Nine months after conception are responsible and stressful period in the life of the expectant mother. Growing fetus requires a lot of energy, minerals and nutrients. Because of this, pregnancy is a condition strongly affects women's metabolism. One manifestation of this change is considered gestational insulin resistance.
And the liver and muscles, and fatty tissue are not very sensitive to the hormone the pancreas - insulin. Under unfavorable conditions this may lead to an increase in blood sugar levels and the development of diabetes. Diabetes in pregnancy is detected during examination in the antenatal clinic. To analyze for up to 24 weeks taken venous blood (defined sugar or glycated hemoglobin), at a later date to conduct "a sugar curve."
Until recently, for the first time detected any increase in blood sugar during pregnancy is considered gestational diabetes.
Modern understanding of gestational diabetes
Currently, there is a Russian national consensus "Gestational diabetes: diagnosis, treatment, postnatal care." This document is a guide for all physicians, including endocrinologists and obstetricians. In this guide a woman during pregnancy can be installed and gestational diabetes mellitus, and overt. And overt diabetes diagnosed at higher numbers of blood sugar. Such a diagnosis indicates that the increase of sugar is associated not only with the pregnancy and postpartum carbohydrate metabolism is not normalized.
Gestational diabetes can be seen as a temporary situation and expect to improve after giving birth. Thus, the diagnosis of gestational diabetes is considered to be more favorable. However, even a slight increase in blood sugar during pregnancy is dangerous for the woman and the fetus. In children whose mothers did not receive adequate treatment, may develop defects of the internal organs, it is also very characteristic considered weight at birth of more than 4 kg. Large fruit at greater risk during childbirth. For women, gestational diabetes can be a precursor to serious violations of carbohydrate metabolism in the future.
Diagnosis of the disease
Diagnosis is based on symptoms of gestational diabetes and laboratory values. Norm recognizes the importance of venous blood sugar on an empty stomach to 5, 1 mmol / l. If the blood sugar of a vein is placed in prmezhutok 5, 1 7, 0 mmol / L, the doctors interpret the results as gestational diabetes. In that case, if the result of above 7, 0 mM / l, diagnosed manifest diabetes mellitus.
Risk factors for gestational diabetes
The prevalence of gestational diabetes is increasing both in Russia and in the world. On average, the incidence is 7%. Most likely increase in blood sugar during pregnancy in women older than 30 years, are overweight and relatives suffering from type 2 diabetes.
Symptoms of gestational diabetes
Increased blood sugar levels in this disease is quite small, so the complaints expressed in pregnant women occur infrequently. Sometimes there are thirst, frequent urination, dry skin. Quite often the woman has swelling, rapid weight gain, urinary tract infections.
Treatment of gestational diabetes during pregnancy
Pregnancy should have regular monitoring of obstetrician-gynecologist, internist or endocrinologist. It is necessary to measure the daily blood sugar meter. The first therapeutic measure is to diet. In addition, immediately recommend adequate physical activity (walking, swimming). Two weeks later, the treatment may be added insulin. The indication for insulin is a continuing high level of blood sugar. Also, ultrasound examination of the fetus may cause insulin destination. In most cases pregnant introduced genetically engineered insulin intensify mode.
This means that hormone injections are performed repeatedly during the day. Hypoglycemic pills during pregnancy are strictly prohibited, as they have a negative effect on the fetus. Hospitalization in detecting gestational diabetes is not considered mandatory. Also, there is no reason to carry out a caesarean section, or early delivery with the diagnosis without the presence of obstetric complications. The main measure in the gestational diabetes diet is considered.
Diet for Gestational Diabetes Mellitus
Food pregnant should be regular and fractional. During the day, you need 4-6 times to eat small portions. It is important to eliminate all sweet, that is, simple carbohydrates, sucrose, glucose, fructose. These substances will only increase the level of blood sugar. Of the products of simple carbohydrates found in large quantities in all pastry products. Diet for gestational diabetes involves the rejection of honey, fruit juice, bananas, grapes, dried fruits and all sweet products. Also carbohydrates, fats and power limited, primarily of animal origin. Fats very rich in calories and thus affect the weight gain.
The basis of the diet in the gestational diabetes should be vegetables, grains, low-fat dairy, meat and fish products. Bread must be limited to 50 grams per day. Preference is to give classes with the addition of bran or wholemeal. Rice, pasta, semolina better use rarely. The potato is desirable to have boiled, steamed, not fried. Soups should be lean meat or vegetable broth. Displaying add each food intake of vegetables raw or cooked. Salads can not refill the mayonnaise, sour cream, vegetable oil. During the day, should not be abused salt, coffee, tea. Canned food, semi-finished products is better to minimize in the diet.
Postpartum care of women with gestational diabetes
Immediately after birth, all women with gestational diabetes canceled insulin if it has been used. While the patient is in the nursing home, she repeatedly control blood sugar. Typically, in the first days after delivery is completely normal carbohydrate metabolism. However, women need to be monitored regularly by an endocrinologist on a residence. To avoid type 2 diabetes, it will be necessary in the future to comply with hypocaloric diet to reduce body weight to normal, expand physical activity.
It is important to conduct control of fasting blood sugar or a sugar curve after 6-12 weeks after birth. Plan your next pregnancy should be carried out in conjunction with the obstetrician and endocrinologist. The child, whose mother suffered from gestational diabetes during pregnancy, is also likely to develop disorders of carbohydrate metabolism. Therefore, the pediatrician should be informed about this complication of pregnancy.