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Pregnancy and Diabetes:

Pregnancy multiplies concerns about high blood sugar levels, whether you were diabetic prior to pregnancy or became diabetic during pregnancy.

Women with no previous diabetes diagnosis who manifest high blood sugar levels during pregnancy are said to have gestational diabetes. It's estimated that this condition affects 18% of pregnancies. Gestational diabetes usually manifests around the 24th week.

Whether you contracted diabetes during pregnancy, or you had diabetes prior to becoming pregnant, the message is the same: it's important to follow your doctor's advice regarding blood glucose (blood sugar) levels so you can minimize complications to you and your baby.

With diabetes during pregnancy your pancreas works overtime to produce insulin, but the insulin does not lower your blood glucose levels. Although insulin does not cross the placenta, glucose does, raising the baby's blood glucose levels. The baby's pancreas responds by making extra insulin. This can lead to macrosomia, or a "large" baby.

Babies with macrosomia face health problems of their own, including very low blood glucose levels at birth, higher risk for breathing problems, and even damage to their shoulders during birth. Throughout childhood they are at higher risk for obesity, and in adulthood they run a higher risk for developing type 2 diabetes.

Diabetes during pregnancy can also lead to complications to the mother such as preeclampsia (high blood pressure and protein in the urine), and may increase her chances of needing a cesarean section, or c-section, because of the baby's increased size.

How can I protect my baby?

Work with your health care team to develop a plan to keep your blood sugars in a good range. Following this plan can help you to have a healthy pregnancy and baby.

Your plan will include:

• Monitoring your blood sugar levels
• Using medication if blood sugar levels remain high
• Healthy eating
• Physical activity
• Regular visits with your team

Endocrine Disorders

Endocrinology is the branch of medicine dealing with diseases involving hormones and the glands that produce them. Hormones are substances produced by specialized organs called endocrine glands whose role is to regulate a wide range of functions in the body. The pituitary, the thyroid, the ovaries and testes, the adrenals, and parts of the pancreas are all endocrine glands.

Endocrine disorders can result in low energy; weight difficulties; allergies and recurrent infections; low body temperature; poor memory, focus, and concentration; and other symptoms. If you're experiencing problems related to weight control, energy or fatigue, anxiety, heart rate, temperature control, growth, or digestion, you may need to see an Endocrinologist to help you restore the normal balance of hormones produced by your endocrine glands.

The Pituitary:

This is a small but vital gland located at the base of the brain that serves as a master gland regulating the functions of other glands such as the thyroid, the adrenals, and the ovaries and testes, as well as producing growth hormone, prolactin to induce lactation, and a hormone: the anti-diuretic hormone that regulates the excretion of water in the urine. Excess or under-production of any of these hormones can lead to disease.

The Thyroid:

The thyroid gland is a butterfly shaped organ located at the front of the neck. It produces thyroid hormone that regulates multiple functions in the body. Both under-activity: Hypothyroidism, and over-activity: Hyperthyroidism can occur. Nodules, most of which are non-cancerous can occur as can cancers that, in most instances, are easily treated, and only very rarely affect a patient’s lifespan. Nodules are assessed by ultrasound and biopsies if warranted.

The Adrenal Glands:

The left and right adrenal glands lie above the kidneys. They produce the stress hormones adrenaline and cortisol as well as the blood pressure regulating hormone: aldosterone, as well as small amounts of sex-hormones. Damage or disease of the adrenals can impair our capacity to respond adequately to stress and can on some occasions be life threatening. Over-production of any of the hormones can result in disease as well. Tumors of the adrenals, both benign and malignant can occur as well.

Osteoporosis

Osteoporosis is a bone disease that occurs when the body loses too much bone, makes too little bone, or both. As a result, bones become weak and may break from a fall or, in serious cases, from sneezing or minor bumps. About 54 million Americans have osteoporosis and low bone mass, placing them at increased risk for osteoporosis. Studies suggest that approximately one in two women and up to one in four men age 50 and older will break a bone due to osteoporosis.

Osteoporosis means “porous bone.” Viewed under a microscope, healthy bone looks like a honeycomb. When osteoporosis occurs, the holes and spaces in the honeycomb are much larger than in healthy bone. Osteoporotic bones have lost density or mass and contain abnormal tissue structure. As bones become less dense, they weaken and are more likely to break.

If you’re 50 or older and have broken a bone, ask your doctor or healthcare provider about a bone density test.