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-   -   Diabetes in Pregnancy (https://www.diabetesforum.com/gestational-diabetes/634-diabetes-pregnancy.html)

brettruben 11-07-2008 05:16

Diabetes in Pregnancy
 
Diabetes in pregnancy is classified into two types- Overt Diabetes which is seen in women who are diabetic even before the onset of pregnancy and Gestational Diabetes in which diabetes is detected in the course of pregnancy.

The insulin requirements during pregnancy increases alot because of very large increase in insulin antagonising hormones like Human placental lactogen, progesterone and cortisol. It is also increased because of the production enzymes like placental insulinase by the placenta which increases the degradation of insulin. The patient should be watched carefully otherwise it may lead to ketosis. Good medical and obstetric care throughout pregnancy results in favourable outcome. However the following complications may occur.

There is an increased risk of abortion among patients with uncontrollable diabetes. Fetal malformations and preterm delivery is a risk factor among overt diabetics. Moreover diabetic women may develop pregnancy induced hypertension and urinary tract infection. There is a chance of developing Hydramnios among uncontrollable diabetic women which may be due to large placenta, fetal malformation, etc.

Gestational diabetes can be diognised by undergoing screening test for diabetes which should be performed between 24 and 28 weeks of pregnancy. If the test is found to be positive then they should undergo Glucose Tolerance Test. Risk factors for screening for gestational diabetes include- Maternal obesity (120% increase in the body weight when compared to ideal weight), previous large baby (above 4kh), previous unexplained still births, previous abnormal glucose tolerance test, Hydramnios or macrosomia in the present pregnancy.

Because of the risk of sudden intra-uterine death in the third trimester, diabetic women have traditionally been delivered at 36-38 weeks either by caesarian section or by vaginal delivery following induction. Today improved metabolic control makes later delivery possible and most are now delivered between 38 and 39 weeks gestation.

NOTE- Good antenatal care and intervetion at the appropriate time will improve the outcome.

Prenatal counselling and proper guidance will decrease the incidence of fetal malformations and fetal loss.:)

herzelgarcia72 04-21-2009 03:10

Quote:

Originally Posted by brettruben (Post 2177)
Diabetes in pregnancy is classified into two types- Overt Diabetes which is seen in women who are diabetic even before the onset of pregnancy and Gestational Diabetes in which diabetes is detected in the course of pregnancy.

The insulin requirements during pregnancy increases alot because of very large increase in insulin antagonising hormones like Human placental lactogen, progesterone and cortisol. It is also increased because of the production enzymes like placental insulinase by the placenta which increases the degradation of insulin. The patient should be watched carefully otherwise it may lead to ketosis. Good medical and obstetric care throughout pregnancy results in favourable outcome. However the following complications may occur.

There is an increased risk of abortion among patients with uncontrollable diabetes. Fetal malformations and preterm delivery is a risk factor among overt diabetics. Moreover diabetic women may develop pregnancy induced hypertension and urinary tract infection. There is a chance of developing Hydramnios among uncontrollable diabetic women which may be due to large placenta, fetal malformation, etc.

Gestational diabetes can be diognised by undergoing screening test for diabetes which should be performed between 24 and 28 weeks of pregnancy. If the test is found to be positive then they should undergo Glucose Tolerance Test. Risk factors for screening for gestational diabetes include- Maternal obesity (120% increase in the body weight when compared to ideal weight), previous large baby (above 4kh), previous unexplained still births, previous abnormal glucose tolerance test, Hydramnios or macrosomia in the present pregnancy.

Because of the risk of sudden intra-uterine death in the third trimester, diabetic women have traditionally been delivered at 36-38 weeks either by caesarian section or by vaginal delivery following induction. Today improved metabolic control makes later delivery possible and most are now delivered between 38 and 39 weeks gestation.

NOTE- Good antenatal care and intervetion at the appropriate time will improve the outcome.

Prenatal counselling and proper guidance will decrease the incidence of fetal malformations and fetal loss.:)



Thanks for your knowledge on Brett. Im on first date of my pregnancy and I'm to regular dosage of insulin. I found your article very resourceful.

sasko petrov 06-03-2009 17:55

my wife is pregnant and we whent to a doctor with the test result and the doctor
said that we should make another one sow we can be sure of the test results
glicose-6.3
and it's in the average but we are scared what we should do?
please advice as sow we can proceed
my wife is pregnant in the 24 week of pregnancy
thanks man
regards

Terrie 06-04-2009 10:16

Hello: :)

I'm Happy that you are in a Dr's Good care. If another test is required as he suggests, then it would be a Good idea to repeat it.
Congratulations!

sasko petrov 06-04-2009 11:21

glicose level 10
 
Quote:

Originally Posted by Terrie (Post 5106)
Hello: :)

I'm Happy that you are in a Dr's Good care. If another test is required as he suggests, then it would be a Good idea to repeat it.
Congratulations!

we made another test with glicose and the level is 10 sow we are a bit scared about my wife and baby
the reason is that it could make some trouble or ?
and suggestion will be welcomed
10x regards

Terrie 06-04-2009 13:39

Hello Sasko: :)

Please try not to panic. I realize that it is not easy but Your Wife needs to feel as calm as possible. Feeling stressed raises most Diabetics blood sugar. Hopefully she feels comfortable with her Dr.

Did your Wife's Dr. suggest that she start taking Insulin? That is what most Drs. here prescribe to help lower the Woman's blood sugar.

She should eat a balanced diet but with less starchy foods and preferrably no sugary foods. Exchanging some of the starchy foods with vegetables will help to lower her blood sugar. She could eat a fruit with a protein like a piece of cheese. Protein such as meat, eggs, cottage cheese, other cheeses, a tablespoon of peanutbutter, etc. does not raise the blood sugar much. Olive oil is a Good oil to use. Having about 45 grams of carbs per meal is Good and 15 grams of carbs per snack if she counts carbs.

Taking a daily walk or another easy exercise is healthy for Mom and Baby. She should have Folic Acid and other vitamins suggested by her Dr. Her daily intake of 6-8 glasses of water is important for a Diabetic.

sasko petrov 06-04-2009 14:11

we whent again to the doctor and we should have a 10 gramms glicosa test sow the doctor can make a better diagnose
sow we hope it will be better for bouth of them
thanks for you'r reply
chat with you on monday when we see the results
regards and have a nice weekend

sasko petrov 06-04-2009 22:59

does if everuthing goes well "can the wife become a diabetic" or?
we are worry sow please tell us sow we can proceed with some tretmant in time
thanks

Terrie 06-05-2009 19:01

No one can say for sure since various risk factors may be involved with different Families and pregnancies. If she has Gestational Diabetes(becoming Diabetic while pregnant)she will most likely not be a Diabetic after she gives birth.

If she becomes pregnant with a second Child then the Diabetes may not disappear after the second Baby is born. Also within 10 years, the Woman will probably become a Diabetic again and this time it will not leave. This happens in most cases but not all cases.

The Best thing to do is to eat healthy and get some exercise daily. We cannot tell you what treatment that she should take since we are not her Dr. or medical professionals.

Thank you. Please enjoy your week-end.

Sevdeto 08-03-2009 19:45

hello,
Can someone tell me something about pregnancy and diabet complications.I know that the pregnancy has to be planned.


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