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{'en': 'Gestational diabetes and doubts endocrine criteria', 'es': 'Diabetes gestacional y dudas criterio endocrino'} Image

Gestational diabetes and doubts endocrine criteria

lnazgza's profile photo   12/21/2010 11:16 a.m.

Good afternoon!

My name is Elena and I am currently pregnant 34 weeks, my second daughter.In my first pregnancy I had gestational diabetes, rather "mild, if it is correct to use that term.

In the glucose overload curve I had two altered values, but very close to the limit, and with diet and exercise everything was controlled, without insulin.My daughter was born by caesarean section (because they were buttocks, without having anything to do with diabetes) just a few days after turning 40 weeks and weighing 3,800 kg.In the ultrasound of week 33 a weight of 2,500 kg was estimated.

In this second pregnancy the glycemia curve only was altered in a value (the first after overload) and not in excess (200), but I preferred to carry a follow -up with endocrine, by caution.

I make controls with glucometer day yes and day, on an empty stomach and at the time breakfast, eat and dinner.Until now, all the postprandial values ​​that I have measured are correct, the limit that was indicated is 140, being my values ​​between 100 and 130, approx and the highest breakfast, followed by dinner and finallyFood. However, at breakfast I have proven that under levels of almost hypoglycemia at two hours.

The fasting values ​​come out of a little altered days, no matter how small rank, since they are always between 92 and 99, being the limit indicated 95. This circumstance of fasting values ​​also occurred in my first pregnancy and the endocrine does notIt gave importance.

My question comes to Raiz that last week, in the ultrasound of the 3rd quarter, it would be told that the girl's weight was 2,400 kg and the econgrafa scored "macrosomy", an issue with which I am not totally satisfied, sinceDepending on the tables that I have consulted this weight, only the 90th percentile in some of them, being in other tables below.

Seeing the term Macrosomia, the endocrine prescribed me insulin, in extremely low doses (2 units before the fast action meals and 5 at night, slow action).He justified it by saying that if there was macrosomia, insulin was necessary although the glycemia values ​​were normal.

I do not understand this difference in endocrine criteria with respect to my first pregnancy, since in this case the girl weighs a little less, the measured values ​​of postprandial blood glucose are similar or better than in that pregnancy, my first daughter did not reach macrosomy inThat occasion and I was not prescribed insulin, I even told me to eat a little more, since everything was right ...

Why is insulin necessary on this occasion, if not even the possible macrosomia is clear?

I am not afraid to inject insulin, neither for its effects nor for the punctures, but such a strict control generates a lot of stress, that I am willing to assume if it is totally necessary, but not if it is not.

I would appreciate a lot of opinions about whether you consider the prescription of insulin in this case (I have decided not to start treatment until they consult the endocrine, tomorrow 22).

Sorry for extending me so much and thank you very much!

lnazgza's profile photo
lnazgza
12/21/2010 11:16 a.m.
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Welcome Elena, and congratulations on your pregnancy.It is normal for you to have doubts, and above all pay attention to the doctor and write here everything you want, you are sure that we read you and everyone.I have type 1 diabetes for 2 years, and I'm older.:( tell us how will I go tomorrow. Adeu: D

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Consu
12/21/2010 2:12 p.m.

DM LADA (7-4-09). Con 50 años. Novorrapit flexpen, y Tresiva. Sin complicaciones.

  

Hi Elena
With normal values ​​I don't understand insulin ...

The figures are normal except 1:-/: shock:

Check another opinion before starting treatment with insulin, I don't see it clear.

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DiabetesForo
12/22/2010 3:32 p.m.
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Thank you very much for your answers!
Finally yesterday talking to the endocrine more calmly we were all clearer and I am much quieter.He explained that the girl was possibly macrosomic not because of the estimated weight, but because the measure of her abdominal contour was quite discordant with the rest, that is, she is a berigone, heh, heh., Indicating that she is chubby, not greatin general.Regarding insulin, he said that it was proven in the case of gestational diabetes to administer small doses of insulin, but throughout the day, it helps the fetus not grow so much, perhaps because it maintains the most stable levels and stimulatessomething the insulin production of the pancreas itself.That I was not very clear why, but that it was proven that still so tiny dose of insulin helped to stop that macrosomic growth, even without barely lowering the postprandial blood glucose values, which in my case are correct ... you already know that in these issuesRelated to metabolism, it seems that many times conclusions are obtained by experience, without the scientific explanation being clear:-/
So we have started and at least understanding things I am more calm ... I also look very little!
On the other hand, I wanted to express my support and admiration for the people who live day by day with this disease.I believe with sincerity, because of my little experience that is limited to my pregnancies (and I hope that it continues to be limited to that in the future, hopefully) that it is a very big bass and that is fucking, but said it would not be sincere, but that facing it with theCourage and poise from most people in this forum, you have a lot of cattle to have a happy life, which in the end is what matters.
Thank you very much again and happy holidays!

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lnazgza
12/23/2010 4:16 a.m.
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Very interesting what you contribute inazgza, I had not heard/read anything about it.

Mother's hyperglycemia causes hyperglycemia and hyperinsulinism in the fetus (one of the causes of macrosomy, although this is only considered whether it exceeds 4 kg).
So putting the mother insulin, the need for insulin of the fetus is reduced because less glycemia comes and therefore the possibility of macrosomia is reduced.

Remember that insulin does not cross the placenta, so on that side there are no problems.

Normally women with gestational diabetes are guided around 0.3 units/kilo per day of insulin .... I imagine that they will reduce you much less, I do not know if you will even need to dilute it.

I hope everything goes well.

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DiabetesForo
12/23/2010 11:40 a.m.
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Hello!
When I was amazed, I was diagnosed with gestational diabetes at first since I said 472 in the sugar test.
I had my 34 -week girl in a normal delivery and weighed 31oo kg.They already told me that I was coming and had a date of provoking the delivery at 37 weeks.
I started to click insulin at 4 and a half months.

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lore_bcn
12/30/2010 6 a.m.
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Hello!

I am type I diabetic (this, or at least that is believed, it has no relationship), but my mother had gestational diabetes during her two pregnancies.My brother weighed 4.5 kg at birth, I 2 kilos, but I was premature (Sevenmesino scraped) and according to the endocrine and gynecologist, mine was very considerable to only have 7 months ... my mother now does not suffer from diabetes, sometimes that gestational diabetes persists in women who suffer from it.However, eye!Suffering gestational diabetes considerably increases the risk of type 2 diabetes !!
Try to lead a healthy life, exercise, not abuse fat and sweets and a check from time to time to see how your glucose goes very occasionally (this will have already told you).Type II Dabets can spend enough years living with the person without being noticed, with the circumstances that this entails ...

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ManuLC92
03/16/2011 6:06 p.m.
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Helloaaaaaaaaa,
Manulc92, I am seven memesin and with a weight greater than 2 kilos, and of course to be seven months it is a lot, but it will surely have to do with diabetes, it is a thing that had not raised it to me, it has now beenWhen reading you.
Greetings

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anabeg
03/16/2011 6:27 p.m.
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Hi, I'm 26 weeks pregnant and I have told me gestational diabetes.I am measuring blood glucose but my question is if I have to click to measure glucose when I start eating or when I just eat (breakfast, eat and dinner).
Thank you so much

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Pepelilla
12/02/2017 12:54 a.m.
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That is to say the time I must expect to click that I tell her since I start eating or when I just eat

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Pepelilla
12/02/2017 12:55 a.m.
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At the time, an hour and a half of starting ..., it is not known exactly, because it depends on the speed of absorption of food, but the important thing is that you see the highest peak and how long it takes to go down.

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Regina
12/02/2017 1:33 a.m.

Hija de 35 años , diabética desde los 5. Glico: normalmente de 6 , pero 6,7 la última ( 6,2 marcaba el Free)
Fiasp: 4- 4- 3 Toujeo: 20

  

Thank you very much Regina is that since it took a long time to eat when I had just eaten, I had only 30 minutes or less to prick

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Pepelilla
12/02/2017 12:47 p.m.
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Hello.I started with DG.It was controlled with diet and exercise (walking 1h a day).In principle you should verify your values ​​before and 1h after each meal so that you are able to assess how you are and how you assimilate the HC.You should be between 80 and 120 before and until 180 later.Many luck and take care of yourself :-)

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Carito
12/03/2017 7:45 p.m.
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Hello
I wanted to make a consultation, if you can help me.
I have had a child and in my first pregnancy I had gestational diabetes since I have a history because my mother is type1 diabetic, when giving birth they told me that with a second pregnancy I would have risks of staying diabetic but the other day I was in the gynecologist and saidthat I wanted to get pregnant again and she told me that I am 28 years old and a thin constitution that would not stay with diabetes for life, that I surely get gestational diabetes but taking care of me it is not likely that I stay.
I don't know what to do people who have stayed diabetic.
You could tell me your experiences.
Thank you

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marquez03
12/27/2020 3:40 p.m.
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@Marquez03 Type 1 diabetes has nothing to do with gestational, they are different diseases.The gestational looks more like a type 2 but still the cause is different and usually only occurs during pregnancy, once you give birth.
Type 1 is autoimmune, your own body attacks your pancreas and destroys the cells that produce insulin, type 2 and gestational appear due to insulin resistance.In the case of gestational insulin resistance is something physiological that occurs during pregnancy and disappears after childbirth.In women who already have some resistance from before or bad life habits, this resistance added during pregnancy worsens and the body is not able to maintain glucose in normal ranges.Sometimes after pregnancy, diabetes is still followed because the problem was already before and at some point it would appear in the future even if there was no pregnancy.Pregnancy simply accelerates things, but it is not the cause.
There are also cases of type 1 that appears during pregnancy because it is a time when the immune system is less active not to attack the baby and in people with genetic predisposition can be a trigger for some autoimmune disease.Hypothyroidism is very frequent that it appears during pregnancy and if it is autoimmune you can stay later.With the autoimmune nothing can be done because the causes are not known, very little is known about the triggers.
You can ask that they do a type 1 diabetes antibody test before pregnancy, if they give you positive, you are likely to develop the disease over time and pregnancy can accelerate it.If you don't have antibodies, you are no more likely to get pregnant but watch your diet and do sports to avoid type 2 and gestational.

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Yessica_A
12/28/2020 10:37 a.m.

DM1 desde 2003 | Toujeo + Humalog | FreeStyle 2 | HbA1c 5.5

  

Yesssica_a said:
@marquez03 Type 1 diabetes has nothing to do with gestational, they are different diseases.The gestational looks more like a type 2 but still the cause is different and usually only occurs during pregnancy, once you give birth.
Type 1 is autoimmune, your own body attacks your pancreas and destroys the cells that produce insulin, type 2 and gestational appear due to insulin resistance.In the case of gestational insulin resistance is something physiological that occurs during pregnancy and disappears after childbirth.In women who already have some resistance from before or bad life habits, this resistance added during pregnancy worsens and the body is not able to maintain glucose in normal ranges.Sometimes after pregnancy, diabetes is still followed because the problem was already before and at some point it would appear in the future even if there was no pregnancy.Pregnancy simply accelerates things, but it is not the cause.
There are also cases of type 1 that appears during pregnancy because it is a time when the immune system is less active not to attack the baby and in people with genetic predisposition can be a trigger for some autoimmune disease.Hypothyroidism is very frequent that it appears during pregnancy and if it is autoimmune you can stay later.With the autoimmune nothing can be done because the causes are not known, very little is known about the triggers.
You can ask that they do a type 1 diabetes antibody test before pregnancy, if they give you positive, you are likely to develop the disease over time and pregnancy can accelerate it.If you don't have antibodies, you are no more likely to get pregnant but watch your diet and do sports to avoid type 2 and gestational.

Thank you so much!!

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marquez03
12/28/2020 7:12 p.m.
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