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Pregnancy and Diabetes Management: New Guidelines

by Katlyn Joy | November 16, 2013 12:00 AM
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The Endocrine Society has issued new guidelines for the management of patients who are trying to conceive and all pregnant patients.

The guidelines recommend women who have been diagnosed with diabetes be tested for gestational diabetes during the 24th to 28th weeks of pregnancy by having an oral glucose tolerance test. However, they also recommend testing all women who have not been previously diagnosed with diabetes at their first prenatal appointment.

Ian Blumer, MD, of the Charles H. Best Diabetes Centre in Whitby, Ontario, Canada, and chair of the task force responsible for the guidelines stated, "Many women have type 2 diabetes but may not know it. Because untreated diabetes can harm both the pregnant woman and the fetus, it is important that testing for diabetes be done early on in pregnancy so that, if diabetes is found, appropriate steps can be immediately undertaken to keep both the woman and her fetus healthy." Other recommendations by the task force include:

Risks of having diabetes during pregnancy

According to the National Diabetes Information Clearinghouse, which is a service of the National Institute of Diabetes and Digestive and Kidney Diseases and the National Institutes of Health, diabetes poses significant dangers to expectant mothers and their babies including:

What to expect during pregnancy if you have diabetes

If you have diabetes and expecting a baby, your pregnancy will be designated a high risk pregnancy, which may affect your choice of obstetricians and he location of where you will give birth. You will be watched more closely than the average pregnant woman at prenatal visits and will likely see your OBGYN more often.

According to the March of Dimes, women who take pills for diabetes will most likely need to switch to using insulin during pregnancy as the pills are not considered wise for expectant mothers to take. Your body will react differently to the disease during pregnancy and this may result in you needing perhaps two or three times as much insulin as usual. Also, insulin resistance in pregnancy is common and can mean you might need to try different types of insulin.

During pregnancy you will probably be seeing more than one physician, such as an Endocrinologist, and OBGYN and a Perinatologist. You could also be under the care of an ophthalmologist due to eye conditions resulting from diabetes. Additionally, if your kidneys or heart are compromised by the disease, you may see a Cardiologist and a Nephrologist. Make sure everyone on your medical team is in communication with each other and that all your health care providers have a complete list of all your medications, regardless of who prescribed them.

When to Call the Doctor


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