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Last Updated on Tuesday, 16 February 2010 04:28 Written by Michael Cole Tuesday, 16 February 2010 04:23
Gestational diabetes is a condition characterized by high blood sugar (glucose) levels that is first recognized during pregnancy. The condition occurs in approximately 4% of all pregnancies. Almost all women have some degree of impaired glucose intolerance as a result of hormonal changes that occur during pregnancy. That means that their blood sugar may be higher than normal, but not high enough to have diabetes. During the later part of pregnancy (the third trimester), these hormonal changes place pregnant woman at risk for gestational diabetes. During pregnancy, increased levels of certain hormones made in the placenta (the organ that connects the baby by the umbilical cord to the uterus) help shift nutrients from the mother to the developing fetus. Other hormones are produced by the placenta to help prevent the mother from developing low blood sugar. They work by stopping the actions of insulin. Over the course of the pregnancy, these hormones lead to progressive impaired glucose intolerance (higher blood sugar levels). To try to decrease blood sugar levels, the body makes more insulin to get glucose into cells to be used for energy. Usually the mother's pancreas is able to produce more insulin (about three times the normal amount) to overcome the effect of the pregnancy hormones on blood sugar levels. If, however, the pancreas cannot produce enough insulin to overcome the effect of the increased hormones during pregnancy, blood sugar levels will rise, resulting in gestational diabetes. Diabetes can affect the developing baby throughout the pregnancy. In early pregnancy, a mother's diabetes can result in birth defects and an increased rate of miscarriage. Many of the birth defects that occur affect major organs such as the brain and heart. During the second and third trimester, a mother's diabetes can lead to over-nutrition and excess growth of the baby. Having a large baby increases risks during labor and delivery. For example, large babies often require caesarean deliveries and if he or she is delivered vaginally, they are at increased risk for trauma to their shoulder. In addition, when fetal over-nutrition occurs and hyperinsulinemia results, the baby's blood sugar can drop very low after birth, since it won't be receiving the high blood sugar from the mother. However, with proper treatment, you can deliver a healthy baby despite having diabetes. The following factors increase the risk of developing gestational diabetes during pregnancy: Many women who develop gestational diabetes have no known risk factors. Gestational diabetes is a condition characterized by high blood sugar (glucose) levels that is first recognized during pregnancy. The condition occurs in approximately 4% of all pregnancies. Almost all women have some degree of impaired glucose intolerance as a result of hormonal changes that occur during pregnancy. That means that their blood sugar may be higher than normal, but not high enough to have diabetes. During the later part of pregnancy (the third trimester), these hormonal changes place pregnant woman at risk for gestational diabetes. During pregnancy, increased levels of certain hormones made in the placenta (the organ that connects the baby by the umbilical cord to the uterus) help shift nutrients from the mother to the developing fetus. Other hormones are produced by the placenta to help prevent the mother from developing low blood sugar. They work by stopping the actions of insulin. Over the course of the pregnancy, these hormones lead to progressive impaired glucose intolerance (higher blood sugar levels). To try to decrease blood sugar levels, the body makes more insulin to get glucose into cells to be used for energy. Usually the mother's pancreas is able to produce more insulin (about three times the normal amount) to overcome the effect of the pregnancy hormones on blood sugar levels. If, however, the pancreas cannot produce enough insulin to overcome the effect of the increased hormones during pregnancy, blood sugar levels will rise, resulting in gestational diabetes. Diabetes can affect the developing baby throughout the pregnancy. In early pregnancy, a mother's diabetes can result in birth defects and an increased rate of miscarriage. Many of the birth defects that occur affect major organs such as the brain and heart. During the second and third trimester, a mother's diabetes can lead to over-nutrition and excess growth of the baby. Having a large baby increases risks during labor and delivery. For example, large babies often require caesarean deliveries and if he or she is delivered vaginally, they are at increased risk for trauma to their shoulder. In addition, when fetal over-nutrition occurs and hyperinsulinemia results, the baby's blood sugar can drop very low after birth, since it won't be receiving the high blood sugar from the mother. However, with proper treatment, you can deliver a healthy baby despite having diabetes. The following factors increase the risk of developing gestational diabetes during pregnancy: Many women who develop gestational diabetes have no known risk factors. High risk women should be screened for gestational diabetes as early as possible during their pregnancies. All other women will be screened between the 24th and 28th week of pregnancy. To screen for gestational diabetes, you will take a test called the oral glucose tolerance test. This test involves quickly drinking a sweetened liquid, which contains 50g of sugar. The body absorbs this sugar rapidly, causing blood sugar levels to rise within 30-60 minutes. A blood sample will be taken from a vein in your arm 1 hour after drinking the solution. The blood test measures how the sugar solution was metabolized (processed by the body). A blood sugar level greater than or equal to 140mg/dL is recognized as abnormal. If your results are abnormal based on the oral glucose tolerance test, another test will be given after fasting for several hours. In women at high risk of developing gestational diabetes, a normal screening test result is followed up with another screening test at 24-28 weeks for confirmation of the diagnosis. Learn more about diagnosing diabetes. Gestational diabetes is managed by: Testing your blood sugar at certain times of the day will help determine if your exercise and eating patterns are keeping your blood sugar levels in control, or if you need extra insulin to protect your developing baby. Your health care provider will ask you to maintain a daily food record and ask you to record your home sugar levels. Testing your blood sugar involves pricking your finger with a lancet device (a small, sharp needle), putting a drop of blood on a test strip, using a blood sugar meter to display your results, recording the results in a log book, and then disposing the lancet and strips properly (in a "sharps" container or a hard plastic container, such as a laundry detergent bottle). Bring your blood sugar readings with you to your doctor appointments so your doctor can evaluate how well your blood sugar levels are controlled and determine if changes need to be made to your treatment plan. Your health care provider will show you how to use a glucose meter. He or she can also tell you where to get a meter. You may be able to borrow it from your hospital, as many hospitals have loaner meter programs for women with gestational diabetes.The goal of monitoring is to keep your blood sugar as close to normal as possible. The ranges include: Time of Test Target Blood Sugar Reading Before breakfast plasma below 105; whole blood below 95 2 Hours After Meals plasma below 130; whole blood below 120 Insulin treatment is started if above levels are not maintained.What Causes Gestational Diabetes in Pregnancy?
What Are the Complications of Gestational Diabetes?
Who Is at Risk for Gestational Diabetes?
Pregnancy and Gestational Diabetes
What Causes Gestational Diabetes in Pregnancy?
What Are the Complications of Gestational Diabetes?
Who Is at Risk for Gestational Diabetes?
How Is Gestational Diabetes Diagnosed?
How Is Gestational Diabetes Managed?
How Do I Monitor My Blood Sugar Levels?
Based on your blood sugar monitoring results, your health care provider will tell you if you need to take insulin in the form of injections during pregnancy. Insulin is a hormone that controls blood sugar. If insulin is prescribed for you, you may be taught how to perform the insulin injection procedure. As your pregnancy progresses, the placenta will make more pregnancy hormones and larger doses of insulin may be needed to control your blood sugar. Your health care provider will adjust your insulin dosage based on your blood sugar log. When using insulin, a "low blood glucose reaction," or , can occur if you do not eat enough food, skip a meal, do not eat at the right time of day, or if you exercise more than usual.Symptoms of hypoglycemia include: Confusion Dizziness Feeling shaky Headaches Sudden hunger Sweating Weakness Hypoglycemia is a serious problem that needs to be treated right away. If you think you are having a low blood sugar reaction, check your blood sugar. If your blood sugar is less than 60 mg/dL (milligrams per deciliter), eat a sugar-containing food, such as 1/2 cup of orange or apple juice; 1 cup of skim milk; 4-6 pieces of hard candy (not sugar-free); 1/2 cup regular soft drink; or 1 tablespoon of honey, brown sugar, or corn syrup. Fifteen minutes after eating one of the foods listed above, check your blood sugar. If it is still less than 60 mg/dL, eat another one of the food choices above. If it is more than 45 minutes until your next meal, eat a bread and protein source to prevent another reaction.Record all low blood sugar reactions in your log book, including the date, time of day the reaction occurred andhow you treated it.How Will My Diet Change With Gestational Diabetes?If you have gestational diabetes, follow these diet tips: Eat three small meals and two or three snacks at regular times every day. Do not skip meals or snacks. Carbohydrates should be 40%-45% of the total calories with breakfast and a bedtime snack containing 15-30 grams of carbohydrates. If you have morning sickness, eat 1-2 servings of crackers, cereal, or pretzels before getting out of bed. Eat small, frequent meals throughout the day and avoid fatty, fried, and greasy foods. If you take insulin and have morning sickness, make sure you know how to treat low blood sugar. Choose foods high in fiber such as whole-grain breads, cereals, pasta, rice, fruits, and vegetables. All pregnant women should eat 20-35 grams of fiber a day. Fats should be less than 40% of calories with less than 10% consumed being from saturated fats. Drink at least 8 cups (or 64 ounces) of liquids per day. Make sure you are getting enough vitamins and minerals in your daily diet. Ask your health care provider about taking a prenatal vitamin and mineral supplement to meet the nutritional needs of your pregnancy Diabetes costs hinder economic growth PRESS RELEASE 5 December 2006 Cape Town, South Africa The global number of people living with diabetes will exceed 380 million by 2025, according to newly released data from the International Diabetes Federation (IDF). The majority, more than 300 million, will live in the developing world. Despite the fact that low andmiddle-income countries will bear the brunt of the forecast explosion, they account for less than 15% of global diabetes spending. In a press conference held today, the International Diabetes Federation warned that diabetes threatens to subvert the gains of global economic advancement If nothing is done to address this imbalance. The economic effects of diabetes go beyond the costs that economies need to invest in diagnosis, care and prevention. They include loss of life, disability, the impact on quality of life, the economic impact that the disease has on individuals with diabetes and their families as well as lost economic growth. The global diabetes epidemic is resulting in spiralling health costs. Data from the International Diabetes Federation show that it will cost at least USD232 billion to treat and prevent diabetes and its complications next year. By 2025, the cost is likely to exceed USD302.5 billion. Expressed in international dollars (ID), which correct for differences in purchasing power, the figure rises from a current ID286.1 billion to ID381.1 billion in 2025. More than 80% of expenditures for medical care for diabetes are made in the world’s richest countries. One country, the United States of America, home to about 8% of the world’s diabetic population, is responsible for more than 50%; Europe accounts for another 25%, while the remaining industrialized countries, such as Australia and Japan, account for most of the rest. According to Dr Jonathan Brown, Chair of the IDF Task Force on Health Economics, “investment in diabetes care and prevention is lowest in the countries where it is needed the most.” Very inexpensive, simple to use and highly effective diabetes treatments already exist, but are not widely used. Many would actually save total medical care costs, even in the poorest regions of the world. The costly and life-threatening effects of diabetes arise largely from its complications, especially heart disease, stroke, amputation and kidney failure. These can be prevented or long-delayed by inexpensive, off-patent pills to control blood sugar, blood pressure, and bad cholesterol; by low-dose aspirin to reduce heart disease risk by 25-30 percent; by stopping smoking, and by better diet and exercise. The most effective way to prevent diabetes is by losing weight and getting exercise. “When poverty andlack of sanitation drive families to low cost-per-calorie foods and packaged drinks, type 2 diabetes thrives,” said Dr Brown. Diabetes hits the poorest hardest In low- and middle-income countries, illness, injury and death are among the main causes of household impoverishment. In Latin America, for example, families pay 40-60% of diabetes care from their own pockets. In the poorest countries, people with diabetes and their families bear almost the whole cost of whatever medical care they can afford. In India, the poorest persons withdiabetes spend an average of 34% of their total income on private care. In the world’s poorest countries, not enough is spent to provide even the least expensive lifesaving diabetes drugs. IDF’s new estimates of national diabetes-care spending for 2007 include USD6 per person with diabetes in Burundi, USD10 in Tajikistan, USD78 in Guyana, and USD48 in Haiti. Some of these amounts could not cover the annual wholesale price of a generic oral agent capable of preventing acute, life-threatening high blood sugar. In the industrialized world many studies confirm the economic wisdom of diabetes treatment. Many treatments save money by preventing costly complications. Others save years of life at costs that wealthy nations can easily afford. ENDS The International Diabetes Federation (IDF) is an organization of over 190 member associations in more than 150 countries. Its mission is to promote diabetes care, prevention and a cure worldwide. IDF leads the campaign for a UN Resolution on diabetes. See www.unitefordiabetes.org. The Diabetes Atlas provides up-to-date estimates of diabetes prevalence and impaired glucose tolerance, and health expenditures for more than 200 countries for the years 2007 and 2025. See www.eatlas.idf.org/media for relevant graphics and background materials. For further information, contact Special Projects Manager Delice Gan ( This e-mail address is being protected from spambots. You need JavaScript enabled to view it ) +46-73-8002799 or +27-828-583496 or Dr Jonathan Brown, Chair of the IDF Task Force on Health Economics +1-5034734796.
