Pregnancy and Gestational Diabetes (cont.)

The following factors increase the risk of developing gestational diabetes during pregnancy:

  • Being overweight prior to becoming pregnant (if you are 20% or more over your ideal body weight).
  • Being a member of a high risk ethnic group (Hispanic, Black, Native American, or Asian).
  • Having sugar in your urine.
  • Impaired glucose tolerance or impaired fasting 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 pounds.
  • Previously giving birth to a stillborn baby.
  • Having gestational diabetes with a previous pregnancy.
  • Having too much amniotic fluid (a condition called polyhydramnios).

Many women who develop gestational diabetes have no known risk factors.

How Is Gestational Diabetes Diagnosed?

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.

How Is Gestational Diabetes Managed?

Gestational diabetes is managed by:

  • Monitoring blood sugar levels four times per day - before breakfast and 2 hours after meals. Monitoring blood sugar before all meals may also become necessary.)
  • Monitoring urine for ketones, an acid that indicates your diabetes is not under control.
  • Following specific dietary guidelines as instructed by your doctor. You'll be asked to distribute your calories evenly throughout the day. the day.
  • Exercising after obtaining your health care provider's permission.
  • Monitoring your weight gain.
  • Taking insulin, if necessary. Insulin is currently the only diabetes medication used during pregnancy.
  • Controlling high blood pressure.

How Do I Monitor My Blood Sugar Levels?

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 medical appointments so your health care provider 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:

Monitoring Blood Glucose
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 is started if above levels are not maintained.

Do I Need to Take Insulin for Gestational Diabetes?

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 hypoglycemia, 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.

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