If we can reconcile diabetes and pregnancy, diabetic pregnancy is at risk. Transmission of diabetes from mother to child (inherited) is possible, and poor glycemic control is dangerous to the fetus. Medical monitoring (blood glucose, diet, treatment) at each stage (design, delivery, breastfeeding) is necessary for a pregnancy safely.

Diabetes in Women: Is it Save to be Pregnant?

Exceptions (retinopathy, severe hypertension …), there is no indication today-cons for diabetic women to have children . There are still two decades, the medical profession did little encouragement, or when under very restrictive: for 25 years, an only child, cesarean delivery with compulsory …

What has changed? The glucose monitoring and new insulins , “a revolution”, says Patrick Vexiau, Chief of Diabetes, Hôpital Saint-Louis in Paris.

But beware, if you want a child is diabetic (type 1 or 2) and have a pregnancy, it is coming, even before conception! That’s why we say that a diabetic pregnancy that lasts 12 months. 3 months before, and during pregnancy until delivery, must be in a process that maximizes the safety conditions for mother and child.

Diabetes in Women: Programmed pregnancy

The diabetic women should be rigorous in their contraception to prevent pregnancy “surprises” or “marked late.” Unframed, pregnancy exposes the fetus in the first months and require the mother to make more efforts to balance her diabetes. So much anticipation and talk about your desire for motherhood with your doctor.

Diabetes in Women: Diabetes Transmission Risk

In fact, the issue of possible transmission of the disease concerned diabetic women: ” It’s the first question I asked when I became diabetic, “says Isabelle Burdet, co-founder of the association ‘s diabetic mothers . Professor Patrick Vexiau says: ” Heredity is low for type 1 diabetes, the order of 3 to 4%. It is stronger for the type 2 diabetes: the order of 30 to 40%. Hence the need to monitor the child, especially when he reaches adulthood at the outset to inculcate good habits and dietary hyginéno “.

Diabetes in Women: Fluctuations in Blood Sugar

The pregnancy is diabetogenic in nature, so much so that it can trigger a temporary diabetes called “gestational” in women who are not diabetic, or reveal longstanding diabetes go unnoticed. Pregnancy subjects the body to blood sugar fluctuations with the effects of poor glycemic control dangerous for a diabetic mother and fetus.

Although each case is different, patterns emerge. The first quarter is often characterized by hypoglycemia with rebound effects (new hormones set off, nausea disrupt meals …). The third quarter (rather brutally to the sixth month) often results in insulin requirements sometimes multiplied by 2 which must be compensated by injections of insulin for blood glucose levels remain normal. In the last few weeks, it’s the opposite, the need for insulin may decrease slightly : involved aging of the placenta and probably most important consumption of glucose by the baby.

Diabetes in Women: Diabetic Pregnancy Risk

Diabetic pregnancy and gestational diabetes are therefore high-risk pregnancies . They expose the mother and child to the same complications: macrosomia (baby’s weight over 4kg) and of other risks . Diabetic women should engage in a process of strict control and monitoring of blood glucose, with a series of reviews that will facilitate enhanced delivery and allow the baby as the mother to be healthy. Learn more the risks of maternal diabetes for the child.

Preparation and monitoring of diabetic pregnancy

• Several elements will ensure a successful pregnancy in the perinatal period.
• Medical monitoring
• Throughout pregnancy and by stage, the appointments and regular examinations are to be taken in addition to conventional monitoring in pregnant women.

Among the screenings include:
HbA1c to 4.250 kg), it uses a C-section.

Diabetes in Women: Post Natal / After delivery

After delivery, the hypoglycemia may be common in the mother : the insulin requirements and lactation consumes a lot of calories. The main risk for the newborn hypoglycemia is to watch for in the early hours.

Newborn Baby Risk of Hypoglycemia

While in utero the baby depends on the blood sugar of the mother via the umbilical cord after birth, it is no longer the case. If in late pregnancy, maternal hyperglycemia is common, for example, the baby produces more insulin to compensate . After delivery, the pancreas hyperplastic baby will continue to produce much insulin can cause the baby and then hypoglycemia.
Monitoring of the newborn
In general, monitoring of the newborn of a diabetic woman is done every quarter of an hour the first hour, then every hour, then every three hours for 48 hours, then gradually, after four days, then 2 times, etc. (until it is no longer necessary).

If hypoglycemia persists after these initial steps, the baby will be hospitalized in the neonatology department and fed by gastric tube or infusion until the return of a satisfactory blood sugar.

The benefits of breast milk for the child are known. Women with diabetes can breastfeed and even give their milk in a milk bank so much that breastfeeding increases energy expenditure and has a positive effect on weight loss and glycemic control of the mother.

However here are some recommendations:

• be careful of hypoglycemia (which may be sudden and violent)
• resucrer is if they occur during the feeding
• drink plenty and increase your caloric intake if there are no overweight
• No recovery of your oral antidiabetic (OAD) and maintaining insulin during lactation.

Finding information on men’s sexual problems is easier than to find those of the woman, even if women begin to emerge in the scientific literature. See the diabetes in women sexuality here.

By 1974, the World Health Organization estimates that: “The individual has fundamental rights including the right to sexual health and pleasure, and the power to control his sexual activity and reproductive output as a personal social ethics “?

Women Sexual Problems and Diabetes in Women

Sexual problems faced by women with diabetes are basically the genital infections : they can cause pain during sex. There may be vaginal dryness also making reports difficult or painful, as well as disorders of sexual pleasure associated with the neurological clitoral , such as erectile dysfunction that is observed in humans (see diabetes in male sexuality and diabetes in humans ).

To all these factors can add mood disorders, up to the true vacuum. They are responsible for a decreased libido : it has less desire to make love, you have less desire, less fun, less orgasm. As in humans, the imbalance of diabetes can have an impact on the psychological state and on the sexuality .

Diabetes and Sexual Health: a long neglected problem

Elsa says that at a workshop on “Diabetes and sexual problems,” with assistance predominantly male, she dares to ask whether the disorders listed in men could meet in women in other forms (vaginal dryness etc..) : “I remember having had a look of puzzled sexologist this, saying that so far he had not heard and that perhaps the problem lies elsewhere! “.

Monique was surprised too: “I am a diabetic since I was 38 years, so after my two children, and no one ever told me about sexuality issues. I realize now that I have missed out on much by not knowing that I could talk, but to whom? ”

Diabetes in Women – Diabetes and Sexual Infections

Fungi

“Since my diabetes is out of balance, I have severe pain that prevent me from having sex. Why? ” , Marlene. Many diabetics and nondiabetics are carriers of fungi ( candidiasis or thrush ) at the sexual level. The imbalance of diabetes leads to the presence of sugar in the urine, which greatly facilitates the development of these fungi. Taking antibiotics, common in diabetics, has the same effect and leaves the possibility of mushroom grow. The presence of fungi causing inflammation and swelling of the vulva, responsible for major disturbances at the time of intercourse, with pain and itching.

Mycosis

“I have had fungal infections, do I risk to do it again? ” Gisele. These fungal infections (see previous paragraph) be treated with antifungal and diabetes control. But the subjects remain carriers of the fungus and each imbalance of diabetes, it happens again. As likes to say Vexiau Professor ” is the barometer of diabetes . ”

When antibiotic treatment is necessary, and if the person has already had such problems, we must prevent the doctor to give preventive treatment against fungi, along with antibiotics.

Urinary tract infections

Urinary tract infections are also more common in diabetic women, especially during episodes of imbalance of diabetes. These urinary infections may give pain with a low impact on sex.

Vaginal dryness

Vaginal dryness may be related to infectious factors seen previously. But it may also be due to a lack of female hormones (estrogen). This deficiency can be spontaneous but also favored by some hormonal contraceptives (particularly by certain IUDs or progestin). Do not hesitate to talk to her gynecologist or doctor, as this can be treated.

Diabetes in Women – Rules and diabetes

“Before the rules, my diabetes is still unbalanced, is this normal? ” Christine. It can happen. The hormonal changes that occur during the cycle can affect diabetes control, especially since there is often some changes in mood, stress, all factors that can have a negative influence on the control diabetes. Under these conditions, increased monitoring of blood glucose and adjustment of therapy may be needed for each cycle.

Diabetes in Women – Insulin pump and sexuality

Aline says: “I wear a pump for 8 years, and I am delighted. I had already proposed at least 15 years earlier, and at that time I refused because the pumps were not disconnected, and I found the stress too heavy in relation to the bathroom (bath or restriction showers) and also to sexuality. At first I déconnectais my pump at the time of reporting, but my husband got used to it, and now I keep it, with occasionally a small “hook” of tubing that makes us laugh instead … never my catheter has been pulled. If that can reassure some … ”

Diabetes in Women – Who to talk to?

If there is pain, a doctor should be notified to investigate the cause of these infections and treat them. The complexity of female sexuality requires a multidisciplinary management. The usual contact is the (or) gynecologist. The ideal is that it works with the treating physician and / or diabetologist.

The sex therapist is also designed to help solve the sexual problems of all those who are not great sex: it may be a psychologist, doctor ..

What is the relation between diabetes in women and contraception? All contraceptives may be prescribed to diabetic women. The only restrictions are the hormonal contraceptive pills, implants, patches, vaginal rings. However, the effects of diabetes such contraceptives are minor.

Diabetes in Women – Contraception Pills and insulin treatment

The pill oestroprogestative -cons is not indicated by diabetes. Women who have not been pregnant, and in whom the IUD is cons-indicated, may be used, provided that:

• that there are no complications of diabetes
• associations to choose the lower dose after consulting the gynecologist and diabetologist.

However, the pills microprogestatives are less well tolerated on the gynecological, and require greater rigor in the decision to be effective. They are reserved for patients in whom other contraceptives are cons-indicated, and subject to regular use (at a fixed time). However the latest (Cerazette ®) are as effective as conventional pills.

Micro-dose Pills and Diabetes

Definitions must be clear. COCs (the majority) containing estrogen and progestin. Estrogens may be “normodosés” (50 mcg) or, for almost all cases, “Low-dose ‘, but from 15 to 35 mcg. However the dose pills are those that contain only progestin, it is the microprogestatifs (see previous paragraph).

Diabetes Tablets and Non-Insulin Contraception Pills

The restrictions are the same as in women treated with insulin. But patients treated with tablets are often older, and there may be indications of cons-just age related. In addition, diabetes can be older and, especially, we do not always know the date of onset of diabetes. The balance on the lookout for cons-indications related to complications of diabetes is especially important.

Finally, women treated with tablets are often overweight and obesity itself can be a cons-indications to the use of hormonal contraceptives, because of the risk of phlebitis and pulmonary embolism, as venous insufficiency is extremely common in these subjects. Careful consideration of the state of venous leg is therefore essential in the instructions or not the pill.

Contraception Pills Diabetes Side Effects

” What are the side effects? Do any of it specific to women with diabetes? “, Carole. Side effects are similar in women with diabetes than women without diabetes. However, some pills may promote some hormonal imbalances and vaginal flora, and thus promote fungal infections and vaginal dryness (see above).

Contraception Pills and weight gain
” Does the pill could make me look fat? “Michele. The pill, even consisting of hormones, has no reason to grow. Many patients are trying hard not to constantly grow, and when you introduce a drug whose reputation is to gain weight, it demotivates women often tend to be less careful thinking ” if I take the weight, it’s not my fault, it’s the fault of the pill . ” It is the drug “alibi”.

There is, at best, when you look objectively, there can be a jack of one to two pounds under the maximum COCs.
Contraceptive patch and vaginal ring
On contraceptive patches (different treatment of menopause) and vaginal rings, there is little difference with low-dose pills (see above).
Pill – tobacco – Diabetes
Tobacco and associations COCs (pill) do not mix. Indeed, smoking greatly increases the risks vascular, especially arterial, on the pill. This is especially true in diabetics as diabetes itself increases the risk. Risks caused by diabetes and tobacco do not add but multiply.
IUD
” Is there more risk of infection because of my diabetes? “Germaine. First, both the IUD is recommended for women with diabetes than women without diabetes and its effectiveness is the same. There is no greater risk of infection on IUD because of diabetes provided that it is properly balanced. But as in all women, the risk of infection is mainly related to the number of partners (the higher the number, the higher the risk is important).
Implants
The implants are not cons-indicated in patients with diabetes. Side effe cts and cons-indications are the same as in women without diabetes. However, the duration of effect of the implant could be a little shorter in women who are overweight or obese, which is often the case in patients with type 2 diabetes. This should be discussed with your doctor or gynecologist.
Contraception and complications
” Are there contraceptives to avoid when you have diabetes complications? “. Estrogens given orally (pills) can affect the retina and may aggravate retinopathy lesions. In addition, they can raise blood pressure which often plays a role in worsening retinopathy. It is therefore absolutely necessary to examine the damage to the retina with the diabetologist and ophthalmologist to determine whether there is a cons-indication to taking hormonal contraceptives. Moreover, they can increase diabetic nephropathy. A dosage of microalbuminuria and / or proteinuria is essential before prescribing and monitoring thereafter.

Remember also that other cons-indications are the same as in women without diabetes. Being overweight can cause phlebitis and pulmonary embolism.

Finally, hormonal contraception by IUD or implant, does not protect against sexually transmitted diseases (STDs or sexually transmitted infections called: STI) and that the condom remains the best protection, especially protection from HIV.

What is Diabetes Type 2 – Introduction

The term “diabetes” means excessive urination, and the term “sweet”, the Latin mellitus, meaning honey. In the past, doctors diagnosed diabetes by tasting the patient’s urine and found that it had a sweet taste.

What does not work in the case of diabetes mellitus?

Diabetes mellitus is a chronic disease caused by a partial or total lack of insulin. Insulin is a hormone, a substance of vital importance, which is manufactured by the pancreas that lowers blood sugar. Insulin works like a key that open the doors of your cells and to let in sugar (glucose).

In a diabetic, the pancreas makes too little insulin to allow the whole blood sugar to enter your muscle and other cells to produce energy. If sugar can not enter your cells to be used, it accumulates in the bloodstream. Therefore, high levels of glucose are the hallmark of diabetes. The excess sugar is excreted in the urine, hence the ancient practice consisting in the urine sample for diagnosis.

Different types of diabetes

There are two main types of diabetes: Type 1 or insulin, tends to occur in children or young adulthood and that always requires treatment with insulin. It is caused by the own body’s immune system destroys the pancreatic cells responsible for producing insulin (beta cells), diabetes type 2 or non-insulin usually settles slowly into adulthood. This is a progressive disease that can sometimes be treated only with diet and exercise but, in most cases, type 2 diabetes require oral medications and / or insulin injections.

What is the cause of type 2 diabetes?

Diabetes Type 2 (designated in the past under the term diabetes mellitus or NIDDM) develops when two anomalies are met: – The cells of your body become less sensitive to insulin who can not fulfill its role. This occurs most often in people who are overweight, sedentary and having a diet too rich.

As a result of this inefficiency, your pancreas produces more insulin to get the same effect. – Your pancreas is failing and after a few months or years, can no longer produce enough insulin to compensate for the reduced sensitivity of your cells to insulin. This deficiency is more pronounced during meals.

It is at this point in diabetes. This failure of the pancreas is probably hereditary. – These two anomalies are needed to develop diabetes. For example, only 30% of patients with diabetes are overweight. Others have a pancreas that works quite normally and may compensate for the ineffectiveness of insulin.

Who is at risk of developing diabetes type 2?

From what was said above, one can understand why the majority of cases undoubtedly a family origin, because there are often cases of type 2 diabetes in families. Some breeds seem to be most vulnerable to type 2 diabetes than others. The lifestyle is also important to determine whether a person predisposed to type 2 diabetes develop the disease.

This is more common in people who are not getting enough exercise, which have a diet too fat or too many calories and / or overweight. Women who develop diabetes during pregnancy (gestational diabetes) will then be more prone to disease. The exact cause of diabetes remains poorly understood at present, but some cases can be blamed on the specific genetic defects.

The normal blood glucose

People without diabetes have a fasting glucose less than 1.10 g / l (6.0 mmol / l) and blood glucose after meals less than 1.40 g / l (7.8 mmol / l) according to international guidelines. We talk about diabetes when the fasting blood glucose greater than or equal to 1.26 g / l (7 mmol / l), measured at least twice. It is also diabetic so, whatever the time of day, blood glucose is greater than or equal to 2 g / l (11mmol / l) at least twice. Source: ANAES “Principles of screening for type 2 diabetes” People who have blood glucose levels are ranging from normal values ​​and values ​​characteristic of diabetes are identified as having an “impaired glucose tolerance”, a state of “pre-diabetes” which increases the risk of developing diabetes later. Your doctor may need to perform a specific test for accurate diagnosis.

Now that You Have Diabetes Type 2

Insulin acts like a key that opens the door to your cells with glucose. But, now that you have diabetes, you do not have the capacity to produce these keys sufficient to open the doors of your cells. If sugar can not get into your muscles and other cells to produce energy, you feel tired and sugar can not enter cells to be used, it accumulates in the blood.

From Sugar in Urine

Urine is formed in the kidneys when the blood is filtered. Without enough insulin, the sugar in your blood reaches very high levels. When this happens, some of the sugar is then removed with the urine via the kidneys. Sugar, which is eliminated with urine taking with him a lot of water. This gives you very thirsty. You drink a lot and urinate frequently.

Diabetes Type 2 Treatment

Once diagnosed, your goal should be to control your blood sugar. This will allow you to feel good, to lead a normal life and avoid long term complications of diabetes. You and your doctor should set goals for your blood sugar. Remember that any improvement in blood glucose levels will reduce the risk of complications. To keep control of your blood sugar, you need to do now that your organization was previously automatically. You can make better use of insulin that your body continues to produce by improving your diet and eating schedule, doing exercise and losing weight if needed. If, by these measures, you do not get the desired result, you can take medications that increase the ability of insulin production in your body, or improve your insulin sensitivity. If these drugs are not effective, or if your body is under stress, including illness, you may need insulin injections temporarily.

The Medical and Paramedical Specialist for Diabetes Type 2

Diabetes Support of People with Diabetes is the domain of the treating physician and / or endocrinologist specializing in diabetes. The use of diabetes specialist is recommended in case of imbalance of diabetes. The therapeutic patient education conducted by the physician, may be supplemented by: – allied health professionals specializing in diabetology (dietitians, nurses, podiatrists, sports medicine educators); – a support with an educational program (type of diabetes home, the program offered by patient associations) – a coordinated follow specific (preventive podiatric, medical and social difficulties, patient education and dietary) proposed a network of care. Source : High Health Authorities Recommendation on “Management of type 2 diabetes”, May 2006

Other Help For Diabetes Type 2

Most medical practices can give you information leaflets that you can win and take the time to read. An association diabetics are also perhaps not far from home. You may find, in this type of association, friendly support and meet other diabetics and sharing experience and advice. You can also find lots of information about diabetes through websites that your doctor can advise you.

What is Diabetes Type 1?

Diabetes is characterized by a partial or total lack of insulin production by the body.
Diabetes type 1 (formerly insulin-dependent) is a condition in which the body can not produce insulin or the cells and the pancreas responsible for producing insulin are destroyed.
Diabetes is defined by a fasting glucose greater than 1.26 g / l (7 mmol / l) or a blood sugar greater than 2 g / l (11mmol / l) at any time of day (Source: HAS Guide for Patients – ALD – October 2006 ).
There are also non-insulin dependent diabetes or type 2, which usually settles slowly into adulthood.

Diabetes Type 1

Diabetes Type 1 is a lifelong condition caused by lack of insulin. Insulin is a hormone, a substance of vital importance, made ​​by some of those pancreatic cells BETA. Without insulin, your body can not properly use the stoker and food, especially sugars you eat. So you’re tired, and the consequence is that your blood sugar gets too high, even without eating.

What is the cause of type 1 diabetes?

The type 1 diabetes sets in when the natural defense system of the body against viruses and bacteria destroys the pancreatic cells responsible for insulin production. The cause behind such a condition are not yet clearly established. However, we know that some families are more likely than others to get diabetes. We also know that some external factors (viral infections) are involved. Note that in most cases (90%) cases of diabetes are isolated, not family. mode of interaction of these factors is unknown.

Before becoming type 1 diabetic

Before you become diabetic, your body maintained your blood sugar at exactly the right level. Your blood sugar was less than 1.26 g / l (7 mmol / l) after an overnight fast. After a meal containing carbohydrates (complex sugars, transformed into simple sugars), sugar (glucose) is absorbed very rapidly in the blood. The amount of sugar in the blood should be neither too high nor too low. Two hormones, insulin (hypoglycemic) and glucagon (hyperglycemic), produced by the pancreas, ensure good glycemic control, regardless of the amount of food you eat and whatever the level of physical activity that you.

blood glucose rises after eating

After eating, blood sugar (called postprandial, 1:30 to 2 hours after a meal) increases. In a person without diabetes, insulin is released into the bloodstream and taken with sugar, to all body cells. Insulin acts as a key opens the door and in the walls of muscle cells, allowing the sugar in the blood to enter the cell to provide energy. Insulin also opens the doors of the fatty tissue or muscle for the sugar is stored until they are salted out as and when required. This lowers the blood sugar back to normal.

When you have diabetes type 1

Insulin acts like a key. In diabetes, the body can not produce these keys sufficient to open the cell doors. If sugar can not get into your muscles and other cells to produce energy, you feel tired (asthenia), and sugar can not enter cells to be used, accumulates in the blood ( hyperglycemia). At the beginning of your diabetes, hyperglycemia is observed.

Sugar in the urine

Urine is formed in the kidneys when the blood is filtered. Without enough insulin, the sugar in your blood reaches very high levels. Beyond blood glucose equal to 1.80 g / l (10 mmol / l), some of the sugar is then removed with the urine via the kidneys (the “glycosuria”). This means, in a sense, that dietary carbohydrates are not used and are released into the urine. Sugar, which is eliminated with urine taking with him a lot of water, causing urine clear and abundant and a large thirst. You drink so much (“polydipsia”) and urinate often (“polyuria”).

Ketones in urine

Without the need insulin, your body can not use sugar, and he tries to burn fat when used as an alternative source energy. When your liver burns fat too quickly, it produces in the degrading of toxic called “ketones”. These ketones are dangerous as when produced in large quantities they make the blood acidic and are responsible for the onset of acidosis. When ketones reach your kidneys, some are excreted in the urine with sugar: it is the “ketonuria”.

Ketoacidosis

During the development of diabetes type 1, in the absence of treatment by insulin, there occurs a severe acute complication called ketoacidosis. You may feel ill, probably suffering from stomach pains and vomiting, and breathing difficulties that can lead to unconsciousness. This condition can lead to diabetic coma. It requires immediate treatment with insulin and fluid intake by infusion. In patients already treated, ketoacidosis can occur with cessation of insulin or inadequate intake (eg during infections or fever or increase insulin requirements). This is a medical emergency that should suffer no delay, which fortunately can be prevented by care and education in the discovery of the disease.

Now that you have diabetes type 1

Your blood sugar to be constantly monitored Now that you have diabetes, you do what your organization was previously automatically. The goal is to mimic, by multiple injections, insulin secretion that you had before becoming diabetic and maintain blood glucose levels as close to normal as possible.

Treatment of diabetes type 1

every day, you will need several insulin injections. It is important to have a healthy diet. Be sure to correct and possibly three meals a day snacks. Remember to exercise regularly. You will also need to learn the diabetes, learn how to test your blood sugar and how to react appropriately according to the reading of your blood sugar.

Diabetes is an increased rate of glucose (sugar) in the blood, which is defined by a fasting blood glucose greater than or equal to 1.26 g / l (measured twice). 

In the case of type 1 diabetes (insulin dependent), this increase in glucose in the blood is mainly due to the lack of insulin secretion by pancreatic cells.

In the case of type 2 diabetes (non insulin dependent), a decreased secretion of Insulin is associated with poor use of insulin by the body cells (insulin resistance).

Insulin is normally produced by the pancreatic beta cells – it is in this part of the body that is produced insulin and other hormones and substances involved in the metabolism of nutrients.

Insulin is the most important hormone involved in regulating blood glucose.Diabetes can also affect lipid metabolism. It is the other most often associated with obesity, cardiovascular disease and hypertension in the case of type 2 diabetes.