Diabetes and Pregnancy

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Pierce Charles
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1 Diabetes and Pregnancy Gestatinal Diabetes U.S. Department f Health and Human Services Centers fr Disease Cntrl and Preventin

3 What is gestatinal diabetes? Gestatinal (jes-stay-shuh-nal) diabetes is diabetes that a wman can develp during pregnancy. When yu have diabetes, yur bdy cannt use the sugars and starches (carbhydrates) it takes in as fd t make energy. As a result, yur bdy cllects extra sugar in yur bld. We dn t knw all the causes f gestatinal diabetes. Sme but nt all wmen with gestatinal diabetes are verweight befre getting pregnant r have diabetes in the family. Frm 1 in 50 t 1 in 20 pregnant wmen has gestatinal diabetes. It is mre cmmn in Native American, Alaskan Native, Hispanic, Asian, and Black wmen, but it is fund in White wmen, t. Gestatinal diabetes can be cntrlled. Wrk with yur dctr t make a plan t keep yur bld sugar in cntrl. (See pages 7 and 8 fr upper and lwer levels.) Fllwing this plan can help yu have a healthy pregnancy and baby. It als can help yu and yur baby stay healthy after birth. 1

We dn t knw all the causes f gestatinal diabetes. Sme but nt all wmen with gestatinal diabetes are verweight befre getting pregnant r have diabetes in the family.

4 Gestatinal diabetes can affect yur baby. Gestatinal diabetes that is nt cntrlled can cause yur baby t Grw very large (weigh mre than 9 punds), which in turn can lead t prblems with the delivery f yur baby. A large baby brn thrugh the birth canal can injure nerves in his shulder; break her cllarbne; r, rarely, have brain damage frm lack f xygen. Have quickly changing bld sugar after delivery. Yur baby s dctr will watch fr lw bld sugar after birth and treat it if needed. Be mre likely t becme verweight r bese during childhd r adlescence. Obesity can lead t type 2 diabetes.* 2 * Type 2 diabetes is a cnditin in which the bdy either makes t little insulin r can t use the insulin it makes t use bld sugar fr energy. Often, type 2 diabetes can be cntrlled thrugh eating a prper diet, exercising regularly, and keeping a healthy weight. Sme peple with type 2 diabetes have t take diabetes pills r insulin, r bth.

A large baby brn thrugh the birth canal can injure nerves in his shulder; break her cllarbne; r, rarely, have brain damage frm lack f xygen. Have quickly changing bld sugar after delivery.

5 Gestatinal diabetes can affect yu. Gestatinal diabetes that is nt cntrlled can cause yu t Have prblems during delivery. Have a very large baby and need t have a cesarean sectin (C-sectin) (an peratin t get yur baby ut thrugh yur abdmen). Take lnger t recver frm childbirth if yur baby is delivered by C-sectin. Other prblems that smetimes happen with gestatinal diabetes Wmen with gestatinal diabetes als can develp preeclampsia* (pree-e-klamp-see-uh). Smetimes, diabetes des nt g away after delivery r cmes back later after pregnancy. When this happens, the diabetes then is called type 2 diabetes. Wrk with yur dctr befre, during, and after pregnancy t prevent prblems. * Preeclampsia is a prblem that happens amng sme wmen during pregnancy. Wmen with preeclampsia have high bld pressure; prtein in their urine; and, ften, swllen feet, legs, fingers, and hands. Preeclampsia can harm yu by causing seizures r a strke. It might als cause yur baby t be brn early. 3

Other prblems that smetimes happen with gestatinal diabetes Wmen with gestatinal diabetes als can develp preeclampsia* (pree-e-klamp-see-uh).

6 Nw is the time t keep yu and yur baby healthy. It is imprtant during yur pregnancy t keep yur bld sugar under cntrl. Here s hw: 1 See yur dctr regularly Ask yur dctr if yu need t see him r her mre ften because f yur diabetes. Wrk with yur dctr and, tgether, yu will be able t catch prblems early, r even prevent them entirely. 2 Eat healthy fds and stay active Wrk with a dietitian r diabetes educatr t develp a diabetes meal plan fr yurself. Learn what t eat t keep yur bld sugar under cntrl. Stay active t help keep yur bld sugar under cntrl. Exercise regularly befre, during, and after pregnancy. Mderate exercise, such as a brisk walk, 30 minutes a day, 5 days a week is a gd gal if it is kay with yur dctr. 3 Take yur medicines Fllw yur dctr s advice. 4 Take yur medicines as directed.

Wrk with yur dctr and, tgether, yu will be able t catch prblems early, r even prevent them entirely.

7 4 Mnitr yur bld sugar ften Be aware that yur bld sugar can change very quickly, becming t high r t lw. What yu eat, hw much yu exercise, and yur grwing baby will change yur bld sugar many times during the day. Check yur bld sugar ften as directed by yur dctr, and any time yu have symptms. Knw what bld sugar levels mean. Learn hw t adjust what yu eat; hw much yu exercise; and, if prescribed, hw much insulin* t take depending n yur bld sugar tests. 5 Cntrl and treat lw bld sugar quickly Check yur bld sugar right away if yu have symptms. (See page 9.) Treat lw bld sugar quickly. Always carry with yu a quick surce f sugar, like hard candy r glucse tablets. Wear a medical alert diabetes bracelet. * Insulin is usually made in the bdy and helps change sugars and starches int energy. If the bdy desn t make enugh insulin r can t use the insulin it makes, extra insulin is given in a sht. 5

Knw what bld sugar levels mean. Learn hw t adjust what yu eat; hw much yu exercise; and, if prescribed, hw much insulin* t take depending n yur bld sugar tests.

8 Stay healthy after the birth f yur baby. Gestatinal diabetes ges away after pregnancy, but smetimes diabetes stays. It s imprtant t be checked fr diabetes after yur baby is brn. Abut half f all wmen wh have gestatinal diabetes get type 2 diabetes later in life. After pregnancy and in the future Make sure t ask yur dctr abut testing fr diabetes sn after delivery and again 6 weeks after delivery. Cntinue t eat healthy fds and exercise regularly. Have regular checkups and get yur bld sugar checked by yur dctr every 1 t 3 years. Talk with yur dctr abut yur plans fr mre children befre yur next pregnancy. Watch yur weight. Six t twelve mnths after yur baby is brn, yur weight shuld be back dwn t what yu weighed befre yu gt pregnant. If yu still weigh t much, wrk t lse 5% t 7% (10 t 14 punds if yu weigh 200 punds) f yur bdy weight. Plan t lse weight slwly. This will help yu keep it ff. 6 Eating healthy, lsing weight and exercising regularly can help yu delay r prevent type 2 diabetes in the future. Talk with yur dctr t learn mre.

After pregnancy and in the future Make sure t ask yur dctr abut testing fr diabetes sn after delivery and again 6 weeks after delivery. Cntinue t eat healthy fds and exercise regularly.

9 Tear ut p age an d ke ep it hand y! Mnitring Yur Bld Sugar The American Cllege f Obstetricians and Gyneclgists (ACOG) says yu shuld try t keep yur bld sugar belw these levels: ACOG The levels my dctr Recmmendatins recmmends Befre meals 95 mg/dl r lwer 1 hur after eating 130 mg/dl r lwer 2 hurs after eating 120 mg/dl r lwer Bld sugar is measured in milligrams/deciliter (mg/dl) Yur dctr might recmmend different bld sugar levels. Ask yur dctr t write in the chart abve the levels yu shuld have. High bld sugar Yur bld sugar is high when the numbers are 130 mg/dl r higher. High bld sugar can Make yu thirsty Make it hard t pay attentin Cause headaches Blur yur visin Make yu g t the Make yu feel weak r tired bathrm ften t urinate (pee) Cause yeast infectins Talk with yur dctr if yu ntice any f these signs r symptms. Call yur dctr if yur bld sugar is greater than. (Ask yur dctr t write the levels). My dctr s name: Phne number:

95 mg/dl r lwer 1 hur after eating 130 mg/dl r lwer 2 hurs after eating 120 mg/dl r lwer Bld sugar is measured in milligrams/deciliter (mg/dl) Yur dctr might recmmend different bld sugar levels.

10 Lw bld sugar Yur bld sugar is lw when the numbers are 70 milligrams/ deciliter r less. Lw bld sugar is als called hypglycemia (hiph-gli-see-me-ah). Lw bld sugar can Make yu feel hungry Make yu sweat Cause headaches Cause weakness Make yu feel dizzy r shaky Make yu feel anxius r Cause yu t feel cnfused cranky Make yu lk pale Make yur heart feel like it s beating t fast If yu ntice any f these signs r symptms, check yur bld sugar. If it is lw, eat r drink a surce f quick sugar like a piece f hard candy r 4 unces f a fruit juice, skim milk, r a sft drink (nt diet). Check yur bld sugar again in 15 minutes. If it s nt better, eat r drink a surce f quick sugar again. When yu feel better, have a prtein snack like cheese and crackers r half a peanut butter sandwich. Talk with yur dctr if yu have tw r mre lw bld sugars during 1 week. Call yur dctr if (Ask yur dctr t fill in.) Remember! See yur dctr regularly Check yur bld sugar as directed Take yur medicine as directed Eat a healthy diet Exercise and be active

like it s beating t fast If yu ntice any f these signs r symptms, check yur bld sugar.

11 Diabetes Lgbk: r ess. Cpy t Cir h c e c le b h ar l t a d s s m uga a n r r y t es im W u l t e es a eek f ac s y h t im u n e y ee d i u r t t Br Befre eakfast After Bld sugar r eadings Cmments* Br Befre eakfast After Bld sugar r eadings Cmments* C mmen (1/2 c u p ts: R f r ep ice = r t a b n l yt hin g t d s uga ha t migh r); ex erci s t ha v e m e (wa lke e a k b e v e r b el ep t rac k Befr Lunch e After Befre Lunch After ade a c han ge in y d fast x 30 min); i w y f y ur t a ur b l r g et. A d s uga dd c r. Dinner Befre After Dinner Befre After l ur b ln es l s (f d s ev uga n er a r, f r exa d s r e t hr m a p mm en ts n diet, exer ci s e, il Bedtime Other Bedtime Other le: m t); ea r s s a es l t r n d c s (c n mm cer en n a ts a b u b t h u t cer usb a ln es t n a in f d g s, et d tin r s t Date T ime Date T ime s g l Medicines u take y Medicines yu take * a id ff).

Bld sugar r eadings Cmments* C mmen (1/2 c u p ts: R f r ep ice = r t a b n l yt hin g t d s uga ha t migh r); ex erci s t ha v e m e (wa lke e a k b e v e r b el ep t rac k Befr Lunch e After Befre

12 800 CDC INFO ( ) Order Number: CS B

Medication Guide. AUBAGIO (oh-bah-gee-oh) (teriflunomide) tablets

Medication Guide. AUBAGIO (oh-bah-gee-oh) (teriflunomide) tablets Medicatin Guide AUBAGIO (h-bah-gee-h) (teriflunmide) tablets Read this Medicatin Guide befre yu start using AUBAGIO and each time yu get a refill. There may be new infrmatin. This infrmatin des nt take