Diabetes mellitus during pregnancy or gestational diabetes is a diagnosis that has become more frequent in recent years. It can be dangerous not only for the mother, but also for the future baby. Its signs are not always obvious, and it is sometimes possible to diagnose it only with the help of tests. That is why you should not neglect the scheduled inspections.
Why develop gestational diabetes
Diabetes mellitus that began during pregnancy is called gestational. It is associated with hormonal changes that the future mother’s body undergoes – placenta hormones contribute to an increase in the amount of glucose in the blood. Her excess badly affects both the expectant mother and the child: glucose enters the fetal bloodstream and excessively loads the child’s pancreas, causing it to produce more insulin. Insulin promotes glucose uptake and increases baby weight. Acceleration of carbohydrate metabolism can lead to oxygen starvation, since oxygen supply is limited.
Why is so much attention paid to gestational diabetes now, and statistics show an increase in the incidence rate? In 2012-2013, the National Consensus on Gestational Diabetes was adopted in the Russian Federation. In fact, the country has joined the international standards for the diagnosis and treatment of this disease. In accordance with them, the rate of glucose in plasma taken from a vein decreased in comparison with the previous figures. Therefore, in the field of view of doctors now get those women who, according to the old norms were not considered sick.
What is dangerous diabetes during pregnancy?
Modern research has proven that chronic glucose increases during pregnancy negatively affects the health of the mother and child, may complicate childbirth and lead to birth injuries. Injuries happen due to the fact that the baby has a lot of weight and a developed shoulder girdle, and is hardly moving along the mother canal. If it is “stuck”, this condition has a special name – distosia of the shoulders. It is extremely dangerous, because the child suffers from a lack of oxygen and severe pain, can get a fracture or a dislocation of the neck and shoulders. For mom, dystocia is fraught with perineal tears.
In addition to complications in childbirth, due to diabetes mellitus during pregnancy, preeclampsia and preeclampsia can develop, threatening the life of a woman and a baby. With this complication, the expectant mother has a persistent increase in blood pressure to high numbers with all its symptoms: “flies” and fog before the eyes, dizziness and headache. In addition, external and internal edemas appear, protein is detected in the urine. Sometimes delivery is the only way to treat pre-eclampsia and eclampsia, and then the baby can be born deeply premature.
International standards determine the plasma glucose level for pregnant women not more than 5.1 mmol / l. For diagnosis, it is enough that the sugar be higher than 5.1 mmol / l at least once. Women take blood for sugar several times: first, when registering for pregnancy – a normal analysis, and then in the period of 24-28 weeks, all expectant mothers must pass a glucose tolerance test – a special study, when blood sugar is measured after taking a portion of carbohydrate drink or food. Normally, it should be no more than 10 mmol / l after 1 hour and no more than 8.5 mmol / l 2 hours after drinking.
Diabetes can not have pronounced symptoms, and a woman can take them for the usual signs typical of pregnancy: increased thirst, frequent urination, “thrush”, dry mouth. Therefore, the main diagnosis is testing. If they show abnormalities, diabetes treatment should be started, even if there are no visible manifestations of the disease.
Who is at risk?
The risk of getting gestational diabetes mellitus is determined by a genetic predisposition and certain circumstances. The disease is most likely to develop if:
- Diabetes (gestational) has already been observed in women in past pregnancies.
- Expectant mother has a lot of excess weight, especially if it is combined with signs of metabolic syndrome (high cholesterol, hypertension).
- A woman is over the age of 30.
- She has direct blood relatives who are diagnosed. diabetes second type.
- Previous pregnancies were severe with toxicosis and preeclampsia.
- Previous pregnancies ended in the birth of a very large child (more than 4 kg), stillbirth, or were repeatedly interrupted in 1-2 trimester for an unspecified reason.
- The future mother has hypertension and heart disease.
Treatment of diabetes caused by pregnancy
The treatment of diabetes is usually initiated by the fact that the expectant mother is prescribed a carbohydrate-restricting diet and adequate physical activity in the form of walking. It is more correct to go on foot after eating – so the body can consume all carbohydrates received from food. In addition to walking, you can also swim, perform simple exercises that are allowed during pregnancy.
Blood sugar should be constantly monitored with a glucometer, and the results recorded and shown to the doctor. Measurements should be carried out before and after breakfast, lunch and dinner, in the morning after waking up and in the evening, going to bed. If blood glucose, despite the diet and exercise, remains above the norm, insulin therapy is used to treat diabetes.
During pregnancy, you can not use any other drugs other than insulin. It is injected subcutaneously with a special syringe pen, which measures the required dose. The dosage of the drug and the scheme of drug administration (alternation of “long” and “short” insulin) is determined by the doctor. After birth, the drug is canceled, as carbohydrate metabolism in most cases, independently returns to normal. Women who have suffered gestational diabetes remain at risk for type 2 diabetes: many of them in the following years have a disease that is no longer associated with pregnancy.
What principles should be guided in nutrition, if you have found gestational diabetes?
- The observance of a low-carb diet with a moderate calorie content is an indispensable part of treating diabetes, so you need to stick to it until the end of pregnancy, without interruption.
- Eating should be fractional, in small portions, at certain hours.
- The amount of fluid consumed should be sufficient (not less than 1.5-2 liters per day, not counting soups, juices and tea).
- It is better to abandon the frying dishes in favor of stewing, baking and boiling.
- You should not eat fatty meat, smoked fish and sausage.
- Forbidden sweets, cakes, fruits with high glycemic index.
- Milk and its products should be low fat. Of the cheeses, it is better to give preference to the Adyghe.
- The basis of nutrition should be lean meat, fish, cottage cheese, cereals (except rice), pasta from durum wheat, whole grain bread, fruits and vegetables with a low glycemic index.