Gravidute si Mamici curajoase de Nov-Dec2008 (108)

Otiliav spune:

Hai ca mi-am gasit motiv de stres.

Nu-i deloc de bine ce am gasit despre Ketons:
Ketones are formed when your body's fat stores have to be accessed for energy. Normally, you eat food and then the body converts it to glucose/blood sugar for use as energy by your cells. Your insulin is then like a key, unlocking the door to the cell so it can access this blood sugar. In pregnancy, placental hormones make you more resistant to your own insulin (in essence 'warping' the key to the door) and make it harder to get that glucose from your blood into your cells. So while your blood remains high in blood sugar, your cells can be starving. The fetus absolutely must have energy, so if your pancreas cannot make enough insulin to overcome the hormone-caused resistance, the cells start accessing other sources of energy, like fat stores. The by-product of this is ketones.

Ketones may be dangerous when pregnant, although this is controversial and still being studied and disputed. There were several studies that showed that babies exposed to a lot of ketones had learning problems and reduced IQ later in life. These have since been disputed by other studies, but just in case, everyone plays it safe during pregnancy, which is very prudent.



What Causes Ketones?

Ketones usually occur because you are either:

1. not eating enough total calories
2. going too long between meals
3. skipping meals/snacks
4. nauseous, not eating well/throwing up, and so not getting enough food for energy
5. so insulin-resistant from hormones that your body cannot access the blood sugar that's there

Your doctor should have you monitoring your first morning urine for ketones daily. Because of the long overnight fast, blood sugar can drop too low in the night, and the body would have to turn to other sources of energy like the fat stores, thus giving off or 'spilling' ketones. Your morning blood glucose numbers on your glucometer would not reflect ketones, nor would your bG numbers necessarily be low, since energy had been obtained from other sources. It is possible for your bG numbers to be normal or even high and yet to also be spilling ketones.

Not all providers who deal with gd even monitor ketones or place much emphasis on them. Some are not convinced that ketones pose a potential health threat to the fetus. And yet, some providers place great emphasis on ketones, while still others try to avoid them but do not give much attention to the issue one way or the other. It's hard to know how important the issue really is.


It should be pointed out that his reasoning does not exonerate ketones from blame, just casts doubts---still an important point. On the other hand, most major authorities remain concerned about the influence of ketone levels and advocate avoiding them. The diabetic food plans are designed with frequent small meals spaced carefully throughout the day in an effort to keep blood glucose (bG) even and to prevent ketones from developing, just in case they are harmful after all. The American Dietetic Association's journal, in its 1995 article reviewing nutrition management in women with gd, notes that:


The issue of ketones is particularly pertinent to large women since ketones can be brought on by the use of low-calorie food plans, often prescribed to obese gestational diabetics and even obese women without gd . This common practice of giving hypocaloric diets without extremely careful attention to ketone testing should be questioned, and the even the practice of giving obese women just enough calories to keep them just above the level of ketonuria should be questioned, since very little has been done to establish the long-term safety of near-ketonuria levels. This is an area greatly neglected in the research on hypocaloric diets for obese pregnant women. Although hypocaloric plans offer apparent benefits in some cases, the safety of this approach has not been established adequately, and a number of sources urge caution in their use.

For example, the American College of Obstetricians and Gynecologists (ACOG) says that "while maternal weight gain and fetal macrosomia may be decreased, the safety of this approach has not been established, and thus it is not recommended" (ACOG Bulletin #200, 1994). A number of other sources also recommend caution in approaching hypocaloric diets for obese women, including Gunderson in her 1997 article in Diabetes Care ("caloric restriction during pregnancy even in obese women must be viewed with caution, since its effects may pose some risk to the fetus") and Hachey in his 1994 article in American Journal of Clinical Nutrition ("more caution is necessary in using fat- and energy-modified diets to treat women with gestational diabetes mellitus"). In addition, the 1995 Journal of the American Dietetic Association article quoted above also notes that "Risk of high levels of blood ketones and risk of sacrificing maternal nutritional status are higher in women who consume hypocaloric diets." Far more attention to this in the research is necessary and has largely been ignored thus far, so hypocaloric diets for obese gestational diabetics must be treated with great caution and reserve.

Ketones can also be present even when caloric intake is adequate, especially if intake is sporadic or there are large gaps in time between meals. Large swings in blood sugar may also exacerbate the ketone problem, and newly diagnosed gestational diabetics often find that they have some levels of ketones present. As long as these ketones are mild and are tested for and resolved, they are probably not a huge health drain unless large levels are present and are unable to be resolved. Some studies have found that many normoglycemic pregnant women experience some levels of ketonuria at some points in pregnancy, though probably not as strong as in women with gd. Kmom is not a medical expert on ketones, but her reading indicates that the consensus seems to be that small amounts on occasion are probably not a serious problem but should be avoided if possible; larger amounts or consistent amounts are more of a worry. Just how much and how often constitute a concern is a matter of debate.

In summary, although ketones have not been conclusively proven to be dangerous, neither have they proven to be benign, and there is a fair amount of data linking significant amounts to problems in the baby. It seems safest at this time to err on the side of safety and carefully test for and avoid ketones. It is Kmom's opinion that any provider who does not place a high priority on this should be questioned strongly.


Treaba este ca ieri am luat pranzul la 8-9 seara, deci interval mare intre masa de dimineata si urmatoarea masa. Medicul de familie m-a intrebat daca consum lichide si in general consum 2L sigur.
Si ma intreb de ce nu mi-a facut glicemia daca au iesit Ketonii astia.

Mami de www.dropshots.com/otiliav" target="_blank">Ana nazdravana (18.12.2004) si Minunea din burtica 33+
Pozele noastre

oceanborn spune:

Neatza buna!!
O alta noapte chinuita...uf.. nici pe stanga nu ma mai lasa...si-a schimbat bebele pozitia si acum imi da suturi in partea stanga..
windy bine ca mai apari si tu pe aici!
In legatura cu condusul, da, eu ziceam ca ma simt din ce in ce mai aeriana la volan, si am renuntat sa mai conduc de vreo luna sau chiar mai mult(eu sunt o aeriana si negravida..dar la volan nu am fost niciodata!)...nu e un moft..probabil ca in caz de urgenta m-as urca dar atata timp cat pot, evit .... de condus conduc de cativa ani buni si nu-s sofer de duminica sa zic ca asta ar fi motivul..inainte de sarcina 80% din serviciu mi-l petreceam la volan, am renuntat cand au inceput greturile pt ca au fost foarte violente chiar daca au tinut doar o luna ,in care am facut naveta pat wc (si forum) , mai mult de atat nu reuseam . ... asa ca ,eu cred ca depinde de la om la om... Eu probabil ca m-am culcat pe-o ureche, iesind din ritmul in care eram obisnuita sa traiesc.. imi revin eu, nu-mi fac griji!
Alra tensiunea mea toata sarcina a fost de 12 cu 7 sau 8.. la ultimul control a fost de 13 cu 8 iar de atunci e monitorizata... mi-e cam groaza si mie ca dupa aceea tot 14 cu 7 sau 8 am avut...iar daca trece de 14 cu 9 trb sa-l sun pe ginec...
Va doresc o zi frumoasa cu vesti bune !

34+Thomas

VonHelen spune:

Buna dimineata burtici! invitatie la
cand am intrat azi dimineata pe forum m-am minunat de cati bebei sunt acum la noi la odisee!
Felicitari tuturor mamicilor! sa le traiasca minunile si sa se bucure de ele !!!

la mine a inceput deja stresul..ma trezesc noaptea si ma gandesc cum o sa fie operatia de cezariana...mi-e ff frica de anestezie, si cu cat stiu ca se apropie cu atat imi este mai frica. doar gandul ca dupa o sa-l intalnesc pe bebe ma mai linisteste.

Voi burtici cum va mai simtiti? cum mai dormiti noaptea?
eu de cand cu indigestia asta nu am mai avut nici o contractie, nu m-am mai sufocat si fara dureri de spate..sau sufeream prea mult de pe urma indigestiei si nu le-am mai bagat in seama..sper sa fi trecut si sa nu mai vizitez buda prea des azi ca m-am cam saturat!

35+
"Faptul ca ai un pian nu te face pianist, dar nasterea unui copil sigur te face parinte" Michael Levin

Z_IULIA spune:

Buna dimineata

VonHelen mersi de cafeluta.
Mai dar ce mult ati vorbit! Ma apuc de citit ca aseara am fost prea obosita sa mai dau drumul la calculator!
Va pup si sa aveti o zi superba!



Iulia lui Claudiu (23.04.2002) si Maria Clara DPN 23.12.2008

monicus spune:

Imi pare rau Otilav ca te-ai simtit rau. Sa fie oare si din cauza oboselii? Sa se fi acumulat de-a lungul timpului? Trebuie sa aimulta grija de tine. Nu imbatranim... nu mai spune asta... Noi suntem mamicile vesele si voioase... si tinerele... [flori]

http://community.webshots.com/user/Bebitza_Iorgulescu
graviduta 31+
AMR 9 saptamani

loren@ spune:

Neata fetele..am mai bifat o saptamina...
Dandusa ai fost super tare cu pupatul lui bb si banii bagati de rude...ha si eu urasc chestia asta!Mi se pare elementar sa se descalte la usa, sa se spele pe maini, sa nu se apropie de bb, doar sa il vada in primele sapt., sa nu-i sufle in fata etc.!
Alra eu inca conduc, ce-i drept numai pe linga casa ca desi mi-am luat permisul acum aproape 1 an, nu am mers mai deloc in afara de serviciu care este la 5 min. de casa!
Ma simt binisor, deci nu nasc in weekend!

Bianca Andreea
Larisa Elena38+
A M R numai 2 saptamini

monicus spune:

Am uitat sa va comunic ca am mai pus poze in album comun si la adresa mea. Sa va spun un secret,, eu aproape in fiecare seara beau o canutza cu laptic cu biscuitzei.. si dom f bine.. fara sa ma trezesc sa f multe ori pe noapte si nu am insomnii... Poate fi un "medicament" pentru noi in perioada aceasta.. frumaosa....


http://community.webshots.com/user/Bebitza_Iorgulescu
graviduta 31+
AMR 9 saptamani

VonHelen spune:

Fetelor care este cel mai bun ceai pentru lactatie???
de la Hipp? de la Humana?? still tea? ceai de fenicul?
mamicile care sunt la al 2 lea bebe..ce ati folosit , de care dintre ele ati fost multumite?

35+
"Faptul ca ai un pian nu te face pianist, dar nasterea unui copil sigur te face parinte" Michael Levin

futuremother spune:

neata fetele !
eu am baut ceai de fenicul si a dat randament ... celelalte cam au chimicale ... parerea mea



36+ si mamica de
AMR 4 sapt

Miky-ea spune:

'Neata,burtici!
Si eu am dormit cam agitata,am visat cam aiurea...dar e normal acum cand se apropie momentul mult asteptat.Ma gandesc mereu ca printesa sa fie sanatoasa,sa stea in burtica cat mai mult( de fapt cat trebuie) ,cu cine seamana,cum va fii...

Graviduta fericita...
http://bd.lilypie.com/6phTp3.png
AMR 3 SAPTAMANI