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Gestational Diabetes Learning Center
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In our last post, we discussed the basic differences between type 1 and type 2 diabetes and concluded with the characterization of gestational diabetes mellitus(GDM), diabetes that is first expressed(or detected) as the result of pregnancy, as fit...
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Back in August of this year, I started a series on Diabetes in Pregnancy. A recent reader reminded me that I hadnt gotten around to finishing that series(which is true because I got distracted by other topics).
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Gestational diabetes mellitus(GDM) and type 2 diabetes comprise more than 95% of the diabetes complicating pregnancy. Both are characterized by a relative(not absolute) deficiency in insulin as the result of inadequate production/secretion, periph...
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She is the third such patient we have cared for in the past month. I will return to her story in a later post, but she has given me the incentive to begin a long overdue series on diabetes in pregnancy, and so we begin.
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In our last two posts on diabetes in pregnancy, we discussed the importance of diet and exercise and the value of self-monitoring as the foundations of blood sugar control. If these measures fail to achieve normalization of blood sugars(fasting va...
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After discussing the basics and importance of diet, the next step in counseling for the newly diagnosed woman with gestational diabetes mellitus(GDM) revolves around the means of assessing her diabetic control. The mainstay of management is freque...
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Although I have left the discussion of pregestational diabetes until the end of our series on Diabetes in Pregnancy, that was not done with the intent of diminishing its significance with regard to maternal and fetal morbidity and mortality. Even ...
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In our last post, we discussed the preconceptional evaluation of the woman with pregestational diabetes this evaluation pertains to women with either type 1 or type 2 diabetes. As part of the evaluation, we mentioned screening for hemoglobin A1c a...
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Once we have established the diagnosis of gestational diabetes mellitus(GDM), the first step in management is to counsel the patient regarding the diagnosis, management options, potential risks to the pregnancy, antepartum assessment of the baby, ...
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In our second post on diabetes in pregnancy, we gave a simple overview of glucose metabolism and discussed the essential role insulin plays in assuring that glucose gets into the cell. Pregnancy alters the normal balances involved in glucose metab...
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To continue the discussion of diabetes in pregnancy, lets first start with a very simplified review of glucose metabolism and the role of insulin so that we understand what the furor is all about. Glucose is one of the primary substrates for the p...
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The guidelines for weight gain during pregnancy are pretty straightforward: Underweight(BMI less than 18.5) 28-40 pounds Normal weight(BMI 18.5-24.9): 25-35 pounds Overweight(BMI 25-29.9): 15-25 pounds Obese(BMI over 30): no more than 15 pounds A ...
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Before I get into details regarding specific abnormalities of the maternal immune system and clotting system that appear to be related to recurrent early pregnancy loss, let me tell you a story about one of those special patients in my life who ch...
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Soumya has left a new comment on your post" Recurrent Early Pregnancy Loss- 6- A Special Pat...". (I have modified/revised her comment somewhat to the best of my understanding of her concerns)...
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Anyway, surprise to us we became pregnant however the baby turns out, having an amniocentesis or any other genetic testing is irrelevant. Now at 19 weeks we had a 2nd ultrasound and my baby was found to have a Choroid Plexus Cyst one measuring app...
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Below are excerpts from a comment/query that appeared recently on my post Recurrent Early Pregnancy Loss-6- A Special Patient. In this post, I recount my first experiences with a woman who had pregnancy complications(miscarriages and severe preecl...
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The"back ache" could also be uterine contractions associated with miscarriage or caused by something outside the uterus such as an ectopic pregnancy or ovarian cyst. At 7 weeks, your doctor can do a transvaginal ultrasound and should be able to co...
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In the last couple of posts we have reviewed causes and complications related to excessive amniotic fluid, otherwise known as polyhydramnios or, simply hydramnios. Although 50-60% of cases of hydramnios are idiopathic(no identifiable cause) and ab...
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My local hospital claims their amnio miscarriage rate is between 0.5 and 1.0 per cent. I am torn between no getting pregnant again given my age and driving myself ill with stress of not knowing for sure. many thanks anonymous.
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Within the past week the National Center for Health Statistics released its annual report on mortality in the U.S. for the year 2004(National Vital Statistics Reports. 2007. 55;19) Buried as the last area of comment in the report were the maternal...
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For many years now, we have placed women with recurrent early pregnancy loss on low-dose aspirin(81 mg) and heparin, or low molecular-weight heparin such as lovenox, to help them improve their prospects for pregnancy outcome. In some instances thi...
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I have a short cervix, but what has not appeared to be IC. With my first healthy pregnancy(2 prior miscarriages in the first trimester) my cervix shortened from 35mm to 22mm between 19 and 28 weeks.
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Today I received another comment to a post I wrote awhile back on aneuploidy(chromosomal abnormality) from a reader who has a first trimester baby that was found to have a cystic hygroma. With the growing acceptance of first trimester screening fo...
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