Diabetes

Diabetes

Diabetes mellitus (MEL-ih-tus), often referred to as diabetes, is characterized by high blood glucose (sugar) levels that result from the body’s inability to produce enough insulin and/or effectively utilize the insulin. Diabetes is a serious, life-long condition and the sixth leading cause of death in the United States. Diabetes is a disorder of metabolism (the body's way of digesting food and converting it into energy). There are three forms of diabetes. Type 1 diabetes is an autoimmune disease that accounts for five- to 10-percent of all diagnosed cases of diabetes. Type 2 diabetes may account for 90- to 95-percent of all diagnosed cases. The third type of diabetes occurs in pregnancy and is referred to as gestational diabetes. Left untreated, gestational diabetes can cause health issues for pregnant women and their babies. People with diabetes can take preventive steps to control this disease and decrease the risk of further complications.

Recently Answered

  • 1 Answer
    A

    Before you conceive, check with your insurance company about what is covered. Your insurance plan may cover more during your pregnancy with the appropriate documentation. Some of the items that may be covered are listed below.

    • You will need to see both your obstetrician and your diabetes health care provider frequently--perhaps every week or every 2 weeks for most of your pregnancy. You will learn to make adjustments in insulin dose based on blood glucose values. This takes time and practice and lots of support from your health care team.
    • Your health care should include nutrition counseling with a registered dietitian and diabetes education. You will likely learn how to count carbohydrates and adjust insulin doses.
    • You’ll need to check blood glucose values often to make sure you are within your target ranges. Many pregnant women do seven or more tests each day. Test strips are the big expense in monitoring.
    • You may need to do ketone monitoring each day. This will protect you against surprise ketoacidosis as well as starvation ketosis, which can occur after a low blood glucose value, when carbohydrate intake is very limited, or when calorie intake is lower than needed. This means buying ketone strips.
    • If you treat your type 2 diabetes with oral diabetes medications, you’ll probably need to switch to insulin before you become pregnant. This means paying for insulin pens or syringes and insulin, plus training from an educator on how to give insulin and to adjust your dose.
  • 1 Answer
    A

    Having a baby is a major financial investment for any parent. Your pregnancy will include the added expenses involved in tight blood glucose management. It used to be worse. Before self-monitoring of blood glucose, a woman could easily spend half of her pregnancy in the hospital. Now the major expenses are fetal monitoring and blood glucose monitoring instead of hospitalizations.

    Before you conceive, check with your insurance company to find out what is covered. Your insurance plan may cover more during your pregnancy if you have the appropriate documentation.

    Extra Expenses and Doctor Visits

    • You will need to see both your obstetrician and your diabetes health care provider frequently—perhaps every week or every 2 weeks for most of your pregnancy. You will learn to make adjustments to insulin doses based on blood glucose values. This requires time, practice, and lots of support from your health care team.
    • Your health care should include nutrition counseling with a registered dietitian and diabetes educator. You will likely learn how to count carbohydrates and adjust insulin doses.
    • You’ll need to check blood glucose values often to make sure you are within your target ranges. Many pregnant women do seven or more checks each day. Test strips are the big expense in monitoring.
    • You may need to do ketone monitoring each day. This will protect you against surprise ketoacidosis as well as starvation ketosis, which can occur after a low blood glucose value, when carbohydrate intake is very limited, or when calorie intake is lower than needed. This means buying ketone strips.
    • If you treat your type 2 diabetes with oral diabetes medications, you may need to switch to insulin before you become pregnant. This means paying for insulin pens or syringes and insulin, plus training from an educator on how to give insulin and to adjust your dose.
  • 1 Answer
    A

    Here are some tips for diabetes management before a pregnancy:

    • Before you become pregnant, you probably will intensify your daily diabetes care.
    • If you have type 1 diabetes, you will begin or fine-tune your plan by using several insulin injections each day or switching to insulin pump therapy.
    • If you have type 2 diabetes, using oral diabetes medicines may not be recommended.
    • You will probably need to begin insulin therapy. Many women with type 2 diabetes find that they need to use insulin during pregnancy.

    Your A1C level will be measured frequently. It is recommended that your A1C level be as close to normal as possible before you stop using birth control.

  • 1 Answer
    A

    Because you want your blood glucose levels to be as favorable to your developing baby as possible. All of the baby’s major organs are formed during the first 6–8 weeks of pregnancy, which may be before you know you’re pregnant.

    Research Behind Tight Control and Pregnancy

    In several studies, women who had an A1C that was 1% above normal levels before conception lowered their baby’s risk of birth defects to 1–2%, the same as women without diabetes. Normal A1C is less than 7%. Babies of mothers who began intensive diabetes management after conceiving were more likely to have birth defects.

    Planning ahead of time will ensure that you find a diabetes management plan that will work for you. This takes some trial and error as well as patience. It may take too long if you wait until you are pregnant.

  • 3 Answers
    A
    ALaura Motosko, MSEd, RD, Nutrition & Dietetics, answered

    Your obstetrician should refer you to a diabetic clinic or endocrinologist to treat gestational diabetes. A registered dietitian, and registered nurse of which either is a diabetic educator, is essential to see for diabetes management.

    See All 3 Answers
  • 1 Answer
    A

    You’ll need a thorough physical exam before you become pregnant to assess any problems that could jeopardize your health or that of your baby.

    Pre-Pregnancy Checkup

    • An assessment of any complications, such as high blood pressure, heart disease, and kidney, nerve, and eye damage. If you have any of these complications, they need to be treated before you try to conceive. Even kidney transplant recipients who are otherwise healthy have had babies.
    • Your A1C level will be measured.
    • If you have type 1 diabetes, your thyroid function will be measured.
    • In addition, your exam will include a review of all the medications, herbs, and supplements you are taking to make sure they are compatible with a safe pregnancy.
  • 1 Answer
    A

    Ask your provider to refer you to a medical geneticist or genetic counselor if you have concerns about your baby’s risk for diabetes. They are trained to assess the contributions of genetic and environmental factors in causing many diseases, including diabetes. They will know the results of the latest diabetes and genetics studies and studies to prevent diabetes in high-risk individuals.

  • 1 Answer
    A

    Although women with diabetes and their unborn children face additional risks because of diabetes, these can be kept to a minimum through careful blood glucose management, before and during pregnancy, and intensive obstetrical care. For this reason, all women with diabetes need to plan ahead before becoming pregnant. 

    The first step is to meet with your health care team to consider the specific challenges you may face during your pregnancy. You need a complete evaluation of your overall health and any diabetes complications. It’s important to get a good idea of how much extra work and expense may be involved before you become pregnant.

    You may have specific questions for your health care provider. You may be concerned that your baby could develop diabetes. You may be worried for your own health. Your glucose levels may also be an issue.

  • 1 Answer
    A

    In general, hormonal methods of birth control are safe for women with diabetes. If you are over 35 and smoke, or you have a history of heart disease, stroke, high blood pressure, peripheral blood vessel disease, or blood clots, these methods may be risky for you. 

    If you’ve found that your insulin sensitivity varies at certain times of the month, being on the pill, patch, ring, or injections may help smooth out your blood glucose levels. By providing a steady dose of hormones, blood glucose swings can be kept to a minimum. 

    Some women find that oral contraceptives increase insulin resistance. If your blood glucose levels are affected, your insulin or your dose of oral diabetes medication can be adjusted. Taking the lowest possible dose or the mini pill can also help.

  • 1 Answer
    A

    Important Tests for Women Taking Hormone Replacement Therapy

    • Have your A1C tested two to four times a year. This test tells you about your blood glucose levels over the long term.
    • Have your cholesterol and triglyceride levels checked as recommended by your provider.
    • Have yearly eye exams and kidney function tests.
    • Have a yearly mammogram to detect breast cancer.
    • Have a yearly Pap smear and gynecologic examination to detect cancer of the cervix, uterus, endometrium, and ovaries.