Gestational diabetes is characterized by glucose in tolerance leading to diabetes
first detected during pregnancy. It will affect up to 14% of some high-risk. These women must be identified during prenatal care in order to optimize maternal and fetal health.
The need for pregnancy
prevention or preconceptional planning should be discussed during care by the diabetologist with referral to a perinatologist for further preconceptional counseling.
PRECONCEPTIONAL COUNSELING
Overall, more than two-thirds of pregnancies are unplanned. Because first trimester hyperglycemia may lead to fetal malformations and pregnancy loss and because untreated target organ damage may worsen during early pregnancy, women contemplating pregnancy
should be referred for preconceptional counseling to optimize maternal health, to tighten glycemic control, and to anticipate maternal diabetic, obstetric, and fetal complications.
The preconceptional visit should include a thorough history of disease state, comorbidities, and an extensive maternal examination. Not only will women want to discuss how diabetes
will affect the pregnancy but also they will wish to know how the pregnancy may impact their diabetes
. Discussion of the anticipated risks may further include questions on how to achieve pregnancy.
GLYCEMIC CONTROL DURING PREGNANCY
The key to successful obstetrical out comes with optimization of maternal and fetal health can be achieved primarily through aggressive glycemic control. In order to obtain this narrow window of normoglycemia in pregnancy, the patient, perinatologist, diabetologist, diabetic nurse educator, and nutritionist
must embark on a multidisciplinary approach to disease management. Active participation by the patient in her care is essential.
Increasing insulin
resistance in pregnancy may require continued meetings with the nutritionist
and diabetic educator to optimize a diet and medication regimen that works in pregnancy. The patient will need to self-monitor blood glucose concentrations with a glucometer
with memory. The capacity to download glucose concentrations with dates and times will aid adjustment to diet, scheduled food intake, and exercise regimens.
first detected during pregnancy. It will affect up to 14% of some high-risk. These women must be identified during prenatal care in order to optimize maternal and fetal health.The need for pregnancy
prevention or preconceptional planning should be discussed during care by the diabetologist with referral to a perinatologist for further preconceptional counseling.PRECONCEPTIONAL COUNSELING
Overall, more than two-thirds of pregnancies are unplanned. Because first trimester hyperglycemia may lead to fetal malformations and pregnancy loss and because untreated target organ damage may worsen during early pregnancy, women contemplating pregnancy
should be referred for preconceptional counseling to optimize maternal health, to tighten glycemic control, and to anticipate maternal diabetic, obstetric, and fetal complications.The preconceptional visit should include a thorough history of disease state, comorbidities, and an extensive maternal examination. Not only will women want to discuss how diabetes
will affect the pregnancy but also they will wish to know how the pregnancy may impact their diabetes. Discussion of the anticipated risks may further include questions on how to achieve pregnancy.GLYCEMIC CONTROL DURING PREGNANCY
The key to successful obstetrical out comes with optimization of maternal and fetal health can be achieved primarily through aggressive glycemic control. In order to obtain this narrow window of normoglycemia in pregnancy, the patient, perinatologist, diabetologist, diabetic nurse educator, and nutritionist
must embark on a multidisciplinary approach to disease management. Active participation by the patient in her care is essential.Increasing insulin
resistance in pregnancy may require continued meetings with the nutritionist and diabetic educator to optimize a diet and medication regimen that works in pregnancy. The patient will need to self-monitor blood glucose concentrations with a glucometer with memory. The capacity to download glucose concentrations with dates and times will aid adjustment to diet, scheduled food intake, and exercise regimens.
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