Study links blood sugar to newborn risks

[one...two...tree 2,762]

By CARLA K. JOHNSON, Associated Press Writer

The higher a pregnant woman's level of blood sugar, the greater the risk to her newborn — whether the mother has diabetes or not, the largest study on the problem suggests. The findings released Friday may lead to more women being diagnosed with diabetes during pregnancy and given stricter diet advice or medication to lower blood sugar.

The research involved more than 23,000 pregnant women in nine countries. It found a surprisingly strong relationship between the blood sugar levels of the women and the rate of big babies and first-time Caesarean sections, said lead investigator Dr. Boyd Metzger of Northwestern University.

The newborns also were more likely to have low blood sugar levels and high insulin levels if their mothers' blood sugar levels were higher. The problems can lead to obesity, diabetes and high blood pressure later in life.

Large babies risk shoulder damage and other injuries if delivered vaginally and lead to more C-sections, which also pose health risks to mothers and babies.

Large babies were defined in the study as those bigger than 90 percent of those born in the local population, so large Thai babies would be smaller than large U.S. babies.

Researchers reported the findings Friday at the American Diabetes Association's annual scientific meeting.

The higher the mother's blood sugar, the more risk for the newborns, the study found. Researchers took into account obesity, age and family history of diabetes and still found the mother's blood sugar independently affected the infant's size and health.

It's long been known that gestational diabetes — a type of diabetes that starts during pregnancy and often goes away after birth — is unhealthy for a woman and her baby. The study is the largest to document the frequency of newborn problems at increasing levels in mother's blood sugar and the first to find that levels now considered acceptable posed some risks.

"We have established without any question that levels of blood sugar less elevated than typical diabetes carry risks," Metzger said. Currently, the goal for a pregnant woman's fasting blood sugar is below 95 milligrams per deciliter during the final few months of pregnancy.

A new target of 90 may be more reasonable, Metzger said. Researchers are not making recommendations for now, he said. New guidelines may come next year after international experts meet to analyze the findings, he said.

In the study, large babies were born 5 percent of the time to women with the lowest level of fasting blood sugar (less than 75 milligrams per deciliter). The rate of large babies was 27 percent at the highest level (greater than 100 milligrams per deciliter).

Other measures of gestational diabetes in the pregnant women, such as glucose tolerance tests, also correlated with infant risk.

The risk was seen in babies in the United States, Canada, Barbados, Britain, Israel, Thailand, Australia, Singapore and Hong Kong. The $19 million study was funded by the National Institutes of Health and the diabetes association.

Gestational diabetes affects about 4 percent of pregnant women, about 135,000 a year in the United States. That number may climb by tens of thousands of women a year if guidelines are revised, Metzger said.

"The question is, what is the best blood sugar to have? Probably there is no threshold. The lower, the better," said Dr. Joel Zonszein, director of the Clinical Diabetes Center at New York's Montefiore Medical Center.

Dr. John Kitzmiller, a maternal and fetal health expert at Santa Clara Valley Medical Center in San Jose, Calif., said the study will raise debate over how to treat women with mild elevations in blood sugar. More evidence may be needed to show that treatment works.

Women with gestational diabetes are treated with special diets that limit carbohydrates and include high-fiber foods in frequent smaller meals. They sometimes also require injected insulin at a cost of $80 to $120 a month and need regular doctor checkups.

Some doctors use glyburide, a generic glucose-lowering pill, but large studies of the drug's safety in pregnant women have not been done.

___

On the Net:

American Diabetes Association: http://www.diabetes.org

[Aymerlu 3]

By CARLA K. JOHNSON, Associated Press Writer

The higher a pregnant woman's level of blood sugar, the greater the risk to her newborn — whether the mother has diabetes or not, the largest study on the problem suggests. The findings released Friday may lead to more women being diagnosed with diabetes during pregnancy and given stricter diet advice or medication to lower blood sugar.

The research involved more than 23,000 pregnant women in nine countries. It found a surprisingly strong relationship between the blood sugar levels of the women and the rate of big babies and first-time Caesarean sections, said lead investigator Dr. Boyd Metzger of Northwestern University.

The newborns also were more likely to have low blood sugar levels and high insulin levels if their mothers' blood sugar levels were higher. The problems can lead to obesity, diabetes and high blood pressure later in life.

Large babies risk shoulder damage and other injuries if delivered vaginally and lead to more C-sections, which also pose health risks to mothers and babies.

Large babies were defined in the study as those bigger than 90 percent of those born in the local population, so large Thai babies would be smaller than large U.S. babies.

Researchers reported the findings Friday at the American Diabetes Association's annual scientific meeting.

The higher the mother's blood sugar, the more risk for the newborns, the study found. Researchers took into account obesity, age and family history of diabetes and still found the mother's blood sugar independently affected the infant's size and health.

It's long been known that gestational diabetes — a type of diabetes that starts during pregnancy and often goes away after birth — is unhealthy for a woman and her baby. The study is the largest to document the frequency of newborn problems at increasing levels in mother's blood sugar and the first to find that levels now considered acceptable posed some risks.

"We have established without any question that levels of blood sugar less elevated than typical diabetes carry risks," Metzger said. Currently, the goal for a pregnant woman's fasting blood sugar is below 95 milligrams per deciliter during the final few months of pregnancy.

A new target of 90 may be more reasonable, Metzger said. Researchers are not making recommendations for now, he said. New guidelines may come next year after international experts meet to analyze the findings, he said.

In the study, large babies were born 5 percent of the time to women with the lowest level of fasting blood sugar (less than 75 milligrams per deciliter). The rate of large babies was 27 percent at the highest level (greater than 100 milligrams per deciliter).

Other measures of gestational diabetes in the pregnant women, such as glucose tolerance tests, also correlated with infant risk.

The risk was seen in babies in the United States, Canada, Barbados, Britain, Israel, Thailand, Australia, Singapore and Hong Kong. The $19 million study was funded by the National Institutes of Health and the diabetes association.

Gestational diabetes affects about 4 percent of pregnant women, about 135,000 a year in the United States. That number may climb by tens of thousands of women a year if guidelines are revised, Metzger said.

"The question is, what is the best blood sugar to have? Probably there is no threshold. The lower, the better," said Dr. Joel Zonszein, director of the Clinical Diabetes Center at New York's Montefiore Medical Center.

Dr. John Kitzmiller, a maternal and fetal health expert at Santa Clara Valley Medical Center in San Jose, Calif., said the study will raise debate over how to treat women with mild elevations in blood sugar. More evidence may be needed to show that treatment works.

Women with gestational diabetes are treated with special diets that limit carbohydrates and include high-fiber foods in frequent smaller meals. They sometimes also require injected insulin at a cost of $80 to $120 a month and need regular doctor checkups.

Some doctors use glyburide, a generic glucose-lowering pill, but large studies of the drug's safety in pregnant women have not been done.

___

On the Net:

American Diabetes Association: http://www.diabetes.org

Yep! I was considered a high risk pregnancy when I found out I was 1 week pregnant! I was told straight up that my baby could have kidney and heart problems and there was a chance that should could be blind if I didn't get my blood sugars in control. I had to go to the high risk OB/GYN, along with my regular OB/GYN every 2 weeks and once I went in pre-trem labor at 23 weeks, I had to see both of them weekly for very detailed ultrasounds. I was VERY strick with my diet while pregnant and my blood sugars were very controlled, but dispite all that, my daughter was born at 34 weeks and was 10 pounds!!!! That was a whole other issue.! She had to stay in the hospital for a week because her blood sugars dropped and they could not get them stable for a while.

I had "gestational diabetes" with my son 6 years before the pregnancy with my daughter and was diagnosed with full blown diabetes a few years later. My doc told me that any condition a pregnant woman may have with her pregnancy such as diabetes and high blood pressure is something that she will more than likely have to deal with later in life.

[one...two...tree 2,762]

Yep! I was considered a high risk pregnancy when I found out I was 1 week pregnant! I was told straight up that my baby could have kidney and heart problems and there was a chance that should could be blind if I didn't get my blood sugars in control. I had to go to the high risk OB/GYN, along with my regular OB/GYN every 2 weeks and once I went in pre-trem labor at 23 weeks, I had to see both of them weekly for very detailed ultrasounds. I was VERY strick with my diet while pregnant and my blood sugars were very controlled, but dispite all that, my daughter was born at 34 weeks and was 10 pounds!!!! That was a whole other issue.! She had to stay in the hospital for a week because her blood sugars dropped and they could not get them stable for a while.

I had "gestational diabetes" with my son 6 years before the pregnancy with my daughter and was diagnosed with full blown diabetes a few years later. My doc told me that any condition a pregnant woman may have with her pregnancy such as diabetes and high blood pressure is something that she will more than likely have to deal with later in life.

She's healthy now, yes? Wow, it seems that this is happening with a lot of women these days.

[BelwinMills 0]

Yep! I was considered a high risk pregnancy when I found out I was 1 week pregnant! I was told straight up that my baby could have kidney and heart problems and there was a chance that should could be blind if I didn't get my blood sugars in control. I had to go to the high risk OB/GYN, along with my regular OB/GYN every 2 weeks and once I went in pre-trem labor at 23 weeks, I had to see both of them weekly for very detailed ultrasounds. I was VERY strick with my diet while pregnant and my blood sugars were very controlled, but dispite all that, my daughter was born at 34 weeks and was 10 pounds!!!! That was a whole other issue.! She had to stay in the hospital for a week because her blood sugars dropped and they could not get them stable for a while.

I had "gestational diabetes" with my son 6 years before the pregnancy with my daughter and was diagnosed with full blown diabetes a few years later. My doc told me that any condition a pregnant woman may have with her pregnancy such as diabetes and high blood pressure is something that she will more than likely have to deal with later in life.

She's healthy now, yes? Wow, it seems that this is happening with a lot of women these days.

Wow great info!

[Aymerlu 3]

Yep! I was considered a high risk pregnancy when I found out I was 1 week pregnant! I was told straight up that my baby could have kidney and heart problems and there was a chance that should could be blind if I didn't get my blood sugars in control. I had to go to the high risk OB/GYN, along with my regular OB/GYN every 2 weeks and once I went in pre-trem labor at 23 weeks, I had to see both of them weekly for very detailed ultrasounds. I was VERY strick with my diet while pregnant and my blood sugars were very controlled, but dispite all that, my daughter was born at 34 weeks and was 10 pounds!!!! That was a whole other issue.! She had to stay in the hospital for a week because her blood sugars dropped and they could not get them stable for a while.

I had "gestational diabetes" with my son 6 years before the pregnancy with my daughter and was diagnosed with full blown diabetes a few years later. My doc told me that any condition a pregnant woman may have with her pregnancy such as diabetes and high blood pressure is something that she will more than likely have to deal with later in life.

She's healthy now, yes? Wow, it seems that this is happening with a lot of women these days.

Oh yeah, she's totally healthy now. I do get her blood sugar checked yearly and on occasion I'll do a finger stick on her (you know she really loves that )just to make sure nothing is going on. There's a few in my family that got diabetes as children so I keep an eye on her.

[KarenCee 3]

When I was pregnant with my daughter, I was dxd with Gestational Diabetes at 4 months and put on insulin. By the time I was induced at 36.5 weeks, I was up to almost 200 units of NPH and R insulins. She's great as far as weight and not having diabetes, she has other health concerns though.

[one...two...tree 2,762]

When I was pregnant with my daughter, I was dxd with Gestational Diabetes at 4 months and put on insulin. By the time I was induced at 36.5 weeks, I was up to almost 200 units of NPH and R insulins. She's great as far as weight and not having diabetes, she has other health concerns though.

I hope we will continue to learn more about it - maybe even find effective, preventive medicine.

Here's something that sounded interesting as to the causes of Gestational Diabetes:

Department of Pediatrics, Mount Sinai School of Medicine, New York, New York.

Diabetes mellitus is a frequent transient or rare permanent complication of pregnancy. The role of autoimmune phenomena in this gestational form of diabetes is incompletely understood. We have examined sera from 312 pregnant women who had abnormal glucose tolerance (based on a screening examination during the second trimester) for the presence of islet cell surface antibodies or insulin autoantibodies. Fifty-eight of these women were lost to follow-up. Of the remaining subjects, 144 (57.1%) had gestational diabetes diagnosed by formal glucose tolerance testing and the others (42.9%) were normal. Sixty percent of the women with gestational diabetes eventually required insulin to control their blood glucose during pregnancy. One serum from the non-diabetic women was positive for insulin antibodies (0.9%); 8 of the sera from the patients with gestational diabetes were positive (5.6%). Subsequent analysis revealed that all nine of the women whose sera were positive for insulin autoantibodies had been treated with insulin previously. Islet cell surface antibodies were strongly correlated with gestational diabetes. Forty-five of 144 gestational diabetic sera were positive (31.3%) whereas only 9 of 108 suspect control sera (8.3%) and 7 of 60 unknown sera (11.7%) were positive. These data suggest that a high percentage of pregnant women who screen positive for glucose intolerance have serological evidence of an autoimmune response against the pancreatic islets, in spite of the state of relative immune tolerance during pregnancy. These data suggest that autoimmune phenomena may play a role in gestational diabetes and that the presence of islet cell antibodies can predict insulin-requiring gestational diabetes.

http://www.ncbi.nlm.nih.gov/sites/entrez?c...p;dopt=Abstract

[KarenCee 3]

Most interesting....I've often wondered what could be the cause of this.

When I was found to be Gest Diabetic at 4 months, my blood sugars were staying well over 200 - even on the strict diet in the hospital. Once my daughter was born, everything went back to normal for a while. Now I am full blown diabetic and quite possibly staring insulin in the face again. *sigh*

[one...two...tree 2,762]

Most interesting....I've often wondered what could be the cause of this.

When I was found to be Gest Diabetic at 4 months, my blood sugars were staying well over 200 - even on the strict diet in the hospital. Once my daughter was born, everything went back to normal for a while. Now I am full blown diabetic and quite possibly staring insulin in the face again. *sigh*

I've been trying to learn more about Diabetes - my mother had pancreatitus just over 10 years ago and since then has been diagnosed with Diabetes. It's a scary disease.

[Aymerlu 3]

Most interesting....I've often wondered what could be the cause of this.

When I was found to be Gest Diabetic at 4 months, my blood sugars were staying well over 200 - even on the strict diet in the hospital. Once my daughter was born, everything went back to normal for a while. Now I am full blown diabetic and quite possibly staring insulin in the face again. *sigh*

I've been trying to learn more about Diabetes - my mother had pancreatitus just over 10 years ago and since then has been diagnosed with Diabetes. It's a scary disease.

It is a very serious condition, but when you do what you're supposed to do, it's very manageable. I know there are days that my blood sugar will run high for no apparant reason and that will totally eat at me. I've always been pretty much a diabetic that took her meds, watched what she ate 'sometimes" and rarely exercised. My A1C's (average blood sugars for 3 months) would run a 8.8 which is not good. Since January I have been watching what I eat and exercising reguarly and my A1C's are now at 5.4!!(non-diabetic range) There are still days that I want that piece of cake and I will eat it and immediatly take off walking or jump on the elliptical. I'm losing weight and feel better than ever!

Ranges for A1C

[Nancy2015 2]

Holy cow... I have high blood sugar... I don't have children yet, but I'm scared as hell already.

[KarenCee 3]

Holy cow... I have high blood sugar... I don't have children yet, but I'm scared as hell already.

If you and your spouse decide to have children, there are ways to have a healthy child even with diabetes. It does require a stricter diet and adhering to the checkups from your doctor. It's the ones that don't follow the doctor's advice and do their own thing that usually have the problems. Knowing that you're scared means (IMHO) that you would definitely do what the dr tells you to do.