diabetes check during pregnancy Dr Mindy Sotsky, an endocrinologist with Westchester Health, shares important information about type 1 and type 2 diabetes, risk factors and ...credibility of research of characteristics of smokers with type 2 diabetes
the 1 last update 08 Jul 2020
This next section is for women who wish to become pregnant, or are already pregnant, and are living with type 1 or type 2 diabetes.
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Planning with your doctor before you become pregnant is vital. Speak to your doctor about your plans at least 3 months before trying to conceive. A team approach is used at our Centre, where you can see a nurse and dietitian at each preconception visit. With the support of a team, the right formula for your healthy pregnancy will be developed.
diabetes check during pregnancy beta cells (🔥 quality of life) | diabetes check during pregnancy ankle swellinghow to diabetes check during pregnancy for Most women do not know that they are pregnant until approximately 5-6 weeks into the pregnancy. During this time the fetus''s risk for birth defects. Rates of spontaneous abortion and stillbirth are similar to women without diabetes but rise in women whose diabetes is poorly controlled. For these reasons, it is best to start working on the following goals about 3 months before conception:
Along with the joys of pregnancy, come some challenges that can affect the woman with diabetes at various times throughout her pregnancy. The following is some helpful information as it relates to each trimester (approximately each three-month time period) of your pregnancy. You can also learn more about the stages of pregnancy in our Pregnancy Health Centre.
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Managing diabetes in the third trimester | The birth and afterwards | Breastfeeding
Much of what you will experience in the first trimester is common to all pregnant women whether they have diabetes or not.
During this stage the fetus is developing rapidly and all of the major organ systems are formed. Visit our Pregnancy Health Centre to learn about the changes that are happening at this time
Discomforts associated with pregnancy in the first trimester include morning sickness and heartburn
There are also some issues unique to women living with diabetes. Use the links below to explore these issues.
Nutrition in the First Trimester
The nutritional needs of the pregnant woman with diabetes are similar to the pregnant woman who does not have diabetes. With diabetes, how these nutritional needs are met should be discussed with a dietitian. Taking into account weight, weight gain, appetite and blood glucose results, a dietitian can develop individualized meal guidelines with you. The goal of these meal planning guidelines is to help you maintain healthy blood glucose levels while providing adequate nutrition to both you and your baby. Pregnant women are encouraged to eat smaller and more frequent meals. This usually means 3 meals and 3 snacks for the woman with diabetes. The amount of food varies from woman to woman depending on her rate of weight gain.
A focus on the carbohydrate content of each meal and snack is important because of the effect it has on blood glucose. Timing of meals and snacks that contain carbohydrate is important to reduce the risk of hypoglycemia, which is a common problem in the first trimester.
If you have a sweet tooth and like to use sugar substitutes, be aware that these should be used in moderation as they may satisfy your hunger but cause you to eat less-nutritious foods. For example, diet soft drinks have no nutritional value and are no substitute for a glass of milk. However, evidence suggests that aspartame (Nutrasweet), sucralose (Splenda) and acesulfame potassium (Sunnett) are safe to use during pregnancy. A registered dietitian can provide you with specific and personalized suggestions for healthy eating during your pregnancy.
Weight Issues and Morning Sickness
A weight gain of 2-8lbs (1-3kg) is normal during this trimester. The rate of weight gain is just as important as the total weight gain.
The baby''s blood glucose quickly. Your doctor or diabetes educator can teach a family member or friend how to give you glucagon and can explain follow-up procedures.
Some women find they need to decrease their insulin to prevent frequent low blood glucose (more than 2 lows/week). Family members should review the signs and symptoms of low blood glucose and its treatment.
Exercise Recommendations in the First Trimester
Exercise and activity levels may need adjustment to accommodate your pregnancy. Starting a vigorous exercise routine after you become pregnant is not recommended. If you were active before pregnancy, speak with your diabetes specialist and obstetrician about how much and when to exercise. Walking is preferred to running or high impact exercise as it does not interfere with oxygen flow to the baby nor does it have the same impact on blood pressure. Pregnant women with high blood glucose or diabetes complications, such as high blood pressure or blood vessel damage, should speak with their doctor before exercising.
Insulin Adjustment and Monitoring your Health
Placental hormones influence the amount of insulin needed in pregnancy. In the first trimester, you may be more sensitive to insulin and need less of it. A diabetes nurse educator can help you learn to self-adjust insulin in order to balance the amount of carbohydrate you eat, physical activity and the possible effects of stress on your blood glucose. During pregnancy, most women prefer the flexibility that four injections per day allow. If you are not already taking four daily injections, we recommend that you speak to your doctor about this option.
Monitoring your Blood Glucose and Urine Ketones
Frequent blood testing before and sometimes two hours after meals is recommended to help you and your diabetes care team make the appropriate adjustments to your insulin. In each trimester, check your meter result against a laboratory result to ensure your meter is reading accurately. There are many meters available that offer fast and accurate results. If your meter is 2-3 years old, it may be time to update it.
If your blood glucose is above 12mmol/L, test for ketones in your urine. Ketones are acids produced from fat breakdown, and in moderate to large amounts are the 1 last update 08 Jul 2020 unhealthy for your fetus. Ketones occur when there is not enough insulin in your system, during illness or with weight loss. If ketones are present, you may test either your urine or blood (using a special meter) every four hours and take fast-acting insulin according to your doctor'' gestation, you will begin to need more insulin. Continued blood glucose monitoring and insulin adjustments are necessary to prevent elevated blood glucose levels.If your blood glucose is above 12mmol/L, test for ketones in your urine. Ketones are acids produced from fat breakdown, and in moderate to large amounts are unhealthy for your fetus. Ketones occur when there is not enough insulin in your system, during illness or with weight loss. If ketones are present, you may test either your urine or blood (using a special meter) every four hours and take fast-acting insulin according to your doctor'' gestation, you will begin to need more insulin. Continued blood glucose monitoring and insulin adjustments are necessary to prevent elevated blood glucose levels.
An average weight gain of about 9lbs (4kg) is expected in this trimester.
Discomforts of the Second Trimester
Although morning sickness often ends by the second trimester, other discomforts may occur. Constipation is common in pregnancy because your intestinal muscles relax.
Drinking plenty of water may help, but avoid fruit juices as these can raise blood glucose. For more information about relieving constipation and other discomforts of pregnancy visit our Pregnancy Health Centre.
You may prefer more frequent, small meals at this time. Again it is important to consult with a dietitian to ensure that you are obtaining adequate nutrition and eating a variety of foods that you enjoy.
Weight increases steadily at this stage. If your weight was at a healthy level prior to pregnancy, you can expect about 1/2 - 1 lb. (1/2 kg) weight gain weekly. If you suddenly gain a lot of weight or notice swelling, you should contact your doctor.
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During this last trimester the baby''s heart rate. All of these tests are done on an outpatient basis.
Daily assessment of the baby''s size, your blood glucose level, blood pressure and overall health. Labour is induced for the majority of women with diabetes around 38 weeks, at which time the baby is mature. Waiting until 40 weeks means that the baby grows larger and this can increase the likelihood of a caesarean section.
Insulin needs during the birth vary. You will be given insulin intravenously if you have type 1 diabetes. Some women with type 2 diabetes do not need insulin at this time. Often during active labour, no insulin is necessary for for 1 last update 08 Jul 2020 women with either type 1 or type 2 diabetes.Insulin needs during the birth vary. You will be given insulin intravenously if you have type 1 diabetes. Some women with type 2 diabetes do not need insulin at this time. Often during active labour, no insulin is necessary for women with either type 1 or type 2 diabetes.
After the birth, insulin is not usually restarted until blood glucose rises approximately above 10mmol/L. You and your doctor can determine this.
A caesarean section is more likely if your baby is large. However, about 50 percent of women with type 1 diabetes are able to give birth vaginally.
Once your baby is born, the baby''s blood glucose to normal. Your baby''s milk before 6 months of age may increase the risk of a child developing type 1 diabetes. This is just a theory and has not been proven, however the Canadian Pediatric Association recommends not giving your child cow''s certainly worth the effort to get back on track.
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