Gestational Diabetes

Gestational diabetes is high blood sugar (diabetes) that starts or is first diagnosed during pregnancy.



Alternative Names
Glucose intolerance during pregnancy


Causes, incidence, and risk factors

Risk factors for gestational diabetes include:

African or Hispanic ancestry
Being over age 25 when pregnant
Birth defect in a previous child
Obesity
Giving birth to a previous baby who weighed more than 9 pounds
Recurrent infections
Unexplained miscarriage or death of a newborn


Symptoms

Usually there are no symptoms, or the symptoms are mild and not life threatening to the pregnant woman. Often, the blood glucose level returns to normal after delivery.

Symptoms may include:

Blurred vision
Fatigue
Frequent infections, including those of the bladder, vagina, and skin
Increased thirst
Increased urination
Nausea and vomiting
Weight loss in spite of increased appetite
However, high blood sugar levels in the mother can cause problems in the baby. These problems can include:

Birth trauma
Jaundice
Large size at birth
Low blood sugar (hypoglycemia)
Rarely, the fetus dies in the womb late in the pregnancy.



Signs and tests

Gestational diabetes is usually diagnosed during the 24th - 28th weeks of pregnancy. All pregnant women should receive an oral glucose tolerance test during this time period to screen for the condition.



Treatment

The goals of treatment are to keep blood glucose levels within normal limits during the pregnancy, and to make sure that the fetus is healthy.

Your health care provider should closely check both you and your fetus throughout the pregnancy. You also can self-monitor your blood glucose levels. Fetal monitoring to check the size and health of the fetus may include ultrasound and nonstress tests.

A nonstress test is a very simple, painless test for you and your baby. A machine that hears and displays your baby's heartbeat (electronic fetal monitor) is placed on your abdomen. When the baby moves, its heart rate normally increases 15 - 20 beats above its regular rate.

Your health care provider can look at the pattern of your baby's heartbeat compared to its movements and find out whether the baby is doing well. The health care provider will look for 3 increases of 15 beats per minute over the baby's normal heart rate, occurring within a 20-minute period.

Managing your diet can give you the calories and nutrients you need for your pregnancy and to control blood glucose levels. You should have nutritional counseling with a registered dietician.

Diabetes diet

If managing your diet does not control blood glucose levels, you should start insulin therapy. You will need to self-monitor your blood glucose levels during insulin treatment.

Heart Failure - Dilated Cardiomyopathy

Dilated cardiomyopathy is the most common form of heart failure. Cardiomyopathy simply means heart muscle disease. In dilated cardiomyopathy (often referred to as congestive cardiomyopathy or congestive heart failure), the heart muscle becomes damaged for some reason (see causes article below), leading to a generalized weakening of the muscular walls of the cardiac chambers. To compensate for this weakening, the cardiac chambers dilate. (The dilation of the cardiac chambers, especially of the left ventricle, is often referred to as "remodeling.") The dilation and weakening of the heart muscle eventually leads to heart failure.

Check the Following Links to Learn About Dilated Cardiomyopathy

The Heart's Chambers and Valves

The purpose of the heart is to pump the blood that bathes every organ of the body. The blood carries oxygen and nutrients to the tissues, and removes waste products from the tissues. If the pumping action of the heart is disrupted, the body’s organs begin to fail very quickly. Therefore, life itself is dependent on the efficient operation of the heart.
Heart chambers and heart valves
The heart has four chambers. The two ventricles (right and left) are muscular chambers that propel the blood out of the heart (the right ventricle to the lungs, and the left ventricle to all other organs). The two atria (right and left) hold the blood returning to the heart, and at just the right moment empty into the right and left ventricles.
The four heart valves (tricuspid, pulmonic, mitral and aortic) keep the blood moving in the right direction through the heart.

How the heart pumps blood
It is helpful to visualize the heart as two separate pumps, working in series – the right heart pump, and the left heart pump.
The right heart pump
Figure 1: The right heart pump consists of the right atrium (RA), tricuspid valve (TV), right ventricle (RV), pulmonic valve (PV), and pulmonary artery (PA).Poorly oxygenated blood returning to the heart from the body's organs enters the right atrium, and is stored there until the right atrium contracts..
Figure 2: When the right atrium contracts, the tricuspid valve opens, allowing the blood to enter the right ventricle
Figure 3: Then, when the right ventricle contracts, the pulmonic valve opens, and the blood is propelled into the pulmonary artery. The pulmonary artery carries the blood to the lungs, where it picks up oxygen.