Diabetes And Pregnancy
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Diabetes And Pregnancy
For pregnant women with diabetes, some particular challenges exist for both mother and child. If the pregnant woman has diabetes as a pre-existing disorder, it can cause early labor, birth defects, and larger than average infants. Therefore, experts advise diabetics to maintain blood sugar level close to normal range about 3 months before planning for pregnancy. When type 1 diabetes mellitus or type 2 diabetes mellitus is pre-existing, planning in advance is emphasized if one wants to become pregnant, and stringent blood glucose control is needed before getting pregnant. Physiology Pre-gestational diabetes can be classified as Type 1 or Type 2 depending on the physiological mechanism. Type 1 diabetes mellitus is an autoimmune disorder leading to destruction of insulin-producing cell in the pancreas; type 2 diabetes mellitus is associated with obesity and results from a combination of insulin resistance and insufficient insulin production. Upon becoming pregnant, the placen ...
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Complications Of Diabetes
Complications of diabetes mellitus include problems that develop rapidly (acute) or over time (chronic) and may affect many organ systems. The complications of diabetes can dramatically impair quality of life and cause long-lasting disability. Overall, complications are far less common and less severe in people with well-controlled blood sugar levels. Some non-modifiable risk factors such as age at diabetes onset, type of diabetes, gender and genetics may influence risk. Other health problems compound the chronic complications of diabetes such as tobacco smoking, smoking, obesity, hypertension, high blood pressure, hypercholesterolemia, elevated cholesterol levels, and lack of regular exercise. Complications of diabetes are a strong risk factor for severe COVID-19 illness. Acute Diabetic ketoacidosis Diabetic ketoacidosis (DKA) is an acute and dangerous complication that is always a medical emergency and requires prompt medical attention. Low insulin levels cause the liver to turn ...
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Breast Feeding
Breastfeeding, or nursing, is the process by which human breast milk is fed to a child. Breast milk may be from the breast, or may be expressed by hand or pumped and fed to the infant. The World Health Organization (WHO) recommends that breastfeeding begin within the first hour of a baby's life and continue as often and as much as the baby wants. Health organizations, including the WHO, recommend breastfeeding exclusively for six months. This means that no other foods or drinks, other than vitamin D, are typically given. WHO recommends exclusive breastfeeding for the first 6 months of life, followed by continued breastfeeding with appropriate complementary foods for up to 2 years and beyond. Of the 135 million babies born every year, only 42% are breastfed within the first hour of life, only 38% of mothers practice exclusive breastfeeding during the first six months, and 58% of mothers continue breastfeeding up to the age of two years and beyond. Breastfeeding has a number ...
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Hypoglycemia
Hypoglycemia, also called low blood sugar, is a fall in blood sugar to levels below normal, typically below 70 mg/dL (3.9 mmol/L). Whipple's triad is used to properly identify hypoglycemic episodes. It is defined as blood glucose below 70 mg/dL (3.9 mmol/L), symptoms associated with hypoglycemia, and resolution of symptoms when blood sugar returns to normal. Hypoglycemia may result in headache, tiredness, clumsiness, trouble talking, confusion, fast heart rate, sweating, shakiness, nervousness, hunger, loss of consciousness, seizures, or death. Symptoms typically come on quickly. The most common cause of hypoglycemia is medications used to treat diabetes such as insulin, sulfonylureas, and biguanides. Risk is greater in diabetics who have eaten less than usual, recently exercised, or consumed alcohol. Other causes of hypoglycemia include severe illness, sepsis, kidney failure, liver disease, hormone deficiency, tumors such as insulinomas or non-B cell tumo ...
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Bolus (medicine)
In medicine, a bolus (from Latin '' bolus'', ball) is the administration of a discrete amount of medication, drug, or other compound within a specific time, generally 1–30 minutes, to raise its concentration in blood to an effective level. The administration can be given by injection: intravenously, intramuscularly, intrathecally, subcutaneously, or by inhalation. The article on routes of administration provides more information, as the preceding list of ROAs is not exhaustive. Placement The placement of the bolus dose depends on the systemic levels of the contents desired throughout the body. An intramuscular injection of vaccines allows for a slow release of the antigen to stimulate the body's immune system and to allow time for developing antibodies. Subcutaneous injections are used by heroin addicts (called 'skin popping', referring to the bump formed by the bolus of heroin), to sustain a slow release that staves off withdrawal symptoms without producing euphoria. A ...
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Basal Rate
Basal rate, in biology, is the rate of continuous supply of some chemical or process. In the case of diabetes mellitus, it is a low rate of continuous insulin supply needed for such purposes as controlling cellular glucose and amino acid Amino acids are organic compounds that contain both amino and carboxylic acid functional groups. Although hundreds of amino acids exist in nature, by far the most important are the alpha-amino acids, which comprise proteins. Only 22 alpha am ... uptake. Together with a bolus of insulin, the basal insulin completes the total insulin needs of an insulin-dependent person. An insulin pump and wristop controller is one way to arrange for a closely controlled basal insulin rate. The slow-release insulins (e.g., Lantus and Levemir) can provide a similar effect. In healthy individuals, basal rate is monitored by the pancreas, which provides a regular amount of insulin at all times. The body requires this flow of insulin to enable the body to utili ...
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Macrosomia
Large for gestational age (LGA) is a term used to describe infants that are born with an abnormally high weight, specifically in the 90th percentile or above, compared to other babies of the same developmental age. Macrosomia is a similar term that describes excessive birth weight, but refers to an absolute measurement, regardless of gestational age. Typically the threshold for diagnosing macrosomia is a body weight of between , or more, measured at birth, but there are difficulties reaching a universal agreement of this definition. Evaluating an infant for macrosomia or LGA can help identify risks associated with their birth, including labor complications of both the parent and the child, potential long-term health complications of the child, and infant mortality. Signs and symptoms Fetal macrosomia and LGA often do not present with noticeable patient symptoms. Important signs include large fundal height (uterus size) and excessive amniotic fluid (polyhydramnios). Fundal height ...
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Neonatal Jaundice
Neonatal jaundice is a yellowish discoloration of the white part of the eyes and skin in a newborn baby due to high bilirubin levels. Other symptoms may include excess sleepiness or poor feeding. Complications may include seizures, cerebral palsy, or kernicterus. In most of cases there is no specific underlying disorder (physiologic). In other cases it results from red blood cell breakdown, liver disease, infection, hypothyroidism, or metabolic disorders (pathologic). A bilirubin level more than 34 μmol/L (2 mg/dL) may be visible. Concerns, in otherwise healthy babies, occur when levels are greater than 308 μmol/L (18 mg/dL), jaundice is noticed in the first day of life, there is a rapid rise in levels, jaundice lasts more than two weeks, or the baby appears unwell. In those with concerning findings further investigations to determine the underlying cause are recommended. The need for treatment depends on bilirubin levels, the age of the child, and the u ...
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ADHD
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by excessive amounts of inattention, hyperactivity, and impulsivity that are pervasive, impairing in multiple contexts, and otherwise age-inappropriate. ADHD symptoms arise from executive dysfunction, and emotional dysregulation is often considered a core symptom. In children, problems paying attention may result in poor school performance. ADHD is associated with other neurodevelopmental and mental disorders as well as some non-psychiatric disorders, which can cause additional impairment, especially in modern society. Although people with ADHD struggle to focus on tasks they are not particularly interested in completing, they are often able to maintain an unusually prolonged and intense level of attention for tasks they do find interesting or rewarding; this is known as hyperfocus. The precise causes of ADHD are unknown in the majority of cases. Genetic factors play an import ...
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Atrioventricular Septal Defect
Atrioventricular septal defect (AVSD) or atrioventricular canal defect (AVCD), also known as "common atrioventricular canal" (CAVC) or "endocardial cushion defect" (ECD), is characterized by a deficiency of the atrioventricular septum of the heart that creates connections between all four of its chambers. It is caused by an abnormal or inadequate fusion of the superior and inferior endocardial cushions with the mid portion of the atrial septum and the muscular portion of the ventricular septum. Symptoms and signs Symptoms include difficulty breathing (dyspnea) and bluish discoloration on skin, fingernails, and lips (cyanosis). A newborn baby will show signs of heart failure such as edema, fatigue, wheezing, sweating and irregular heartbeat. Complications Normally, the four chambers of the heart divide oxygenated and de-oxygenated blood into separate pools. When holes form between the chambers, as in AVSD, the pools can mix. Consequently, arterial blood supplies become less oxygena ...
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Truncus Arteriosus
The truncus arteriosus is a structure that is present during embryonic development. It is an arterial trunk that originates from both ventricles of the heart that later divides into the aorta and the pulmonary trunk. Structure The truncus arteriosus and bulbus cordis are divided by the aorticopulmonary septum. The truncus arteriosus gives rise to the ascending aorta and the pulmonary trunk. The caudal end of the bulbus cordis gives rise to the smooth parts (outflow tract) of the left and right ventricles (aortic vestibule & conus arteriosus respectively). The cranial end of the bulbus cordis (also known as the conus cordis) gives rise to the aorta and pulmonary trunk with the truncus arteriosus. This makes its appearance in three portions. # Two distal ridge-like thickenings project into the lumen of the tube: the truncal and bulbar ridges. These increase in size, and ultimately meet and fuse to form a septum ( aorticopulmonary septum), which takes a spiral course toward the p ...
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Holoprosencephaly
Holoprosencephaly (HPE) is a cephalic disorder in which the prosencephalon (the forebrain of the embryo) fails to develop into two hemispheres, typically occurring between the 18th and 28th day of gestation. Normally, the forebrain is formed and the face begins to develop in the fifth and sixth weeks of human pregnancy. The condition also occurs in other species. Holoprosencephaly is estimated to occur in approximately 1 in every 250 conceptions and most cases are not compatible with life and result in fetal death in utero due to deformities to the skull and brain. However, holoprosencephaly is still estimated to occur in approximately 1 in every 8,000 live births. When the embryo's forebrain does not divide to form bilateral cerebral hemispheres (the left and right halves of the brain), it causes defects in the development of the face and in brain structure and function. The severity of holoprosencephaly is highly variable. In less severe cases, babies are born with normal or ...
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