If blood sugar rises during pregnancy, then it is said that gestational diabetes has developed.Unlike permanent diabetes, which was before pregnancy, it completely disappears after giving birth. High blood sugar can cause problems for you and your baby.The baby may grow too large, causing difficulties at birth.In addition, he often has a lack of oxygen (hypoxia). Fortunately, with proper and timely treatment, most expectant mothers with diabetes have every chance to give birth to a healthy baby on their own. It has been established that those who had high blood sugar during pregnancy, develop diabetes more often with age.This risk can be significantly reduced by weight control, a healthy diet and regular physical activity.
Why blood sugar rises
Normally, blood sugar levels are controlled by the hormone insulin, which secretes the pancreas.Under the action of insulin, glucose from food passes into the cells of our body, and its level in the blood decreases. At the same time, the hormones of pregnancy, which the placenta secretes, act opposite to insulin, that is, they increase the sugar level. The load on the pancreas at the same time increases, and in some cases it does not cope with its task. As a result, blood glucose levels are above normal. Excessive amount of sugar in the blood disrupts the metabolism of both at once: both the mother and her baby. The fact is that glucose penetrates through the placenta into the fetal bloodstream, and increases the load already on its small pancreas.
The pancreas of the fetus has to work with a double load and release more insulin. This extra insulin greatly accelerates the absorption of glucose and turns it into fat, causing the mass of the fetus to grow faster than usual. Such an acceleration of metabolism in a baby requires a large amount of oxygen, while its intake is limited. This causes a lack of oxygen and hypoxia.
Risk factors
Gestational diabetes complicates 3 to 10% of pregnancies. Especially high risk are those future mothers who have one or more of the following symptoms:
- Obesity high;
- Diabetes in a previous pregnancy;
- Sugar in the urine;
- Polycystic ovary syndrome;
- Diabetes mellitus in the next of kin.
The least at risk are those who have all the following criteria combined to get pregnant with diabetes:
- Age less than 25 years;
- Normal weight before pregnancy;
- There was no diabetes in close relatives;
- There has never been high blood sugar;
- There have never been pregnancy complications.
How does pregnant diabetes manifest
Often, the expectant mother may be unaware of gestational diabetes, because in mild cases, he does not manifest itself. That is why it is very important to undergo a blood test for sugar.
At the slightest increase in blood sugar, the doctor will prescribe a more thorough study, which is called “glucose tolerance test”, or “sugar curve”. The essence of this analysis in measuring sugar is not an empty stomach, but after taking a glass of water with dissolved glucose.
Normal fasting blood sugar: 3.3 – 5.5 mmol / l.
Pre-diabetes (impaired glucose tolerance): fasting blood sugar is more than 5.5, but less than 7.1 mmol / l.
Diabetes mellitus: fasting blood sugar more than 7.1 mmol / l or more than 11.1 mmol / l after taking glucose.
Since the level of blood sugar is different at different times of the day, sometimes it may not be detected during the examination. There is another test for this: glycated hemoglobin (HbA1c).
Glycated (i.e., glucose-related) hemoglobin reflects the blood sugar level not for the current day, but for the previous 7–10 days. If at least once during this time the sugar level rose above the norm, the test for HbA1c will notice it. For this reason, it is widely used to monitor the quality of the treatment of diabetes.
In moderate to severe cases of pregnant diabetes, you may receive:
- Intense thirst;
- Frequent and heavy urination;
- Severe hunger;
- Blurred vision.
Since pregnant women often have thirst and increased appetite, the appearance of these symptoms does not speak of diabetes. Only regular testing and examination by a doctor will help prevent it in time.
Do I need a special diet – food taken from diabetes?
The main task in the treatment of diabetes in pregnant women is to maintain normal blood sugar levels at each time point: both before and after meals.
There are always at least 6 times a day so that the supply of nutrients and energy is uniform throughout the day in order to avoid sudden jumps in blood sugar. A diet for diabetics of pregnant women should be structured in such a way as to completely exclude the intake of “simple” carbohydrates (sugar, sweets, jams, etc.) from food, limit the amount of complex carbohydrates to 50% of the total amount of food, and the remaining 50 % divided between proteins and fats.
The number of calories and a specific menu is best to coordinate with a dietitian.
How does physical activity help?
First, active outdoor activities increase the flow of oxygen into the blood, which the fetus is so lacking. It improves his metabolism. Secondly, during exercise, extra sugar is consumed and its level in the blood decreases. Thirdly, training helps to put off calories, stop weight gain and even reduce it. This greatly facilitates the work of insulin, while a large amount of fat makes it difficult.
Increase physical activity
A diet combined with moderate exercise can in most cases save you from the symptoms of diabetes. In this case, it is not necessary to exhaust yourself with daily workouts or buy a club card to the gym for the last money. Most women with diabetes pregnant enough to walk at an average pace in the open air for a few hours 2-3 times a week. Calorie consumption during such walking is sufficient to reduce blood sugar to normal, but it is necessary to follow a diet, especially if you do not take insulin.
A good alternative to walking can be swimming and aqua aerobics. Such activities are especially relevant for those future mothers who had problems with overweight before pregnancy, because excess fat makes insulin difficult.
Do I need to take insulin
Insulin, when properly applied during pregnancy, is absolutely safe for both the mother and the fetus. Insulin does not develop addiction, so after giving birth it can be completely and painlessly canceled.
Insulin is used in cases where diet and exercise do not give a positive result, that is, sugar remains elevated. In some cases, the doctor decides to prescribe insulin immediately, if he sees that the situation requires it.
If your doctor prescribes insulin, you should not refuse. Most of the fears associated with its use – no more than prejudice. The only condition for the correct treatment with insulin is the precise fulfillment of all doctor’s prescriptions (one should not miss the dose and time of admission or change it without authorization), including the timely delivery of tests.
If you take insulin, you will need to measure blood sugar with a special device several times a day (it is called a blood glucose meter). At first, the need for such frequent measurement may seem very strange, but it is necessary for careful control of glycemia (blood sugar). The instrument should be recorded in a notebook and show your doctor at the reception.
How will the birth
Most women with diabetes during pregnancy can give birth naturally. In itself, the presence of diabetes is not talking about the need for cesarean section.
We are talking about a planned caesarean section in the event that your baby grows too large for independent delivery. Therefore, future mothers with diabetes prescribed more frequent ultrasound of the fetus.
During childbirth, mother and baby need careful observation:
- Regular monitoring of blood sugar several times a day.If the glucose level is too high, the doctor may prescribe insulin intravenously.Together with him, they can prescribe glucose in a drip, do not be alarmed by this.
- Careful control of fetal heartbeat on CTG.In case of a sudden deterioration of the condition, the doctor may perform an emergency cesarean section for the speedy birth of the baby.
Perspectives
In most cases, elevated sugar returns to normal a few days after delivery.
If you have suffered gestational diabetes, be prepared for the fact that it may appear in the next pregnancy. In addition, you have an increased risk of developing permanent diabetes mellitus (type 2) with age.
Fortunately, maintaining a healthy lifestyle can significantly reduce this risk, and sometimes even prevent diabetes. Learn all about diabetes. Eat only healthy foods, increase your physical activity, lose weight – and you will not be afraid of diabetes!