TOP 6 Questions about Diabetes and Pregnancy:
1. As a pregnant diabetic patient, may I take any medication
No, you can’t. The commonly used drugs in the class of the ACE inhibitors and AT2 antagonists are harmful to the baby; preferably before pregnancy and otherwise be stopped as soon as possible after starting the pregnancy. Preference in treatment of high blood pressure goes to alpha-methyldopa because that has been in use the longest and are safe to date turned out to be. Labetalol is also safe. The advantage of labetolol is that it protects the kidneys. There’s also at a disadvantage. Because it’s a beta-blocker, it muffles the warning signs of hypoglycaemia, causing an incipient hypo less or not being felt that can, therefore, be more serious and/or longer-lasting. Also, calcium antagonists (preferably nifedipine) shall be considered as safe during pregnancy.
2. I don’t have any complaints, do I have to be screened for thyroid abnormalities?
Thyroid disorders occur in women with type 1 diabetes. two to three times as common as in healthy women. The most common thyroid diseases his hypothyroidism in pregnancy and thyroiditis after childbirth. The latter can lead to both hypo- and hyperthyroidism gives the cause. Because hypothyroidism can be harmful to the mother and for the baby, it is recommended that preferably prior to test the pregnancy for hypothyroidism, and otherwise at least in the first trimester. Hypothyroidism can be treated easily.
3. Is the chance of a spontaneous abortion increased with patients with type 1 and type 2 diabetes?
Spontaneous abortion is meant that the baby is born within 16 weeks of pregnancy. The chance of spontaneous abortion in women with type 1 diabetes is only increased if the blood sugar regulation is not good. In other words: if the blood sugar regulation is good, it is a chance no higher than in women without diabetes. For patients with type 2 diabetes, it’s a little different, because they also have other risk factors such as obesity and high blood pressure. That makes their chances a little higher.
4. I’d like to get pregnant, but my blood sugars rocking a lot, from 2 to 20. Is continuous glucose measurement useful to me?
Yes, for people who are on an intensive insulin schedule or treated with an insulin pump, and in whom If blood sugar regulation is not functioning properly, continuous glucose measurement (CGM) can be a useful tool. Then fluctuations can often be ‘captured’ that can occur with loose readings are missed. Especially for women who want to get pregnant and whose blood sugars are strictly needing to be regulated, CGM can help to achieve that goal. to reach. CGM’s largest profits are recorded when the blood sugar values are compared with the behavior of that moment. That’s where the patient learns the most.
5. What are the advantages of continuous glucose measurement?
Particularly in patients who are highly motivated to use the blood sugars. and who can’t very well arrange it… CGM sometimes give the answer that is missed without CGM. Our experience (at the diabetes clinic of the Twenteborg Hospital) is that in about 50% of the patients a surprising explanation is found for hypo- or hyperglycemic disturbances, because patients have certain have behaviors that are customary for them (and so have become normal), but which have led to fluctuations into blood sugar regulation. Precisely because the patient notes what he or she does and eats and that behavior can immediately compare it with the consequences that that behavior has for the blood sugars, he or she will see what can go wrong.
6. Are there drawbacks to CGM?
The meter’s a technical device you use to handle should be able and willing to go. There are people, for example, elderly people, or people who don’t understand the language well, who there have trouble with it. Often it’s just the people who already injecting insulin four times a day or an insulin pump also have those who don’t have a problem with CGM. It is important that you realize that the meter is not a device is that solves all problems on its own. It’s just a tool for people who themselves to improve blood sugar regulation.
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