your blood glucose before pregnancy, you will probably need to start. Ask your health care team how often and at what times you should check your blood glucose levels. Your blood glucose targets will change during pregnancy. Your health care team also may want you to check your ketone levels if your blood glucose is too high.

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Management Of Diabetes In Pregnancy

Routine SMPG was recommended at least seven times daily every day during pregnancy and at 3:00 a.m. once a week. The patients registered their SMPG values in diabetes diaries, which were evaluated at each clinical visit. The values were not downloaded electronically from the glucose monitors. The diet and insulin dosage were adjusted accordingly. Continuous glucose monitoring systems were not generally available and were only used occasionally in a few of the patients.

The women were instructed to perform self-adjustments of insulin dosages between clinical visits based on the SMPG of the previous 3 days in order to maintain preprandial SMPG of 4.06.0 mmol/l, 1.5-h postprandial SMPG of 4.08.0 mmol/l, and prebedtime SMPG of 6.08.0 mmol/l. In case of symptoms of hypoglycemia and/or SMPG 3.0 mmol/l, oral carbohydrate intake was recommended. If a single premeal SMPG was 8.0 mmol/l, 12 extra units of fast-acting insulin was recommended. In case of SMPG 15.0 mmol/l, vomiting, and stomachache, urine ketones should be checked. They continued their usual insulin regimen, four to five injections daily or insulin pump treatment.

The women received oral and written information about expected changes in insulin dosage during pregnancy, including information about a suspected high risk of severe hypoglycemia at night between 10 and 16 weeks and the need for an increase in insulin dosage from week 20. A glucagon pen was prescribed.

What Is The Treatment For Gestational Diabetes Mellitus

Specific treatment for gestational diabetes will be determined by your doctor based on:

• Your age, overall health, and medical history

• Extent of the disease

• Your tolerance for specific medications, procedures, or therapies

• Expectations for the course of the disease

• Your opinion or preference

Treatment for gestational diabetes focuses on keeping blood glucose levels in the normal range. Treatment may include:

• Insulin injections

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Treatment For A Hypoglycaemic Attack

If you do experience the symptoms listed above, test your blood sugar if you can. This is because similar symptoms may also be caused by high blood sugar. If you cant test, assume that you are having a hypoglycaemic episode.

• Take 1015g of fast-acting carbohydrate. Dextrose tablets are ideal as they are easy to measure .
• If you dont have these, you can use a few sweets or a small glass of sugary drink .
• You could also use a small glass of pure fruit juice, though it does not work as quickly.
• Avoid chocolate or other fatty foods, as the sugar will be absorbed more slowly because of the fat content.

After that, eat a slower-release form of carbohydrate, such as a slice of bread or a piece of fruit, to keep your blood sugar up until the next meal.

As you recover, test your blood sugar regularly to check that your blood glucose is reaching the right levels for you. If you have a severe hypo, you have a greater risk of having another severe hypo for the next 24 hours.

Hypoglycaemia During Pregnancy For Women With Type 1 Diabetes

During the first trimester your blood glucose levels will already be changing. Around the time when most women find out they are pregnant , your blood glucose levels may be more unstable, so insulin doses may need to be changed at this time.

From around six to eight weeks, it is common to become more sensitive to insulin, which means the insulin you take works more effectively. This may continue until about 14 weeks into the pregnancy. During this time insulin doses may need to be reduced to avoid frequent and more severe hypoglycaemia .

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Target Blood Glucose Levels During Pregnancy

Recommended daily target blood glucose numbers for most pregnant women with diabetes are

• Before meals, at bedtime, and overnight: 90 or less
• 1 hour after eating: 130 to 140 or less
• 2 hours after eating: 120 or less3

Ask your doctor what targets are right for you. If you have type 1 diabetes, your targets may be higher so you dont develop low blood glucose, also called hypoglycemia.

What Are Possible Complications Of Diabetes During Pregnancy

Most complications happen in women who already have diabetes before they get pregnant. Possible complications include:

• Need for insulin injections more often

• Very low blood glucose levels, which can be life-threatening if untreated

• Ketoacidosis from high levels of blood glucose, which may also be life-threatening if untreated

Women with gestational diabetes are more likely to develop Type 2 diabetes in later life. They are also more likely to have gestational diabetes with another pregnancy. If you have gestational diabetes you should get tested a few months after your baby is born and every 3 years after that.

Possible complications for the baby include:

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How Can Diabetes Affect My Baby

A babys organs, such as the brain, heart, kidneys, and lungs, start forming during the first 8 weeks of pregnancy. High blood glucose levels can be harmful during this early stage and can increase the chance that your baby will have birth defects, such as heart defects or defects of the brain or spine.

High blood glucose levels during pregnancy can also increase the chance that your baby will be born too early, weigh too much, or have breathing problems or low blood glucose right after birth.

High blood glucose also can increase the chance that you will have a miscarriage or a stillborn baby.1 Stillborn means the baby dies in the womb during the second half of pregnancy.

How Gestational Diabetes Can Affect Your Pregnancy

Most women with gestational diabetes have otherwise normal pregnancies with healthy babies.

However, gestational diabetes can cause problems such as:

• your baby growing larger than usual this may lead to difficulties during the delivery and increases the likelihood of needing induced labour or a caesarean section
• polyhydramnios too much amniotic fluid in the womb, which can cause premature labour or problems at delivery
• premature birth giving birth before the 37th week of pregnancy
• pre-eclampsia a condition that causes high blood pressure during pregnancy and can lead to pregnancy complications if not treated
• your baby developing low blood sugar or yellowing of the skin and eyes after he or she is born, which may require treatment in hospital
• the loss of your baby though this is rare

Having gestational diabetes also means you’re at an increased risk of developing type 2 diabetes in the future.

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Who Is At Risk For Diabetes During Pregnancy

The risk factors for diabetes in pregnancy depend on the type of diabetes:

• Type 1 diabetes often occurs in children or young adults, but it can start at any age.

• Overweight women are more likely to have Type 2 diabetes.

• Overweight women are more likely to have gestational diabetes. Its also more common in women who have had gestational diabetes before. And its more common in women who have a family member with Type 2 diabetes. Women with twins or other multiples are also more likely to have it.

Tips For Women With Gestational Diabetes

Women who had gestational diabetes or who develop prediabetes can also learn more about the National Diabetes Prevention Program , CDC-recognized lifestyle change programs. To find a CDC-recognized lifestyle change class near you, or join one of the online programs.

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Diabetes In Pregnancy: Low Blood Sugar

How Can I Get Low Blood Sugar? You can get a low blood sugar if you… Delay a meal Skip a meal or snack Eat too little Take too much insulin Exercise more than usual Drink alcohol without eating or take 3 glucose tabs. Retest your blood sugar in 15 minutes – If your blood glucose has not increased at least 20 points, consume another 15 grams of carbohydrate. Repeat steps 2 and 3 until blood sugar is 70 or more . Continue to monitor how you feel and retest your blood sugar as indicated. The Following Foods Have About 15 Grams of Fast-Acting Carbohydrates: 3-4 glucose tablets 1 tube glucose gel 1/2 cup fruit juice 1/3 cup regular JELL-O® 1 tablespoon honey or sugar 1 tablespoon jam or jelly 1/2 cup regular soda 6 Life Savers® 4 Starbursts® 1 cup fat-free milkContinue reading > >

• Gestational Diabetes During Pregnancy

How Can I Prepare For Pregnancy If I Have Diabetes

If you have diabetes, keeping your blood glucose as close to normal as possible before and during your pregnancy is important to stay healthy and have a healthy baby. Getting checkups before and during pregnancy, following your diabetes meal plan, being physically active as your health care team advises, and taking diabetes medicines if you need to will help you manage your diabetes. Stopping smoking and taking vitamins as your doctor advises also can help you and your baby stay healthy.

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How Yo Get My Blood Sugar Down

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Will I Get Type 2 Diabetes

Because you had gestational diabetes, you have a greater chance of having type 2 diabetes. But it wonât definitely happen, and you can take action to prevent that.

Your blood sugar levels will likely return to normal about 6 weeks after childbirth. If it does, you should get follow-up tests every 3 years.

To lower your risk:

• Try to keep your weight in a healthy range. Not sure what that is? Ask your doctor.
• Eat a good diet that includes lots of vegetables, whole grains, fruits, and lean protein.
• Make exercise a habit.

If you plan to have another baby, keep in mind that you are more likely to get gestational diabetes again. Ask your doctor if there are any lifestyle changes that would help you avoid that.

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Who Is More Prone To Hypoglycemia

Pregnant women who are most prone to hypoglycemia in the following conditions:

• A pregnant woman is more prone to hypoglycemia during the end of the first trimester, especially between 8 and 16 weeks of pregnancy.
• If you frequently fall sick during pregnancy, it can lead to hypoglycemia.
• A history of low blood sugar or hypoglycemic attacks can also lead to hypoglycemia.

What Causes Hypoglycemia During Pregnancy

Hypoglycemia occurs when there is not enough food to balance insulins blood sugar lowering effect and having too much of the hormone insulin in the blood.

Hypoglycemia can occur in pregnant women who have preexisting type 1 or type 2 diabetes or in women who have gestational diabetes which is usually diagnosed during the second trimester of pregnancy. It rarely occurs in pregnant women without diabetes

If you are diabetic: A low blood sugar condition can happen while pregnant especially if you have developed gestational diabetes or already have diabetes before pregnancy.

Now you may ask how diabetes, i.e., a high sugar level, can be a cause of low blood sugar level problems!!

The medications you use to control gestational diabetes is the culprit here. If you are taking medicines like Insulin or a type of diabetes pill such as Glyburide, the production of insulin in the body increases. More Insulin hormone means more consumption of blood sugar which can lead to depletion of sugar in our bloodstream causing hypoglycemia.

This is one reason why those with gestational diabetics are more likely to get hypoglycemia.

Non-diabetic hypoglycemia: Any pregnant women can experience low blood sugar levels during pregnancy irrespective of whether they have being diagnosed with gestational diabetes or not.

You can also have low blood sugar during pregnancy

• If you delay or skip a meal

• Rapid heartbeat
• Clumsy or jerky movements

How can Hypoglycemia affect the growing fetus?

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What Causes Diabetes During Pregnancy

Some women have diabetes before they get pregnant. This is called pregestational diabetes. Other women may get a type of diabetes that only happens in pregnancy. This is called gestational diabetes. Pregnancy can change how a woman’s body uses glucose. This can make diabetes worse, or lead to gestational diabetes.

During pregnancy, an organ called the placenta gives a growing baby nutrients and oxygen. The placenta also makes hormones. In late pregnancy, the hormones estrogen, cortisol, and human placental lactogen can block insulin. When insulin is blocked, its called insulin resistance. Glucose can’t go into the bodys cells. The glucose stays in the blood and makes the blood sugar levels go up.