Diabetes in Pregnancy

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Diabetes in Pregnancy

Transcript of Diabetes in Pregnancy

Page 1: Diabetes in Pregnancy

Diabetes in

Pregnancy

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Diabetes in PregnancyDiabetes is a condition in which the amount of glucose in the blood is too high (hyperglycemia) as a result of limited or no insulin production.

About (2 to 10 %) of pregnant get gestational diabetes.

The ideal range of glucose for pregnant should be: - 70 to 100 mg/dL before meals. - Less than 120 mg/dL two hours after eating.

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On Mother:• Eye and kidneys problems.• Difficult labor and cesarean delivery due to large baby.• Having a miscarriage (The end of pregnancy before the

24th week). • The gestational type; increase the mother risk for

developing type 2 diabetes later.

Diabetes Effects:

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On Baby: • Large baby over 4 kg (macrosomia).• Fetus congenital abnormalities (specially heart and nervous

system abnormalities).• Stillbirth baby or dying soon after birth.• The baby become at risk for obesity and type 2 diabetes later in

life.• Low blood sugar (hypoglycemia). • Newborn with health problems shortly after birth (such as heart

and breathing problems) and needing hospital care.• Asphyxia (Lack of oxygen in the body).• Polycythemia (Elevation in red blood cell count).• Birth injury related to macrosomia.

Diabetes Effects:

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Large weight newborn (right)Comparing to normal newborn (left)

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1. Type 1 diabetes2. Type 2 diabetes

3. Gestational diabetes.

Classification

Pre-gestational diabetes

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• Type 1 diabetes develops when the body can't produce any insulin.

• It usually begins in childhood, and most women with type 1 diabetes will be aware of their condition before they become pregnant.

• People with type 1 diabetes need to take insulin to control their blood glucose.

1 -Type 1 diabetes:

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• Type 2 diabetes develops when the body can't produce enough insulin, or when the insulin that is produced doesn't work properly.

• It often occurs in obesity people and is usually diagnosed in women aged 40 or over. But it can happen at a younger age, too.

2 -Type 2 diabetes:

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Type 1 diabetes controlled by insulin.

Type 2 diabetes can usually be treated with:• Sugar tablets to lower blood glucose • Well planned diet• Regular exercising • Some pregnant women require insulin injections.

Pre-gestational Diabetes Management:

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• Gestational diabetes only occurs in pregnancy and goes away after the baby is born.

• It can occur at any stage of pregnancy, but is more common in the second 20 weeks.

• It occurs when the pregnant body can't produce enough extra insulin to meet the extra needs of pregnancy.

• Gestational diabetes usually has no symptoms.

3 -Gestational diabetes mellitus (GDM):

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• Overweight mother• Family history of diabetes• Woman who had given birth to a large baby, weighing more

than 4.5kg before.• Woman who had gestational diabetes before• Ethnic group of diabetes; (South Asian, black Caribbean,

Hispanic or African)• Woman who had unexplained stillbirth• Over 35 years mother• Mother with high blood pressure.

Risk factor of Gestational Diabetes

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• The diabetes screening and tests are ideal in second trimester.

• It is important because symptoms of gestational diabetes are uncommon.

• Women with high risk should start the tests earlier in first trimester.

• If the blood screen is abnormal; we do (glucose tolerance test) between 24 and 28 weeks of pregnancy to check for gestational diabetes.

Gestational Diabetes Screening

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A normal result for the glucose screening test is a blood sugar that is ≤140mg/dL 1 hour after drinking the glucose solution. If the result is not normal; we do Oral Glucose Tolerance Test (OGTT):

1. Do the test first before the pregnant eat or take any thing.2. Give a pregnant a liquid that contains (100 gram) of

glucose.3. Test the blood after 1 hour, then 2 hours, then 3 hours.4. If more than 1 of the blood glucose results is higher than

normal, this mean the pregnant have gestational diabetes.

Glucose Tolerance Test (GTT)

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Abnormal reading Interval95 mg/dl or higher Fasting (for 8 hours)

180 mg/dl or higher 1 hour155 mg/dl or higher 2 hours140 mg/dl or higher 3 hours

Abnormal blood values for 100 gram oral glucose tolerance test (OGTT)

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Often gestational diabetes can be controlled through:• Eating a healthy diet:

− Reduce sugar, salt, fat, simple carbohydrate− Increase fibers, minerals, vitamins, omega 3

• Exercising regularly.• Insulin injection and diabetes pills (Glyburide and

Metformin) in some cases

Gestational Diabetes Management:

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• Most women with gestational diabetes; the diabetes goes away soon after delivery. If it does not go; that is mean the mother developed diabetes type 2.

• All women with diabetes in pregnancy should be offered an appointment with a doctor at the postnatal check, around six weeks after the baby is born.