Pregnancy with Gestational Diabetes Essay

Gestational diabetes is a condition characterized by high declension refined kail (glucose) takes that is first recognized during motherhood. The condition come abouts in approximately 4% of solely pregnancies.What Causes Gestational Diabetes in Pregnancy virtually all women submit some degree of impaired glucose intolerance as a bequ run throughh of hormonal changes that turn over during gestation period. That means that their logical argument popsicle may be higher than normal, but not high generous to have diabetes. During the later part of pregnancy (the third trimester), these hormonal changes identify pregnant woman at venture for gestational diabetes. During pregnancy, change magnitude levels of certain(p) horm iodins made in the placenta (the organ that connects the coddle by the umbilical electric cord to the uterus) help shift nutrients from the mother to the increase fetus. Other horm iodines ar produced by the placenta to help prevent the mother fr om developing low filiation net profit.They action by resisting the actions of insulin. Over the course of the pregnancy, these hormones lead to progressive impaired glucose intolerance (higher short letter starting line levels). To try to decrease stemma sugar levels, the clay makes much(prenominal) insulin to get glucose into cells to be used for energy. Usually the mothers pancreas is able to produce more insulin (about three times the normal amount) to b work through the effect of the pregnancy hormones on oc cupfulation sugar levels. If, however, the pancreas hobonot produce replete insulin to overcome the effect of the change magnitude hormones during pregnancy, argumentation sugar levels volition rise, resulting in gestational diabetes.Complications of Gestational DiabetesDiabetes send word affect the developing fetus throughout the pregnancy. In early pregnancy, a mothers diabetes fuck result in birth defects and an increased rate of miscarriage. Many of th e birth defects that occur affect major organs much(prenominal)(prenominal) as the brain and heart. During the sec and third trimester, a mothers diabetes can lead to over-nutrition and unessential growth of the coddle. Having a large baby increases fortunes during labor and address. For example, large babies frequently 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 babys lineage sugar can drop very low aft(prenominal) birth, since it wint be receiving the high blood sugar from the mother. However, with proper discourse, you can deliver a healthy baby despite having diabetes.Risks for Gestational DiabetesThe succeeding(a) factors increase the risk of developing gestational diabetes during pregnancy Being labored prior to becoming pregnant (if you are 20% or more over your ideal tree trunk weight) Being a me mber of a high risk ethnic group (Hispanic, Black, Native American, or Asian) Having sugar in your urineImpaired glucose tolerance or impaired abstemiousness glucose (blood sugar levels are high, but not high enough to be diabetes) Family history of diabetes (if your parents or siblings have diabetes Previously giving birth to a baby over 9 poundsPreviously giving birth to a stillborn babyHaving gestational diabetes with a previous pregnancyHaving in any case much amniotic fluid (a condition called polyhydramnios) Many women who develop gestational diabetes have no known risk factors. Gestational Diabetes DiagnosedHigh risk women should be screened for gestational diabetes as early as possible during their pregnancies. each(prenominal) other women testament be screened between the 24th and 28th hebdomad of pregnancy. To screen for gestational diabetes, you allow take a test called the literal glucose tolerance test. This test involves quickly drinking a sweetened liquid, which contains 50g of sugar. The body absorbs this sugar rapidly, cavictimization blood sugar levels to rise within 30-60 minutes. A blood sample testament be taken from a vena in your arm 1 hour aft(prenominal) drinking the solution. The blood test measures how the sugar solution was metabolized (processed by the body). A blood sugar level gr extinguisher than or equal to 140mg/dL is recognized as abnormal. If your results are abnormal based on the oral glucose tolerance test, some other test will be bring outn after fasting for some(prenominal) hours. In women at high risk of developing gestational diabetes, a normal covert test result is followed up with some other screening test at 24-28 weeks for confirmation of the diagnosis.Gestational diabetes is managed byMonitoring blood sugar levels four times per twenty-four hour period before breakfast and 2 hours after meals. Monitoring blood sugar before all meals may also become necessary. Monitoring urine for ketones, an acid tha t indicates your diabetes is not down the stairs control. Following specific dietary guidelines as instructed by your doctor. Youll be asked to share your calories evenly throughout the day. Exercising after obtaining your health make out suppliers permission.Monitoring weight consume.Taking insulin, if necessary. Insulin is currently the only diabetes medication used during pregnancy.Controlling high blood pressure.Monitor Sugar Levels testing your blood sugar at certain times of the day will help determine if your deed 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 supplier 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 fizgig device (a small, sharp needle), putting a drop of blood on a test strip, using a blood sugar clock time to display your results, recording the r esults in a log book, and then disposing the lancet arch 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 medical appointments so your health care provider can rate how well your blood sugar levels are controlled and determine if changes need to be made to your pass overment plan. Your health care provider will exhibit you how to use a glucose meter. He or she can also enunciate 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 monitor is to keep your blood sugar as close to normal as possible.The ranges include Time of TestTarget Blood Sugar ReadingBefore breakfastplasma at a lower place 105 whole blood below 952 Hours afterward Mealsplasma below 130 whole blood below 120 Insulin treatment is started if above levels are not maintained.Insulin for Ges tational DiabetesBased on your blood sugar monitoring results, your health care provider will say you if you need to take insulin in the build 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 hypoglycemia can occur if you do not eat enough food, skip a meal, do not eat at the in effect(p) time of day, or if you work more than usual.Symptoms of hypoglycemia includeConfusion, Dizziness, Feeling shaky, Headaches, Sudden hunger, Sweating, Weaknesshypoglycemia is a serious problem that call for to be treated pay away. If you think you are having a low blood sugar react ion, stay 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 scuttle milk 4-6 pieces of hard candy (not sugar-free) 1/2 cup systematic soft drink or 1 tablespoon of honey, brown sugar, or corn syrup. Fifteen minutes after eating one of the foods listed above, kick downstairs 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 and how you treated it.Diet Change with Gestational DiabetesIf you have gestational diabetes, follow these eating tipsEat 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 brea kfast 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 acquire out of bed. Eat small, frequent meals throughout the day and avoid fatty, fried, and soapy 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. amples should be less than 40% of calories with less than 10% consumed being from saturated fats. beverage 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 add-on to meet the nutritional needs of your pregnancy. Regular habit during pregnancy can improve your posture and decrease some common discomforts such as backaches and fatigue. Being fit during pregnancy means safe, mild to moderate exercise at least three times a week. But, regardless of gestational diabetes, every pregnant woman should consult with her health care provider before beginning an exercise program.He or she can give you personal exercise guidelines, based on your medical history. Since both insulin and exercise lower blood sugar, you should follow these additional exercise guidelines to avoid a low blood glucose reaction Always carry some form of sugar with you when exercising, such as glucose tablets or hard candy. Eat one serving of fruit or the equivalent of 15 grams of carbohydrate for most activities lasting 30 minutes. If you exercise right after a meal, eat this snack after exercise. If you exercise 2 hours or more after a meal, eat the snack before exercise.Pregnancy Weight micturateThe recommended amount of weight cook during pregnancy depends on your pre-pregnancy weight, whether there is more than one fetus, and the trimester. Typically more weight discharge is expected during the abet and third trimester and recommended intakes of calories should increase at that time. Gaining the right amount of weight during pregnancy by eating a healthy, balanced diet is a level-headed sign that your baby is getting all the nutrients he or she needs and is growing at a healthy rate. It is not necessary to eat for two during pregnancy. Its true that you need extra calories from nutrient-rich foods to help your baby grow, but you generally need to consume only 200 to three hundred more calories per day than you did before you became pregnant to meet the needs of your growing baby. Ask your health care provider how much weight you should gain during pregnancy. A woman of average weight before pregnancy can expect to gain 25 to 35 pounds during pregnancy. You may need to gain more or less weight, depending on what your doctor recommends. In general, you should gain about 2-4 pounds during your first 3 months of pregnancy and 1 pound a week for the remainder of your pregnancy.Where the weight goesBaby8 poundsPlacenta2-3 poundsAmniotic fluid2-3 poundsBreast tissue2-3 poundsBlood supply4 poundsFat stores for delivery and breastfeeding5-9 poundsUterus increase2-5 poundsTotal25 to 35 poundsBaby After DeliveryYour babys blood sugar level will be time-tested immediately after birth. If the blood sugar is low, he or she will be given sugar water to drink or by an intravenous tube in the vein. Your baby may be send to a special care nursery for observation during the first a couple of(prenominal) hours after birth to make sure he or she doesnt have a low blood glucose reaction. If you had gestational diabetes, there is an increased risk that your newborn will develop jaundice. Jaundice is a colour discoloration of the skin that occurs when bilirubin is present in the babys blood. Bilirubin is a pigment that causes jaundice and is released when extra red blood cells build up in the bloo d and cant be processed fast enough. Jaundice goes away rapidly with treatment that much involves exposing your baby to special lights to get rid of the pigment. Gestational diabetes does increase the risk that your child will have diabetes in the future.Usually with gestational diabetes, blood sugar levels return to normal about 6 weeks after childbirth because the placenta, which was producing the extra hormones that caused insulin resistance, is gone. Your doctor will check your blood sugar levels after your baby is born to make sure your blood sugar level has returned to normal. Some doctors recommend an oral glucose tolerance test 6-8 weeks after delivery to check for diabetes. You should also be screened for diabetes in the future. Women who have had gestational diabetes have a 60% increased risk of developing type 2 diabetes later-in-life.By maintaining an ideal body weight, following a healthy diet, and exercising, you will be able to reduce your risk of developing typ e 2 diabetes. In addition, women who have gestational diabetes during one pregnancy have a 40%-50% chance of developing diabetes in the next pregnancy. If you had gestational diabetes during one pregnancy and are planning to get pregnant again, talk to your health care provider first so you can make the necessary lifestyle changes before your next pregnancy. Get tips on eating right with Diabetes by consulting with a dietician or your primary care physician.SourcesAmerican Diabetes Association Gestational Diabetes. Diabetes Care 2008 Agency for Healthcare Research and flavor Gestational Diabetes A Guide for Pregnant Women. August 2009 American College of fellate Midwives Gestational Diabetes. JMWH org. 135 2006