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🔥+ newly diagnosed type 2 diabetes has just been advised that he should begin a 2100 29 May 2020 Symptoms of Type 1 and Type 2. Type 1 and Type 2 diabetes share common symptoms. They are: going to the toilet a lot, especially at night; being really ...

newly diagnosed type 2 diabetes has just been advised that he should begin a 2100 The primary aim of treating type 2 diabetes is to help control blood glucose levels, but another key aim is to help with weight loss or weight ...

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This article is about the effects of pre-existing diabetes upon pregnancy. For temporary diabetic symptoms as a complication of pregnancy, see Gestational diabetes.

For pregnant women with diabetes, some particular challenges exist for both mother and child. If the woman has diabetes as an intercurrent disease in pregnancy, it can cause early labor, birth defects, and larger than average infants.

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During a normal pregnancy, many maternal physiological changes occur and there is an increase in insulin needs[1] due to increased hormonal secretions that regulate blood glucose levels, glucose-'' to the fetus, slowed emptying of the stomach, increased excretion of glucose by the kidneys and resistance of cells to insulin.

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The risks of maternal diabetes to the developing fetus include miscarriage, growth restriction, growth acceleration, fetal obesity (macrosomia), mild neurological deficits,[2] polyhydramnios and birth defects.[3][citation needed]In some studies 4% to 11% of infants born to type 1 diabetic women had defects compared to 1.2% to 2.1% of infants born in the general population.[4] The cause is, e.g., oxidative stress, by activating protein kinase C[5] that leads to apoptosis of some cells.[5] A hyperglycemic maternal environment has also been associated with neonates that are at greater risk for development of negative health outcomes such as future obesity, insulin resistance, type 2 diabetes mellitus, and metabolic syndrome.[6]

During the first trimester, besides increased birth defect risks, having a miscarriage is also increased due to abnormal development in the early stages of pregnancy.[7]

When blood glucose is not controlled, shortly after birth, the infant''s blood sugar was high close to the time of delivery, which causes the baby to produces extra insulin of its own.

Mild neurological and cognitive deficits in offspring — including increased symptoms of ADHD, impaired fine and gross motor skills, and impaired explicit memory performance — have been linked to pregestational type 1 diabetes and gestational diabetes.[8][9][10] Prenatal iron deficiency has been suggested as a possible mechanism for these problems.[11]

Birth defects are not currently an identified risk for the child of women with gestational diabetes, since those primarily occur the 1 last update 29 May 2020 in the latter part of pregnancy, where vital organs already have taken their most essential shape. Birth defects are not currently an identified risk for the child of women with gestational diabetes, since those primarily occur in the latter part of pregnancy, where vital organs already have taken their most essential shape.

Importance of blood glucose level during pregnancy[edit the 1 last update 29 May 2020 ]]

High blood sugar levels are harmful to the mother and her fetus. Experts advise diabetics to maintain blood sugar level close to normal range for 2 to 3 months before planning for pregnancy. Managing blood sugar close to normal before and during pregnancy helps to protect the health of mother and the baby.

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Blood glucose levels in pregnant woman should be regulated as strictly as possible. Higher levels of glucose early in pregnancy are associated with teratogenic effects on the developing fetus.[12] A Cochrane review published in 2016 was designed to find out the most effective blood sugar range to guide treatment for women who develop gestational diabetes mellitus in their pregnancy. The review concluded that quality scientific evidence is not yet available to determine the best blood sugar range for improving health for pregnant women with diabetes and their babies.[13]

During the first weeks of pregnancy less insulin is required due to tight blood sugar control as well as the extra glucose needed for the growing fetus.[14] At this time basal and bolus insulin may need to be reduced to prevent hypoglycemia. Frequent testing of blood sugar levels is recommended to maintain control. As the fetus grows and weight is gained throughout the pregnancy, the body produces more hormones which may cause insulin resistance and the need for more insulin.[14] At this time it is important for blood sugar levels to remain in range as the baby will produce more of its own insulin to cover its mother''s risk for developing type 2 diabetes mellitus later in life may be lower if the baby was breast-fed. It also helps the child to maintain a healthy body weight during infancy. However, the breastmilk of mothers with diabetes has been demonstrated to have a different composition than that of non-diabetic mothers, containing elevated levels of glucose for 1 last update 29 May 2020 and insulin and decreased polyunsaturated fatty acids.[16] Although benefits of breast-feeding for the children of diabetic mothers have been documented, ingestion of diabetic breast milk has also been linked to delayed language development on a dose-dependent basis.[16] During the first weeks of pregnancy less insulin is required due to tight blood sugar control as well as the extra glucose needed for the growing fetus.[14] At this time basal and bolus insulin may need to be reduced to prevent hypoglycemia. Frequent testing of blood sugar levels is recommended to maintain control. As the fetus grows and weight is gained throughout the pregnancy, the body produces more hormones which may cause insulin resistance and the need for more insulin.[14] At this time it is important for blood sugar levels to remain in range as the baby will produce more of its own insulin to cover its mother''s risk for developing type 2 diabetes mellitus later in life may be lower if the baby was breast-fed. It also helps the child to maintain a healthy body weight during infancy. However, the breastmilk of mothers with diabetes has been demonstrated to have a different composition than that of non-diabetic mothers, containing elevated levels of glucose and insulin and decreased polyunsaturated fatty acids.[16] Although benefits of breast-feeding for the children of diabetic mothers have been documented, ingestion of diabetic breast milk has also been linked to delayed language development on a dose-dependent basis.[16]

In some cases, pregnant women with diabetes may be encouraged to express and store their colostrum during pregnancy, in case their blood sugar is too low for feeding the baby breast milk after birth.[17] There is no evidence on the safety or potential benefits when pregnant women with diabetes express and store breast milk prior to the baby''s Hospital of Philadelphia. 2014-08-24.

  • ^ a b Rodekamp E, Harder T, Kohlhoff R, Dudenhausen JW, Plagemann A (2006). "". Journal of Perinatal Medicine. 34 (6): 490–6. doi:10.1515/JPM.2006.095. PMID 17140300.newly diagnosed type 2 diabetes has just been advised that he should begin a 2100 too much insulin (☑ mellitus is primarily a problem with) | newly diagnosed type 2 diabetes has just been advised that he should begin a 2100 insulin resistancehow to newly diagnosed type 2 diabetes has just been advised that he should begin a 2100 for
  • ^ a b East, Christine E.; Dolan, Willie J.; Forster, Della A. (2014-07-30). "" (PDF). The Cochrane Database of Systematic Reviews (7): CD010408. doi:10.1002/14651858.CD010408.pub2. ISSN 1469-493X. PMID 25074749.
  • ^ White P (November 1949). "". Am. J. Med. 7 (5): 609–16. doi:10.1016/0002-9343(49)90382-4. PMID 15396063.
  • ^ Gabbe S.G., Niebyl J.R., Simpson J.L. OBSTETRICS: Normal and Problem Pregnancies. Fourth edition. Churchill Livingstone, New York, 2002. ISBN 0-443-06572-1
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