User:Natalie Bond/sandbox

My ideas for the Article:

Editing this article: Diabetes mellitus and pregnancy

Talk about different ways of controlling DM during pregnancy, ex: Insulin pump, CGM, MDI

Talk about stages of pregnancy and how insulin needs to be adjusted

Make sure article has a nice flow

Sources I will be using:

"Think Like a Pancreas" by Gary Scheiner, MS, CDE

"Pumping Insulin" by John walsh, P.A., CDE and Ruth Roberts, M.A.

https://www.cochranelibrary.com/search

Treatment of pregnant women with diabetes[edit]
Blood glucose levels in pregnant woman should be regulated as strictly as possible. Higher levels of glucose early in pregnancy are associated with teratogenic effects on the developing fetus. A Cochrane review published in 2016 was designed to find out the most effective blood sugar range to guide treatment for women who develop gestational diabetes mellitus in their pregnancy. The review concluded that quality scientific evidence is not yet available to determine the best blood sugar range for improving health for pregnant women with diabetes and their babies.

This section below is what I am adding to above:

Information I will be adding to paragraph above:
During the first weeks of pregnancy less insulin is required due to tight blood sugar control as well as the extra glucose needed for the growing fetus. At this time basal and bolus insulin may need to be reduced to prevent hypoglycemia. Frequent testing of blood sugar levels is recommended to maintain control. As the fetus grows and weight is gained through out the pregnancy, the body produces more hormones which may cause insulin resistance and the need for more insulin. At this time it is important for blood sugar levels to remain in range as the baby will produce more of it's own insulin to cover it's mother's higher blood sugar level which can cause fetal macrosomia. During delivery, which is equivalent to exercise, insulin needs to be reduced again or hyperglycemia can occur. After the baby is delivered and the days following, there are no more hormones from the placenta which demanded more insulin, therefore insulin demand is decreased and gradually returns to normal requirements.

Diabetes pregnancy management[edit]
Diabetes mellitus may be effectively managed by appropriate meal planning, increased physical activity and properly-instituted insulin treatment. Some tips for controlling diabetes in pregnancy include:


 * Meals – Cut down sweets, eats three small meals and one to three snacks a day, maintain proper mealtimes, and include balanced fiber intake in the form of fruits, vegetables and whole-grains.
 * Increased physical activity - walking, swimming/aquaerobics, etc.
 * Monitor blood sugar level frequently, doctors may ask to check the blood glucose more often than usual.
 * The blood sugar level should be below 95 mg/dl (5.3 mmol/l) on awakening, below 140 mg/dl (7.8 mmol/l) one hour after a meal and below 120 mg/dl (6.7 mmol/l) two hours after a meal.
 * Each time when checking the blood sugar level, keep a proper record of the results and present to the health care team for evaluation and modification of the treatment. If blood sugar levels are above targets, a perinatal diabetes management team may suggest ways to achieve targets.
 * Many may need extra insulin during pregnancy to reach their blood sugar target. Insulin is not harmful for the baby.

=== I will be combining paragraph "Treatment of pregnant women with diabetes" with above paragraph. Keeping the heading "Diabetes pregnancy management". I think this flows better as the two topics are similar/same. ===