Diabetes mellitus is a condition that causes high levels of glucose in the blood. Health problems can arise when glucose levels are too high.
Diabetes is caused by a problem with insulin. Insulin moves glucose out of the blood and into the body's cells where it can be turned into energy. When the body does not make enough insulin or does not respond to it, glucose cannot get into cells and instead stays in the blood. High levels of glucose in the blood is called hyperglycemia. Over time, high blood glucose levels can damage the body and cause many problems, like heart disease, eye problems (including blindness), and kidney disease.
There are two types of diabetes: type 1 and type 2. In type 1 diabetes, the body makes little or no insulin on its own. Type 1 diabetes is treated with insulin. A healthy diet and regular exercise also help keep blood glucose levels under control.
In type 2 diabetes, insulin is produced, but the body does not respond to it. More insulin is produced to keep glucose levels normal. Major risk factors for type 2 diabetes are obesity and family history. Type 2 diabetes often can be managed with a program of weight loss, diet, and exercise to maintain an ideal body weight. Oral medication or insulin sometimes may be needed.
Pregestational diabetes mellitus is diabetes that was present before pregnancy. About 1 in 100 women have pregestational diabetes.
If a woman has medical conditions caused by her diabetes, pregnancy can make these conditions worse. Miscarriage and stillbirth are more common in pregnant women with diabetes. The risk of the following problems also is increased:
The risks of these problems can be decreased if a woman maintains her blood glucose levels in the normal range before and during pregnancy. For this reason, getting medical care to prepare for pregnancy is essential for a woman with diabetes.
Gestational diabetes is diabetes that occurs for the first time during pregnancy. Pregnancy changes the way insulin works. Some women develop gestational diabetes as a result of this change. Gestational diabetes is thought to affect 2-10% of all pregnancies.
Several risk factors are linked to gestational diabetes:
In women with gestational diabetes, high blood glucose levels during pregnancy increase the risk of having a very large baby and possible cesarean delivery. Preeclampsia also is more common in women with gestational diabetes.
Management of pregestational and gestational diabetes mellitus during pregnancy requires daily tracking of glucose levels, eating healthy foods, exercising regularly, and taking medication, if needed. Prenatal care also is important.
A glucose meter tests a small drop of blood. The drop of blood is placed on a strip of special paper. The glucose level then is read with the meter.
Women with pregestational diabetes who took insulin before pregnancy usually need to increase their insulin dosage while they are pregnant. The insulin dosage may need to be adjusted throughout pregnancy.
A woman with diabetes may need special tests in addition to routine health care. These tests can help your health care provider be aware of any problems and take steps to correct them. Some of the following tests may be done:
Most women with diabetes are able to have a vaginal birth but are more likely to have a cesarean delivery than women without diabetes. Labor also may be induced (started by drugs or other means) earlier than the due date if problems with the pregnancy arise.
After birth, most babies of women whose glucose is controlled do well. Some may need to spend time in a special care nursery. Problems can include
These problems can be treated soon after birth. If your glucose levels were controlled during your pregnancy, your baby is less likely to have problems after birth.
One third of women who had gestational diabetes during pregnancy have diabetes or a milder form called glucose intolerance after giving birth. Up to one half will develop type 2 diabetes later in life. If you had gestational diabetes, you should have a test for diabetes 6-12 weeks after you give birth. In addition, the American Diabetes Association recommends that women who have had gestational diabetes and who had a normal postpartum glucose test result be tested for diabetes every 3 years.
Amniotic Fluid:Water in the sac surrounding the fetus in the woman's uterus.
Biophysical Profile: An assessment by ultrasound of fetal breathing, fetal body movement, fetal muscle tone, and the amount of amniotic fluid. May include fetal heart rate. Sometimes the profile includes only the nonstress test and an estimate of the amount of amniotic fluid.
Cesarean Delivery: Delivery of a baby through an incision made in the mother's abdomen and uterus.
Insulin: A hormone that lowers the levels of glucose (sugar) in the blood.
Hydramnios: A condition in which there is an excess amount of amniotic fluid surrounding the fetus.
Miscarriage: Early pregnancy loss.
Obesity: A condition characterized by excessive body fat.
Placenta: Tissue that provides nourishment to and takes away waste from the fetus.
Polycystic Ovary Syndrome: A condition in which increased androgen levels occur and eggs are not released from the ovaries.
Preeclampsia: A condition of pregnancy in which there is high blood pressure and protein in the urine.
Preterm: Born before 37 weeks of pregnancy.
Respiratory Distress Syndrome (RDS): A condition of some babies in which the lungs are not mature, causing breathing difficulties.
Stillbirth: Delivery of a baby that shows no sign of life.
Ultrasound: A test in which sound waves are used to examine internal structures. During pregnancy, it can be used to examine the fetus.
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