The toll of toiling with Type 1 diabetes – you deserve a medal

The toll of toiling with Type 1 diabetes – you deserve a medal

Managing Type 1 diabetes demands a lot of work.  At meal times the quality and quantity of food has to be dealt with, the glucose measured, forth coming activity considered, the dose of insulin calculated and administered.  Sometimes I think the amount of work diabetes engenders is about the same as a two year old, you have fed them, changed them, given something to drink, put them down, sit down to have a cup of coffee and “Waahh”;  with diabetes you calculate your carbs, adjust for your glucose level, exercise the right amount, take the appropriate insulin and wham – your glucose is low or high –go figure!

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What is A1c and is it an accurate reflection of blood sugar in pregnancy?

What is A1c and is it an accurate reflection of blood sugar in pregnancy?

In diabetes a lot of attention is paid to the A1c. What is it and is it good at reflecting over sugar levels?
Simple average blood sugars are not that great at telling how the blood sugar control is really like.  Consider Mr Smith who has sugars ranging from 2 to 20 mmol/l (36 – 360 mgs/dl) and Mrs Dixon with sugars of 10 to 12 mmol/l (180 – 216 mgs/dl).  Both have the same average of 11 mmol/l (198 mgs/dl) but the control of sugar in Mr Smith sounds much worse.  The A1c is a much more stable reflection of overall sugar control.

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Why the fuss about the A1c in early pregnancy?

Why the fuss about the A1c in early pregnancy?

When someone with Type 1 or Type 2 diabetes becomes pregnant the main things to think about are: the mom’s own situation with regards to diabetes complications, her blood sugars and the baby.  The big issues for the baby are that he or she might have a congenital malformation, be too large at birth or have low blood sugars just after birth.  Of these the congenital malformation is by far the most important.  A large baby can be delivered by Caesarian section, a low sugar in the baby is readily treated but if the heart, kidney or spine are not formed correctly we can’t turn back the clock.

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Early Gestational Diabetes

Early Gestational Diabetes

A couple of weeks ago in the clinic we had a woman, just over three months gestation, who was diagnosed with gestational diabetes (GDM).  She had GDM on the last pregnancy when it was found at 28 weeks so was surprised when she got it so early this time round. What is going on?

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