Signs & Symptoms Of Diabetic Ketoacidosis
Symptoms of diabetic ketoacidosis usually don’t start all at once they usually come on slowly over several hours. Signs and symptoms include:
- fatigue
- excessive thirst/urination
- dry mouth and dehydration
These symptoms are caused by the sustained hyperglycemia that typically happens before someone develops diabetic ketoacidosis.
If the person isn’t treated, these symptoms can happen:
- abdominal pain
- unconsciousness
Myth #: Mildly Elevated Blood Sugar Is Nothing To Worry About
What if your blood sugar is only slightly elevated, by around 5-10mg/dl above targets? Certainly thats not a problem, right? I wish that was the case, but researchers have observed that some of the problems associated with gestational diabetes can occur even in fairly mild cases, like having a baby with high insulin levels or one who is abnormally large at birth.
The landmark Hyperglycemia and Adverse Pregnancy Outcomes study , which studied 23,316 women with gestational diabetes and their infants, found that even mildly elevated fasting blood sugar levels were linked to high insulin levels in infants at birth and macrosomia .
For example, women with an average fasting blood sugar of 90mg/dl or less had a large baby 10% of the time, compared to 25-35% in women whose average fasting blood sugar was 100mg/dl or higher. A more recent study out of Stanford found a significantly higher risk of congenital heart defects in babies born to women with mildly elevated blood sugar .
The bottom line is: your blood sugar levels in pregnancy matter. Clearly, the adverse fetal programming typically attributed to gestational diabetes may be occurring to mothers who experience only slightly elevated blood sugar. This means what you eat matters, the amount of carbohydrates you eat matters, the amount of sugar you eat matters, the amount of nutrients that naturally regulate blood sugar matters, the amount of sleep you get matters, the amount of exercise you get matters, etc, etc, etc.
You Do Not Need To Achieve Perfect Blood Sugars To Conceive And Birth A Healthy Happy Baby
It should be well-understood that perfect blood sugar management during pregnancy is simply not possible. In a body that struggles to properly produce or properly use insulin, you are simply going to do the very best you can do each and every day of your pregnancy.
Some days, that might look nearly perfect on a blood sugar graph. Other days, it definitely wont.
Thanks to insulin pumps, continuous glucose monitors, and newer types of insulin and medications, women with diabetes can achieve very tight blood sugar levels for a large majority of their pregnancy.
However, the only way youll know its time to increase your insulin doses is by noticing that your blood sugar levels are starting to trend higher.
Additionally, youll find as your pregnancy progresses that youll need to dose your insulin sooner and sooner before eating a meal in order to prevent a post-meal spike in your blood sugar. The only way to learn its time to start dosing sooner is by observing those higher post-meal levels.
At the end of the day, you are going to do the very best you can. Some days will go incredibly well, some days will be incredibly frustrating. The best thing you can do for your growing baby is to pick yourself up and keep trying!
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How Are High Blood Sugar Levels Treated
To treat high blood sugar, it helps to know what is causing it. You might need to take more insulin or diabetes pills because you’re growing and eating more food, or you might need to get more exercise each day.
Having high blood sugar levels every once in a while isn’t a big deal. It happens to everyone with diabetes from time to time. But if your blood sugar levels are high a lot, your diabetes health care team will have to help you figure out how to get them back to a healthy level.
Myth #: Im Thin I Cant Possibly Have Gestational Diabetes
Screening for gestational diabetes might seem like another unnecessary test, especially if youre otherwise healthy, but that doesnt mean youre in the clear. Some studies have shown up to 50% of women with gestational diabetes dont have any of the classic risk factors, like being overweight prior to becoming pregnant or a family history of diabetes.
While the screening tests arent perfect , its still worth being proactive given all that we know about mildly elevated blood sugar levels and risks to your baby. Even if youre not interested in the glucose drink, at the very least, using a glucometer to measure your blood sugar levels for a few weeks while you eat your usual diet teaches you a TON about food and your body. And if youre reading this in early pregnancy, ask to have an A1c added to your blood work.
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What Causes High Blood Sugar Levels In Non
To fully understand what causes high blood sugar levels in non-diabetics, it makes sense to go back to first principles of blood glucose regulation.
You will be glad you did, because by the end of this blog post, you will have the fundamental knowledge to connect all the dots regarding why blood sugar may be high in a non-diabetic.
So, lets do that, shall we:
Behind your stomach is an organ called the pancreas. The pancreas has a cluster of cells scattered within it called the beta cells.
The beta cells are very important to us. As little in size as they are, their importance cannot be over-emphasized.
Why is this?
Because Beta cells of the pancreas are responsible for producing, storing and releasing insulin when called upon.
You need insulin to survive. Without insulin your cells cannot access the glucose in the blood circulation. Without insulin energy production will cease. Insulin is the hormone that drives sugar from the blood circulation into the cells.
When glucose gets inside the cells, it can then be used by the mitochondria to produce energy. This is the energy we need to perform both basic and advanced everyday activities.
How does insulin interact with the food we eat? When you eat, digestion of food begins in the mouth. The glucose in the food you eat gets released by the process of digestion via enzymes in your saliva and stomach.
This is called Second Phase Insulin Release.
How Do You Know If You Have Gestational Diabetes
Your health care provider tests you for gestational diabetes with a prenatal test called a glucose tolerance test. You get the test at 24 to 28 weeks of pregnancy. If your provider thinks youre at risk for GDM, you may get the test earlier.
If your glucose screening test comes back positive, you get another test called a glucose tolerance test to see for sure if you have gestational diabetes.
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Type 1 Pregnancy Risks And How To Minimize Them
Editors Note: This page is part of a series on diabetes and pregnancy. for more great resources and personal stories.
Theres a lot to consider when trying to get pregnant or being pregnant as a Type 1 woman. Theres of course, the maternal desire to do everything you can for your unborn child so that he or she may have the best life possible. An ideal pregnancy is a full-term and uneventful one, the outcome a healthy, happy baby.
Having Type 1 diabetes doesnt mean you cant have that it just means that you have to be more vigilant, more prepared because of the heightened risks involved. But youre a Type 1, so you already know how to do that. In fact, youve been doing it ever since D-day, so take a deep breath and trust yourself.
All pregnancies have the chance for complications, but having Type 1 makes you more susceptible to specific ones. Here are the most important things to do in order to lower those risks:
Why Is Exercise Important
Your doctor will suggest that you exercise regularly at a level that is safe for you and the baby. Exercise will help keep your blood sugar level normal. It can also make you feel better. Walking is usually the easiest type of exercise when you are pregnant. But swimming or other exercises you enjoy are also beneficial during this time. Ask your doctor to recommend some activities that would be safe for you.
If youre not used to exercising, begin by exercising for 5 or 10 minutes every day. As you get stronger, you can increase your exercise time to 30 minutes or more per session. The longer you exercise and the more often you exercise, the more in control you will be of your blood sugar.
You do need to be careful about how you exercise. Dont exercise too hard or get too hot while exercising. Ask your doctor what activities are safe for you. Depending on your age, your pulse shouldnt go higher than 140 to 160 beats per minute during exercise. If you become dizzy or have back pain or other pain while exercising, stop exercising immediately and call your doctor. If you have uterine contractions , vaginal bleeding, or your water breaks, call your doctor right away.
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Who Is At Risk For Diabetes During Pregnancy
The risk factors for diabetes in pregnancy depend on the type of diabetes:
-
Type 1 diabetes often occurs in children or young adults, but it can start at any age.
-
Overweight women are more likely to have Type 2 diabetes.
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Overweight women are more likely to have gestational diabetes. Its also more common in women who have had gestational diabetes before. And its more common in women who have a family member with Type 2 diabetes. Women with twins or other multiples are also more likely to have it.
Can Gestational Diabetes Cause Problems During Pregnancy
Yes. If not treated, GDM can cause pregnancy complications, including:
Gestational diabetes also can cause health complications for your baby after birth, including:
- Breathing problems, including respiratory distress syndrome . This is a breathing problem caused when babies dont have enough surfactant in their lungs. Surfactant is a protein that keeps the small air sacs in the lungs from collapsing.
- Jaundice. This is a medical condition in which a babys eyes and skin look yellow. A baby has jaundice when his liver isn’t fully developed or isnt working well.
- Low blood sugar
- Obesity later in life
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If You Dont Already Walk Daily Pregnancy Is The Time To Start
Well, sure, some women continue to run marathons and do CrossFit workouts throughout every month of pregnancy, but thats not most women.
Instead, consider walking your new best friend as a woman with diabetes. Going for a 15 or 30-minute walk after lunch, for example, can significantly reduce that post-meal blood sugar spike.
If you dont take insulin, using walking as a method for managing your blood sugar around meals can have a huge impact on your overall diabetes health during pregnancy.
If you do take insulin, you may find youll want to cut back the insulin dose for that meal if you plan to walk afterward.
Regardless, to combat the increasing insulin resistance created by pregnancy in those last two trimester, it is critical that you stay active. While the last month or two of pregnancy come present physical challenges for some , do the most walking you safely and comfortably can.
Target Blood Glucose Levels During Pregnancy
Recommended daily target blood glucose numbers for most pregnant women with diabetes are
- Before meals, at bedtime, and overnight: 90 or less
- 1 hour after eating: 130 to 140 or less
- 2 hours after eating: 120 or less3
Ask your doctor what targets are right for you. If you have type 1 diabetes, your targets may be higher so you dont develop low blood glucose, also called hypoglycemia.
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High Glucose Readings Is A Problem Too
The researchers found women with higher blood glucose readings early in their pregnancies were more likely to have a baby with a heart defect. For every increase of 10 milligrams per deciliter in blood sugar levels, the risk increased by 8 percent.
Checking blood sugar early in pregnancy may help doctors screen for possible heart problems and lead to earlier treatment.
Myth #: Cut Back On Carbohydrates But Not Less Than 175g Of Carbohydrates/day
The conventional nutrition advice for gestational diabetes is mind-numbingly nonsensical. Youre given the diagnosis of GD, aka carbohydrate intolerance, yet told to eat a bunch of carbohydrates. You fail a 50 or 75 gram glucose tolerance test, yet are told to eat 45-60 grams of carbohydrates at almost EVERY MEAL. Its no wonder roughly 40% of women will require insulin and/or medication to lower their blood sugar when theyre consistently filling up their carbohydrate-intolerant body with lots of carbohydrates.
Perhaps not-so-shocking is that researchers have shown that eating a lower-glycemic diet reduces the chance a women will require insulin by HALF. Its common sense, friends.
Unfortunately, theres oodles of misinformation low-carb diets. Women are warned not to eat low-carb because they might go into ketosis . Plus, theres entirely no acknowledgement that ketosis can exist outside of diabetic ketoacidosis. Sadly, few healthcare professionals have fully investigated the details and continue to fear-monger based on false information.
Im one of the few that has done the research and Im the first dietitian to scientifically defend the safety of a lower-carbohydrate diet to manage gestational diabetes .
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What Happens After My Baby Is Born
You may not need to have blood tests to check your blood sugar while youre in the hospital after your baby is born. However, it may be several weeks after your babys birth before your gestational diabetes goes away. To make sure it has gone away, your doctor will ask you to have a special blood test 1 or 2 months after you have your baby.
Pregnancy If You Have Diabetes
On this page:
If you have diabetes and plan to have a baby, you should try to get your blood glucose levels close to your target range before you get pregnant.
Staying in your target range during pregnancy, which may be different than when you arent pregnant, is also important. High blood glucose, also called blood sugar, can harm your baby during the first weeks of pregnancy, even before you know you are pregnant. If you have diabetes and are already pregnant, see your doctor as soon as possible to make a plan to manage your diabetes. Working with your health care team and following your diabetes management plan can help you have a healthy pregnancy and a healthy baby.
If you develop diabetes for the first time while you are pregnant, you have gestational diabetes.
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How Is High Blood Sugar Diagnosed
There are different kinds of blood tests that can diagnose hyperglycemia. These include:
Random blood glucose: this test reflects the blood sugar level at a given point in time. Normal values are generally between 70 and 125 mg/dL, as discussed earlier.
Fasting blood glucose: this is a measurement of blood sugar level taken in the early morning prior to eating or drinking anything since the night before. Normal fasting blood glucose levels are less than 100 mg/dL. Levels above 100 mg/dL up to 125 mg/dL suggest prediabetes, while levels of 126 mg/dL or above are diagnostic of diabetes.
Oral glucose tolerance test: this is a test that measures blood glucose levels at given time points after a dose of sugar is consumed. This test is most commonly used to diagnose gestational diabetes.
Glycohemoglobin A1c: is a measurement of glucose that is bound to red blood cells and provides an indication about blood sugar levels over the past 2 to 3 months.
How Is Gestational Diabetes Diagnosed
As part of your prenatal care, your doctor will recommend screening for gestational diabetes around 24 to 28 weeks of pregnancy. This could happen sooner if there is reason to believe you are at risk for developing gestational diabetes. If you have elevated glucose levels in your urine or other risks, your doctor may recommend having the screening sooner.
During the glucose test, youll drink a syrupy-sweet bottle of glucose solution. One hour after drinking that, a lab technician will take a sample of your blood. He or she will measure the amount of sugar in your blood.
If your blood sugar is too high, your doctor will likely prescribe another glucose test. For this test, you will need to fast . A lab technician will test your blood sugar while you are fasting. Then, you will again drink the syrupy-sweet bottle of glucose solution. The lab technician will test your blood once an hour for 3 hours.
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What Are The Risk Factors
Your doctor likely will talk to you about several risk factors during your early checkups. Dr. Chapa says you are more likely to get gestational diabetes if:
- You are overweight, with a body mass index over 30.
- You are over age 35.
- You had a baby that weighed more than 9 pounds.
- Your blood sugar levels are high in the urine or blood.
- Your family has a history of type 2 diabetes.
- You had gestational diabetes before.
- Women who have a few of these factors often get an early screening.
High Blood Sugar Facts
- Low high blood sugar is abnormally high blood levels of insulin in the blood. Hyperglycemia is a hallmark sign of diabetes and prediabetes, and diabetes is the most common cause of it. Severely elevated glucose levels can result in a medical emergency like diabetic ketoacidosis or hyperglycemic hyperosmolar nonketotic syndrome .
- The primary symptom of hyperglycemia is excessive amounts of sugar in the urine. Other symptoms and signs of high blood sugar levels in the blood are blurred vision, hunger , and headaches.
- Other conditions that can cause high blood sugar are pancreatitis, Cushing’s syndrome, unusual hormone-secreting tumors, pancreatic cancer, certain medications, and severe illnesses.
- Insulin is the treatment for people with type 1 diabetes, and life-threatening increases in glucose levels. People with type 2 diabetes may be managed with a combination of different oral and injectable medications. Hyperglycemia due to medical conditions other than diabetes is generally treated by treating the underlying condition responsible for the elevated glucose.
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