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Blood sugar control during pregnancy

Blood sugar control during pregnancy

Blood pressure Tips for stress management — Blood pressure may suar elevated durijg pregnancy and should Blood sugar control during pregnancy measured at every appointment. Blickstein Bloof, Perlman S, Hazan Y, Shinwell ES. This can make diabetes worse, or lead to gestational diabetes. CDC is not responsible for Section compliance accessibility on other federal or private website. These articles are best for patients who want in-depth information and are comfortable with some medical jargon.


Blood Sugar Levels During Pregnancy

Blood sugar control during pregnancy -

Insulin is the most common medicine for treating gestational diabetes. You must give insulin by injection because it does not work when it is taken by mouth. Most pregnant people start by giving one to two shots of insulin per day. If your blood sugar levels are high after eating, you may need to give yourself a shot three or four times per day.

Instructions for drawing up and giving insulin shots are available separately. See "Patient education: Type 2 diabetes: Insulin treatment Beyond the Basics ". If you take insulin, you should check your blood sugar level at least four times per day.

You also need to write down your results or store them in the meter and how much insulin you took and review these records at each prenatal visit or more frequently based on your doctor's recommendation figure 1. Keeping accurate records helps to adjust insulin doses and can decrease the risk of complications.

The bedtime snack is especially important to help keep your fasting first blood sugar of the day before eating in range. Oral diabetes medicines, such as those taken by people with type 2 diabetes, are sometimes used during pregnancy in the United States.

We prefer insulin therapy for pregnant patients with diabetes who cannot control blood glucose levels adequately by their diet nutritional therapy. Insulin is effective and safe and does not cross the placenta to the fetus.

Most oral diabetes medicines pass from the pregnant individual to their baby through the placenta; while they have not been shown to harm the fetus or newborn, it is not known if there are longer term effects on children.

There are studies underway to help answer this question. However, oral anti-hyperglycemic agents are a reasonable alternative for individuals who will not take, or are unable to comply with, insulin therapy, as long as they understand the lack of information on long-term risks or benefits.

Prenatal visits — Most pregnant individuals who develop gestational diabetes have more frequent prenatal visits eg, once every week or two , especially if insulin is used.

The purpose of these visits is to monitor your and your baby's health, discuss your diet, review your blood sugars, and adjust your dose of insulin if you are taking it to keep your blood sugar levels near normal. It is common to change the dose of insulin as the pregnancy progresses.

You may also be asked to have one or two ultrasound examinations to check on the growth and size of the baby. See "Gestational diabetes mellitus: Obstetric issues and management".

Nonstress testing — You may need tests to monitor the health of the baby during the later stages of pregnancy, especially if your blood sugars have been high, you are using insulin, or if you have any pregnancy-related complications eg, high blood pressure. The most commonly used test is the nonstress test.

This test is discussed in a separate topic review. See "Patient education: Postterm pregnancy Beyond the Basics ".

If your blood sugar levels are close to normal during pregnancy and you have no other complications, the ideal time to give birth is between 39 and 40 weeks of pregnancy, no later than your due date.

If you do not give birth by your due date, you may be offered induction of labor or additional testing to monitor your and your baby's health.

In most individuals with gestational diabetes and a normal-size baby, there are no advantages to a cesarean over a vaginal birth, although cesarean may be needed in any pregnancy, especially with a first baby.

Those with a very large baby may be offered cesarean birth before labor starts. The risks and benefits of cesarean birth are discussed separately.

See "Patient education: C-section cesarean delivery Beyond the Basics ". Your blood sugar levels will be monitored during labor. Most individuals have normal blood sugar levels during labor and do not need any insulin. Insulin is given if your blood sugar level becomes high.

High blood sugar levels during labor can cause problems in the baby, both before and after delivery. See "Pregestational preexisting and gestational diabetes: Intrapartum and postpartum glucose management".

After giving birth, most individuals with gestational diabetes have normal blood sugar levels and do not require further treatment with insulin. You can return to your prepregnancy diet, and you are encouraged to breastfeed.

See "Patient education: Deciding to breastfeed Beyond the Basics ". However, your doctor may check your blood sugar level the day after delivery to be sure that it is normal or near normal. Pregnancy itself does not increase the risk of developing type 2 diabetes. However, having gestational diabetes does increase your risk of developing type 2 diabetes later in life.

After you deliver, you should have testing for type 2 diabetes. Typically, this is done between 4 and 12 weeks postpartum, ideally prior to your postpartum check-up. But it may be done in the hospital before you are discharged.

Testing usually includes a two-hour glucose tolerance test GTT so that you are tested for both pre-diabetes and diabetes. Risk of recurrent gestational diabetes — One-third to two-thirds of individuals who have gestational diabetes in one pregnancy will have it again in a later pregnancy.

If you are overweight or obese, weight reduction through diet and exercise can reduce this risk. Risk of developing type 2 diabetes — Individuals with gestational diabetes have an increased risk of developing type 2 diabetes later in life, especially if they have other risk factors eg, family history of type 2 diabetes.

The risk of developing type 2 diabetes is greatly affected by body weight. Individuals with obesity have a 50 to 75 percent risk of developing type 2 diabetes, while this risk is less-than percent in those who are a normal weight. If you are overweight or obese, you can reduce your risk of type 2 diabetes by losing weight and exercising regularly.

The American Diabetes Association ADA recommends that all persons with a history of gestational diabetes have testing for type 2 diabetes every one to three years after their initial post-pregnancy test for diabetes.

If you have elevations in your blood sugars in the pre-diabetes range at the time of your postpartum screening, the ADA recommends testing yearly testing. It is also recommended that you work with your primary care provider to eat a healthy diet, lose any excess weight, and exercise regularly to help decrease your risk of developing type 2 diabetes.

Cardiovascular disease — Individuals who have had gestational diabetes in the past are at increased risk of developing cardiovascular disease, including heart attack and stroke. While this is mostly tied to the risk of type 2 diabetes see above , even those who do not develop type 2 diabetes appear to have a small increase in their risk of heart disease later in life.

Continuing to make healthy lifestyle choices such as eating a balanced diet, exercising regularly, and avoiding smoking can help minimize this risk. See "Patient education: Diet and health The Basics ". Birth control — Individuals with a history of gestational diabetes can use any type of birth control after pregnancy.

A review of all of the birth control options is available separately. See "Patient education: Birth control; which method is right for me? Beyond the Basics ".

Your health care provider is the best source of information for questions and concerns related to your medical problem. This article will be updated as needed on our web site www.

Related topics for patients, as well as selected articles written for health care professionals, are also available. Some of the most relevant are listed below. Patient level information — UpToDate offers two types of patient education materials.

High blood glucose also can increase the chance that you will have a miscarriage or a stillborn baby. Hormonal and other changes in your body during pregnancy affect your blood glucose levels, so you might need to change how you manage your diabetes.

If you have been taking an oral diabetes medicine, you may need to switch to insulin. As you get closer to your due date, your management plan might change again. Pregnancy can worsen certain long-term diabetes problems, such as eye problems and kidney disease , especially if your blood glucose levels are too high.

You also have a greater chance of developing preeclampsia, sometimes called toxemia, which is when you develop high blood pressure and too much protein in your urine during the second half of pregnancy. Preeclampsia can cause serious or life-threatening problems for you and your baby.

The only cure for preeclampsia is to give birth. If you have preeclampsia and have reached 37 weeks of pregnancy, your doctor may want to deliver your baby early.

Before 37 weeks, you and your doctor may consider other options to help your baby develop as much as possible before he or she is born. If you have diabetes, keeping your blood glucose as close to normal as possible before and during your pregnancy is important to stay healthy and have a healthy baby.

Getting checkups before and during pregnancy, following your diabetes meal plan, being physically active as your health care team advises, and taking diabetes medicines if you need to will help you manage your diabetes.

Stopping smoking and taking vitamins as your doctor advises also can help you and your baby stay healthy. Regular visits with members of a health care team who are experts in diabetes and pregnancy will ensure that you and your baby get the best care.

Your health care team may include. You are the most important member of the team. Your health care team can give you expert advice, but you are the one who must manage your diabetes every day.

Have a complete checkup before you get pregnant or as soon as you know you are pregnant. Your doctor should check for. Pregnancy can make some diabetes health problems worse.

To help prevent this, your health care team may recommend adjusting your treatment before you get pregnant. Smoking can increase your chance of having a stillborn baby or a baby born too early. Smoking can increase diabetes-related health problems such as eye disease, heart disease, and kidney disease.

If you smoke or use other tobacco products, stop. You can start by calling the national quitline at QUITNOW or For tips on quitting, go to Smokefree.

Your dietitian can help you learn what to eat, how much to eat, and when to eat to reach or stay at a healthy weight before you get pregnant. Together, you and your dietitian will create a meal plan to fit your needs, schedule, food preferences, medical conditions, medicines, and physical activity routine.

During pregnancy, some women need to make changes in their meal plan, such as adding extra calories, protein, and other nutrients.

You will need to see your dietitian every few months during pregnancy as your dietary needs change. Physical activity can help you reach your target blood glucose numbers. Being physically active can also help keep your blood pressure and cholesterol levels in a healthy range, relieve stress, strengthen your heart and bones, improve muscle strength, and keep your joints flexible.

Before getting pregnant, make physical activity a regular part of your life. Aim for 30 minutes of activity 5 days of the week. Read tips on how to eat better and be more active while you are pregnant and after your baby is born. When you drink, the alcohol also affects your baby.

Alcohol can lead to serious, lifelong health problems for your baby. Management of diabetes in pregnancy: standards of care in diabetes Diabetes Care. Landon MB, Catalano PM, Gabbe SG. Diabetes mellitus complicating pregnancy. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds.

Gabbe's Obstetrics: Normal and Problem Pregnancies. Updated by: John D. Jacobson, MD, Professor Emeritus, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA.

Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A. Editorial team.

Gestational diabetes diet. In general, you should eat: Plenty of whole fruits and vegetables Moderate amounts of lean proteins and healthy fats Moderate amounts of whole grains, such as bread, cereal, pasta, and rice, plus starchy vegetables, such as corn and peas Fewer foods that have a lot of sugar, such as soft drinks, fruit juices, and pastries You should eat three small- to moderate-sized meals and one or more snacks each day.

Most carbohydrates are found in starchy or sugary foods. They include bread, rice, pasta, cereal, potatoes, peas, corn, fruit, fruit juice, milk, yogurt, cookies, candy, soda, and other sweets. High-fiber, whole-grain carbohydrates are healthy choices. These types of carbohydrates are called complex carbohydrates.

Try to avoid eating simple carbohydrates, such as potatoes, french-fries, white rice, candy, soda, and other sweets. This is because they cause your blood sugar to rise quickly after you eat such foods. Vegetables are good for your health and your blood sugar.

Enjoy lots of them. Carbohydrates in food are measured in grams. You can learn to count the amount of carbohydrates in the foods that you eat. They include: Whole-grain breads and crackers Whole grain cereals Whole grains, such as barley or oats Beans Brown or wild rice Whole-wheat pasta Starchy vegetables, such as corn and peas Use whole-wheat or other whole-grain flours in cooking and baking.

They have more fiber. Citrus fruits, such as oranges, grapefruits, and tangerines. Fruit juices without added sugar. Fresh fruits and juices.

They are more nutritious than frozen or canned varieties. MILK AND DAIRY Eat 4 servings of low-fat or nonfat dairy products a day.

Blood sugar control during pregnancy is important Boood your health Boood the health of your baby. Blood sugar control during pregnancy following tips will help you control Salvadoran coffee beans blood sugar levels during pregnancy. Durijg in food turn into Blood sugar control during pregnancy also called glucose when digested. Glucose is important for you and your baby, but too much glucose in your blood can lead to problems. It is important to eat the right amount of carbohydrate and to choose healthy foods. Carbohydrates are found in starches, fruits, vegetables, milk and yogurt so these food portions should be measured. Sweets and desserts should be avoided as they may lead to high blood sugar levels. Blood sugar control during pregnancy

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