Pregnancy diabetes consequences for the baby. The effect of hyperglycemia on the fetus. What is gestational diabetes

During pregnancy, chronic diseases may worsen or signs of previously unknown problems may appear. This problem can be gestational diabetes.

According to the classification of the World Health Organization, “gestational diabetes” is diabetes mellitus detected during pregnancy, as well as impaired glucose tolerance (the perception of glucose by the body), also detected during this period. Its cause is a reduced sensitivity of cells to their own insulin (insulin resistance), which is associated with a high content of pregnancy hormones in the blood. After childbirth, blood sugar levels often return to normal. However, the possibility of developing type 1 and type 2 diabetes during pregnancy cannot be ruled out. Diagnosis of these diseases is carried out after childbirth.

When analyzing data from multiple studies, doctors concluded that more than 50% of pregnant women with gestational diabetes develop true diabetes later in life.

What are the risk factors for developing GDM?

• Overweight, obesity
• Diabetes in next of kin
• Age of the pregnant woman over 30 years
• weighed down obstetric history:
• Previous child born weighing more than 4000 grams
• GSD in previous pregnancy
• Chronic miscarriage (early and late miscarriages)
• Polyhydramnios
• Stillbirth
• Malformations in previous children

Why is gestational diabetes dangerous?

Gestational diabetes in most clinical situations it develops in the interval up to . Early-detected carbohydrate metabolism disorders usually indicate previously unnoticed pregestational (“pre-pregnancy”) diabetes.

Of course oh chronic diseases it is better to find out before pregnancy, and then it will be possible to compensate them as much as possible. It is for this reason that doctors strongly recommend planning a pregnancy. In preparation for pregnancy a woman will pass all basic examinations, including those for the detection of diabetes mellitus. If carbohydrate metabolism disorders are detected, the doctor will prescribe treatment, give recommendations, and future pregnancy will proceed safely, and the baby will be born healthy.

The main condition for managing a pregnancy complicated by diabetes (both gestational and its other forms) is maintaining blood glucose levels within the normal range (3.5-5.5 mmol / l). Otherwise, mother and baby find themselves in very difficult conditions.

What threatens mom? Premature births and stillbirths are possible. There is a high risk of developing preeclampsia (with diabetes it develops more often and earlier - up to 30 weeks), hydramnios, and consequently, placental insufficiency and fetal malnutrition. Perhaps the development of diabetic ketoacidosis (a condition in which there is a sharp increase in glucose levels and concentration ketone bodies in the blood), infections of the genital tract, which are recorded 2 times more often and cause infection of the fetus and premature birth. It is also possible the progression of microangiopathies with an outcome in visual impairment, kidney function, blood flow disorders in the vessels of the placenta, and others. The woman may develop weakness labor activity, which, in combination with clinically narrow pelvis And large fruit om will make delivery by caesarean section inevitable. Women with diabetes are more likely to develop infectious complications in postpartum period.

Dangers for the baby

Features of carbohydrate metabolism between mother and child are such that the fetus receives glucose from the mother, but does not receive insulin. Thus, hyperglycemia (excess glucose), especially in the first trimester, when the fetus does not yet have its own insulin, provokes the development of various fetal malformations. After, when the body of the future baby produces its own insulin, hyperinsulinemia develops, which threatens the development of asphyxia and traumatism during childbirth, respiratory disorders ( respiratory distress syndrome) and hypoglycemic conditions of newborns.

Is there a way to prevent these complications? Yes. The main thing is awareness of the problem and its timely correction.

Diagnosis first...

The first step in diagnosing gestational diabetes is to assess the risk of developing it. When a woman is registered with a antenatal clinic, a number of indicators are assessed, for example, the age and weight of the pregnant woman, obstetric history (the presence of gestational diabetes during previous pregnancies, the birth of children weighing more than 4 kg, stillbirth, and others), family history (the presence of diabetes in relatives) and so on. The following table is filled in:

Options	high risk	moderate risk	low risk
Woman's age over 30	Not really	Yes	Less than 30
Type 2 diabetes in close relatives	Yes	No	No
GDM in history	Yes	No	No
Impaired glucose tolerance	Yes	No	No
Glucosuria during a previous or current pregnancy	Yes	Not really	No
History of hydramnios and large fetus	Not really	Yes	No
Birth of a child weighing more than 4000 g or a history of stillbirth	Not really	Yes	No
Rapid weight gain during this pregnancy	Not really	Yes	No
Overweight (> 20% of ideal)	Yes	Yes	No

Pay attention to the parameter "Birth of a child weighing more than 4 kg." It is included in the assessment of the risk of developing gestational diabetes for a reason. The birth of such a baby may indicate the development in the future of both true diabetes mellitus and gestational diabetes. Therefore, in the future, the moment of conception must be planned and constantly monitored blood sugar levels.

Having determined the risk of developing diabetes, the doctor chooses the management tactics.

The second step is to draw blood to determine the level of sugar, which must be done several times during pregnancy. If at least once the glucose content exceeded 5 mmol / l, a further examination is carried out, namely a glucose tolerance test.

When is a test considered positive? When conducting a test with a load of 50 g of glucose, the level of glycemia is assessed on an empty stomach and after 1 hour. If fasting glucose exceeds 5.3 mmol / l, and after 1 hour the value is higher than 7.8 mmol / l, then a test with 100 g of glucose is necessary.

The diagnosis of gestational diabetes is made if fasting glucose is more than 5.3 mmol / l, after 1 hour - above 10.0 mmol / l, after 2 hours - above 8.6 mmol / l, after 3 hours - above 7.8 mmol / l. Important: an increase in only one of the indicators does not give rise to a diagnosis. In this case, the test should be repeated again after 2 weeks. Thus, an increase in 2 or more indicators indicates diabetes.

Test rules:

1. 3 days before the examination, the pregnant woman is on her usual diet and adheres to her usual physical activity
2. The test is carried out in the morning on an empty stomach (after an overnight fast of at least 8 hours).
3. After taking a blood sample on an empty stomach, the patient should drink a glucose solution consisting of 75 grams of dry glucose dissolved in 250-300 ml of water within 5 minutes. A repeat blood sample to determine the blood sugar level is taken 2 hours after the glucose load.

Normal glycemic values:

1. fasting glycemia - 3.3-5.5 mmol / l;
2. glycemia before meals (basal) 3.6-6.7 mmol / l;
3. glycemia 2 hours after eating 5.0-7.8 mmol/l;
4. glycemia before going to bed 4.5-5.8 mmol / l;
5. glycemia at 3.00 5.0-5.5 mmol / l.

If the results of the study are normal, then the test is repeated on when the hormonal background. At earlier stages, GDM is often not detected, and the establishment of a diagnosis later does not always prevent the development of complications in the fetus.

However, pregnant women face more than just high blood sugar levels. Sometimes a blood test "shows" hypoglycemia - low blood sugar. Most often, hypoglycemia develops during fasting. During pregnancy, the consumption of glucose by cells increases and therefore long breaks between meals should not be allowed and in no case should you “sit down” on a diet aimed at losing weight. Also, sometimes in the analyzes you can find borderline values, which always always indicate more high risk development of the disease, therefore, it is necessary to strictly control blood counts, follow the recommendations of the doctor and follow the diet prescribed by the specialist.

A few words about the treatment of gestational diabetes

A pregnant woman faced with diabetes, it is necessary to master the technique of self-control of glycemia. In 70% of cases, gestational diabetes is corrected by diet. After all, the production of insulin occurs, and there is no need for insulin therapy.

Basic principles of diet therapy:

1. The daily ration must be divided between carbohydrates, fats and proteins -35-40%, 35-40% and 20-25%, respectively.
2. Caloric content in overweight conditions should be 25 kcal per 1 kg of weight or 30-35 kcal per 1 kg with normal weight. Women who have overweight, recommendations are given for its reduction or stabilization. It is necessary to reduce the calorie intake special attention without taking drastic measures.
3. Easily digestible carbohydrates, that is, any sweets, are excluded from the daily menu.
   Should a healthy woman sound the alarm if she wants sweets? "Love for sweets" should alert if there are changes in the analyzes. But in any case, you should follow the recommendations on nutrition and not overdo it with sweets or anything else. It must be remembered that you want to eat “something sweet” more often out of a desire just to feast on. Therefore, "sweet" can be replaced with fruits.
4. Reduce the amount of fat consumed by enriching the diet with fiber (fruits and vegetables) and proteins up to 1.5 g / kg.

In the event that it is not possible to correct the level of glycemia with one diet, insulin therapy is necessary, which is calculated and titrated (corrected) by the attending physician.

Gestational diabetes is called so not only because it manifests (manifests) during pregnancy. Its other feature is that its signs disappear after childbirth. However, if a woman has had gestational diabetes, the risk of developing true diabetes increases by 3-6 times. Therefore, it is important to monitor the woman after childbirth. 6 weeks after birth, it is mandatory to conduct a study of the state of carbohydrate metabolism of the mother. If no changes are found, control is prescribed once every 3 years, and if glucose tolerance is impaired, recommendations on nutrition and observation are given once a year.

In this case, all subsequent pregnancies should be strictly planned.

Comment on the article "Gestational Diabetes"

See other discussions: Pregnancy Diabetes. American endocrinologists tell me that the likelihood of gestational diabetes (if it was already during a previous pregnancy) with next pregnancy- 90%. But I think before the third child...

Discussion

I apologize in advance for being long...
With gestational diabetes, the main problem is the jumps in blood glucose. On an empty stomach, the norm in pregnant women is up to 5.1 (the norm of 5.5 is set for non-pregnant! - it has been like this since 2013 or something), an hour after eating it is not higher than 7.0 (some endocrinologists recommend a maximum of 6.7), after two hours return to "fasting" norms. If the sugar level is corrected by the diet - excellent. If the body does not respond to the diet, insulin is prescribed (there is nothing to worry about in it, usually after childbirth it is no longer necessary).
In addition to weight gain in utero, there is another dangerous moment. ***Next, I will explain in my own words from memory, as the endocrinologist told me*** When the level of glucose in the blood rises sharply beyond the norm (the so-called "jump"), the mother's pancreas cannot cope with the production of insulin, and the pancreas of the unborn child takes over the load. While still inside the mother's body, the child gets used to an increased level of glucose in his blood (the blood flow is something common). In childbirth, when the umbilical cord is cut, the blood flow ceases to be common, and a newborn who has abruptly stopped receiving the usual large amount of glucose may experience a hypoglycemic attack (a sharp drop in blood glucose levels, up to coma). It is this condition that is dangerous, because often neither the mother nor the obstetricians know what to be prepared for. I am not a doctor. I don't scare. I share my experience, maybe someone will find it useful. A normal fasting glucose level does not guarantee the absence of gestational diabetes. There are also intrauterine ultrasound signs of diabetic pathology in newborns (yes, high level mother's blood sugar is reflected in the child, even though "everything is already laid").
I had two pregnancies with GDM (the second with twins), the first time I learned about it at 28 weeks after glucose tolerance test, the second time, immediately after the establishment of pregnancy, she went on a diet and began to control the blood. On ultrasound she always asked me to look for signs diabetic fetopathy(fortunately, all my children were born absolutely healthy), in the delivery room she immediately asked to measure the glucose level in newborns and later even neonatologists baled, if they didn’t immediately orient themselves.
And you can’t say goodbye to carbohydrates so categorically! :-) A sharp restriction of carbohydrates leads to the appearance of ketones in the urine, and this also harms both mother and child. Everything needs a reasonable approach. Decreased portion size, increased physical loads (regular walking will also do), a complete rejection of sugar-containing foods and any "fast" carbohydrates - and this is temporary. Plus, the list of allowed products can be a pleasant surprise. For example, I could eat 100 grams of natural ice cream or 25 grams of dark chocolate per day (at least 75% cocoa). :-) And a definite plus from the diet - you yourself will gain a minimum of weight during pregnancy, which will reduce the likelihood of edema in the last stages.
Below is a link to a forum where the GSD topic is discussed (everything is very sensibly stated, reading and understanding this issue helped me a lot at one time).

I had type 2 gestational diabetes.
For a baby, it is not particularly scary, because all the foundations are laid much earlier. And in the end, when this diabetes is detected, the child just grows. But grow up high sugar it can be very large, which is not good for childbirth. The baby's liver can also be affected.
The doctor gave general recommendations on products, but warned that everything is individual. Therefore, at first I tried a little one thing, then another, to determine what the sugar did not rise to. For example, apples and buckwheat had to be excluded. But grapefruits, pomelo and pears ate without consequences. Bread and milk excluded completely.
Eggs, caviar, turkey, salad mixes, various frozen vegetables, avocados and cucumber-tomatoes are the basis of my diet. In the first month I even threw off one and a half kilograms :)
Sugar was measured 4 times a day. On an empty stomach, he was a bit tall, so the endocrinologist prescribed insulin once a day for the night.
Neither pricking your fingers to measure sugar with a glucometer, nor injecting yourself with injections does not hurt at all. I didn't even ask my husband for help. Now everything is very comfortable and ergonomic. The only thing that bothered me was to be tied in time to the measurements all the time. I set an alarm on my phone so I wouldn't forget.
After giving birth, sugar returned to normal. Now my daughter is 2 weeks old. Out of habit, she kept a diary for another week after giving birth - she looked at the reaction to both hospital and homemade food. Now I've taken a break. In my daughter's month, I'll check again for a week. And a couple of months after the birth, I go to the endocrinologist and do another glucotolerance test to be completely calm.

Gestational diabetes. Need advice. Weight loss and diets. How to get rid of excess weight, lose weight after childbirth, choose the right diet and communicate with losing weight. This happens to pregnant women. Quietly, the load on the body goes, can not cope.

Discussion

Now they put HSD if the sugar of a pregnant woman on an empty stomach is more than 5. But not at once, of course ...
Glycated hemoglobin for pregnant women is not informative.
GSD tablets are not treated, only insulin. But you have a long period already .. Therefore, there is no point in insulin ..
Limit carbs. Muffin, sweets...
Usually everything stops after childbirth and the food is normal.

Based on a blood test for sugar, such a diagnosis is not made. It is necessary to pass glycated hemoglobin (below 6 - the norm).

Gestational diabetes mellitus and maternity hospital. LCD, maternity hospitals, courses, honey. centers. Pregnancy and childbirth. Gestational diabetes mellitus and maternity hospital. at 35 weeks they put GDM, they want to prescribe insulin and delivery in a special maternity hospital. as I understand it is 25 or 29. have ...

Discussion

Only not at 29 - the flayer. Oparina and Sechenovka will also take you for childbirth, if with insulin, without insulin - the list is long. For a consultation, go to 1 city, if they are still working. 29 rd - a waste of time, there is bad endocrinology. For a fee - look for Arbatskaya or Moldovanova (she should be in Mother and Child, a good aunt), they are both from 1 city. Arbatskaya in Lapino, I didn’t get to it - it’s far and expensive. And so - you don’t have long left, maybe you will last on a diet .. At your time, sugar is already stabilizing, in theory. At 35 weeks it’s not scary anymore)) there is a tiny percentage that type 2 diabetes will remain after childbirth, but this is not type 1, so don’t be afraid and don’t worry. The main thing - do not give birth at 29 - a monstrous place (I was there on conservation).

I had many similar experiences in the past in the form of pregnant aunts) from which you were diagnosed, announce all your sugars and the results of OGTT for a start. or search in the archive last year, the topic is regular. Nobody really needs insulin. And for those who need it, you should not be afraid of it, as a rule, the situation is temporary. Insulin is not heroin.

Pregnant women with gestational diabetes. Pregnant women with gestational diabetes. Are there any of us here? Tell us how your pregnancy is going, what are your plans for the maternity hospital (if you are in Moscow). I have a period of 24-25 weeks, all the time the sugar was at the upper limit ...

Pregnancy and childbirth: conception, tests, ultrasound, toxicosis, childbirth, C-section, giving. I've had gestational glucosouria since 29 weeks. If earlier this problem was not detected in you, now it remains to wait a little before delivery and normalization.

Discussion

Thank you all very much for your support and advice, but in any case, on Monday we will see a doctor and from there we will start from what to do next

this is called hormone-induced gestational diabetes. In the US everyone is tested for it at 28 weeks. If there are indications (like my pre-diabetes), they check earlier. I was checked at 11 weeks - there is, of course. I prick insulin and continue to drink metformin.
Since you are already at such a late date, you will not be injected with anything ... Soon you will give birth. :) Limit yourself to sweets, bread and potatoes. When a child is born, they check for sugar. Usually it is low and needs to be raised.

It is strange that you were not tested for sugar during pregnancy.

Diabetes mellitus was predicted in a child. A healthy boy was born. After childbirth, both he and his mother have sugar in the Section: Analyzes, studies, tests, ultrasound (sugar in the urine during pregnancy is dangerous). We are 29 weeks old. The last 2 urinalysis showed an increased...

I had a similar situation in my second pregnancy: glucose in the urine with normal sugar in blood. I went for a consultation to the 1st city, donated blood for sugar on an empty stomach and with a load. As a result, they put glucosuria in pregnant women - such as a feature of pregnancy, this happens. She gave birth in an ordinary maternity hospital, everything is fine with the child, but she donated blood for sugar before childbirth almost every week (then she got tired of taking it, every other time she wrote the result to herself and took it to the w / c)

Gestational diabetes. Analyzes, research, tests, ultrasound. Pregnancy and childbirth. Gestational diabetes. Back in September, I went to the endocrinologist. She wrote to me that the birth of large children causes the development of diabetes in pregnant women.

Discussion

and how old are you? Type 2 diabetes differs from the first not at all in that they drink pills. the differences are significant enough. in general, everything depends on compensation. the better you are compensated, the fewer complications, especially vascular ones, the calmer the pregnancy will be and the more likely you are to give birth healthy baby. ideally, even with type 2 diabetes, switch to insulin, and after childbirth back to pills. but it is advisable to prepare for this before pregnancy. besides, it all depends on the experience of diabetes, the presence of complications, your weight and age. advice: strict daily glycemic control (up to 6 times a day) - you need this to be sure of your compensation, and not to the doctor, proper, balanced nutrition in accordance with medical recommendations and physical activity (lie less on the couch, move more in the fresh air, except of course, indications for lying). and doctors should be listened to, and not feel sorry for yourself. and everything will be fine, you are not the first, you are not the last. Good luck.

01/13/2008 00:22:18, D.D.

The time when doctors considered diabetes mellitus as an indication for abortion is long gone, because in modern pharmacies you can buy very effective medicine, which will help maintain the health of a woman with diabetes in the position, and a pocket glucometer so that at any time you can measure the level of glucose in the blood. Hospitals are provided today for everyone necessary equipment in order to leave a baby born to a mother with diabetes. However, it is impossible to unequivocally state that there will be no risks and dangers during pregnancy. Still, there are a number of features that all pregnant women with diabetes need to consider.

Diabetes mellitus is a chronic disease that occurs due to a lack of the pancreatic hormone insulin in the blood. This hormone is responsible for ensuring that all cells human body Glucose from food was received in a timely and correct manner. If there is not enough insulin in the blood, then the level of glucose in the blood rises, which is very dangerous.

Diabetes can occur for the following reasons:

1. Because of heredity.
2. Due to obesity.
3. Due to diseases of the pancreas that produces insulin (pancreatitis, cancer, and so on).
4. Due to viral infections in the blood.
5. Due to frequent nervous breakdowns.
6. Due to age (such a reason may be additional to the above).

This endocrine disease can have many negative consequences for human health:

• A glycemic coma may occur (when the patient's nerve cells are affected, and he is in a state of complete lethargy).
• Swelling of the extremities (most often the feet).
• Unstable arterial pressure(it can be both low and high).
• Severe pain in the joints and feet.
• Ulcers appear on the legs, which can become big sizes and increase in number.
• Gangrene can occur on the legs, which ends with amputation of the limb.

Types of Diabetes

The disease can take two forms:

1. Insulin dependent diabetes mellitus. It occurs in thin young people who have not yet reached the age of 40 years. Such people cannot live without an extra dose of insulin from a syringe, as their body produces antibodies to the cells of insulin that the pancreas produces. It is impossible to cure this form of diabetes, but it is possible to restore the function of pancreatic hormone production if you eat only raw food.
2. Non-insulin dependent diabetes mellitus. Obese older people suffer from it due to the fact that the cells of their body lose sensitivity to insulin due to an overabundance nutrients in them. Sometimes a doctor prescribes sugar pills for such people and a strict diet to help them lose weight.

Planning pregnancy with diabetes

If a woman knows for sure that she has diabetes, then she is strictly forbidden to become pregnant without prior planning, since a woman’s high blood sugar will affect her health and full development fetus in utero from the first days of conception. Doctors recommend that women with diabetes who dream of experiencing the joy of motherhood start preparing for pregnancy 3-4 months in advance. During this time, specialists will conduct diagnostics in order to determine the risk assessment and contraindications for pregnancy with diabetes. What will this diagnosis be like?

1. Take a blood test for diabetes mellitus for pregnancy planning (A level of 3.3-5.5 mmol is considered normal. The amount of sugar from 5.5 to 7.1 mmol is called a pre-diabetes state. If the sugar level exceeds 7.1 mmol, then they are already talking about one or another stage of diabetes mellitus).
2. Check your blood sugar levels up to 10 times daily with a pocket meter to monitor your glucose up and down system throughout the day.
3. Measure blood pressure daily (preferably several times a day).
4. Get a urine test to check for kidney disease.
5. Visit an ophthalmologist's office to assess the condition of the blood vessels in the eye tissue.
6. Make an ECG if a woman is over 35 years old, and she suffers from arterial hypertension, nephropathy, obesity, high cholesterol levels in the blood, and has problems with peripheral vessels.
7. Check the sensitivity of the nerve endings on the legs and feet (tactile, pain, temperature and vibration).
8. Get your blood tested for thyroid hormones.
9. Visit the office of a gynecologist who will take material to identify urinary infections.
10. Register with an endocrinologist who will accompany the entire pregnancy if it occurs.

Features of the course of pregnancy in diabetes mellitus

Now let's take a closer look at how the course of pregnancy with diabetes mellitus will differ from the usual one. First of all, in the first weeks of pregnancy, a woman's carbohydrate tolerance will improve. Therefore, the level of insulin that a woman consumed before conception should be reduced. It will return to its former norm in the second trimester of pregnancy, when the placenta is already fully formed and begins to produce contra-insulin hormones such as prolactin and glycogen.

In the fourth month of pregnancy, the doctor will increase control over the blood sugar level in the pregnant woman, as the child's pancreas is already starting to work, which begins to react to the mother's blood. If there is a lot of sugar in the blood of a pregnant woman, then the pancreas of the fetus will respond with an injection of insulin, as a result of which glucose will break down and be converted into fat - the child will actively gain weight and be born with diabetes.

In the third trimester of pregnancy, the intensity of the production of contra-insulin hormones will decrease, therefore, the endocrinologist will reduce the dosage of insulin for the expectant mother, who, due to her problem, will have to visit the gynecologist's office every week during pregnancy and lie in the hospital several times at the day hospital under the supervision of doctors:

• The first hospitalization will be shown to a pregnant woman in the first trimester (at 8-10 weeks), where diagnostics will be carried out, which will reveal contraindications to pregnancy, if any;
• The second hospitalization will be shown in the second trimester (5-6 months of pregnancy), when all kinds of fetal pathologies will be detected due to the diabetes of the expectant mother;
• The third hospitalization is carried out in the third trimester of pregnancy (8 months before delivery). Here it must be decided when and how the birth will take place.

Pregnancy with type 1 diabetes

Insulin-dependent diabetes mellitus is the most common type of diabetes for women. They will need to take insulin in different dosages for 9 months, which will be prescribed by the endocrinologist. As a rule, this is:

• In the first trimester, a pregnant woman's need for insulin decreases by about 25-30%.
• In the second trimester, on the contrary, the need for insulin increases - the average daily dose of insulin can reach 80-100 units.
• In the third trimester, the situation of the first period of pregnancy is repeated.

Pregnancy with type 2 diabetes

Type 2 diabetes in pregnant women is much less common due to the fact that it occurs in people after 40 years of age, when women are no longer able to bear children due to menopause.

Gestational diabetes during pregnancy

This type of diabetes occurs only during pregnancy. After giving birth, he always disappears without a trace. Why might it occur? Most often, the reason lies in the increasing load on the pancreas after the release of hormones into the blood, the action of which is opposite to insulin. What are the symptoms of gestational diabetes during pregnancy:

• Very intense thirst;
• Constant feeling of hunger;
• Frequent urge to urinate;
• Visual impairment.
• Changes in blood sugar levels in gestational diabetes during pregnancy:

Due to the fact that these symptoms are often found in all expectant mothers who are not sick, they do not even realize that latent diabetes mellitus is already developing in their blood during pregnancy. Women most at risk of developing gestational diabetes are those with:

• obesity;
• polycystic ovary syndrome;
• sugar in the urine before pregnancy or at its beginning;
• the presence of diabetes in one of the relatives;
• diabetes in previous pregnancies.

According to medical statistics, 4% of pregnant women experience gestational diabetes. The most common treatment for gestational diabetes during pregnancy is diet.

Contraindications for pregnancy in diabetes mellitus

At the 12th week of pregnancy during the first hospitalization, doctors reveal how dangerous diabetes is during pregnancy for a woman. Unfortunately, some women are forbidden to give birth and sent to terminate the pregnancy. This can happen if, in addition to diabetes, a pregnant woman has the following diseases:

• ischemia;
• kidney failure;
• gastroenteropathy;
• negative Rh factor of blood.

Treatment of diabetes during pregnancy

The essence of the treatment of diabetes during pregnancy is insulin therapy and rational nutrition. Only an endocrinologist can recommend a dose of insulin to each woman, but we will tell you in detail what diet for diabetes during pregnancy should be followed.

The diet includes:

• a reduced amount of carbohydrates (200-250 g), fats (60-70 g) and an increased amount of proteins (1-2 g per 1 kg of body weight);
• the energy value of daily food intake should be 2000-2200 kcal, and for obesity - 1600-1900 kcal;
• food intake should coincide in time with the action of insulin (one and a half and 5 hours after insulin administration, as well as before bedtime and upon awakening);
• the use of sugar, sweets, jam, honey, ice cream, chocolate, cakes, sugary drinks, grape juice, semolina and rice porridge is prohibited;
• food should be fractional, preferably 8 times a day;
• you need to take vitamins A, groups B, C, and D, folic acid(400 mcg per day) and potassium iodide (200 mcg per day).

In addition to following the diet of a pregnant woman with diabetes, herbal teas are prescribed:

• brewed blueberry leaves;
• brewed bean pods without seeds, blueberry leaves, chopped oat straw, flaxseed, chopped burdock root.

Expectant mothers with diabetes benefit from physical activity in the form of walking before bedtime.

Childbirth in diabetes mellitus

During the last third hospitalization, doctors will determine how the birth will go. If it is decided that a woman will give birth on her own, and not by caesarean section, then, as a rule, delivery will take place like this:

• the birth canal will be prepared for childbirth (the amniotic sac will be pierced);
• inject the necessary hormones (oxytocin or insulin) and painkillers;
• blood sugar levels and fetal heart rate are monitored using KGT. With the attenuation of labor activity, the pregnant woman is intravenously injected with oxytocin, and with a sharp jump in sugar - insulin.

Consequences of diabetes during pregnancy

1. Miscarriages often occur in early pregnancy.
2. Preeclampsia develops sharply - blood pressure rises, edema appears, protein appears in the urine, the kidneys may fail, the child may die in utero.
3. Much more common toxicosis on later dates pregnancy.
4. Polyhydramnios may develop, which will lead to fetal malformations and may provoke premature birth.

Pregnancy in any case is a serious test for any woman, especially for those who have diabetes. To avoid negative consequences, a future mother with diabetes will need to scrupulously follow all the recommendations of an endocrinologist and gynecologist.

Video: "Pregnancy with diabetes"

Gestational diabetes mellitus (GDM): danger of "sweet" pregnancy. Consequences for the child, diet, signs

According to the World Health Organization, there are more than 422 million people with diabetes in the world. Their number is growing every year. Increasingly, the disease affects young people.

Complications of diabetes lead to serious vascular pathologies, kidneys, retina, are affected. But this disease is controllable. With the right therapy severe consequences move back in time. no exception and gestational diabetes that developed during gestation. This disease is called gestational diabetes mellitus.

• Can pregnancy cause diabetes?
• What are the types of diabetes during pregnancy
• Risk group
• What is gestational diabetes during pregnancy
• Consequences for the child
• What is the danger for a woman
• Symptoms and signs of gestational diabetes in pregnancy
• Analyzes and timing
• Treatment
• Insulin therapy: who is indicated and how it is carried out
• Diet: allowed and prohibited foods, basic principles of nutrition for pregnant women with GDM
• Sample menu for the week
• ethnoscience
• How to give birth: natural childbirth or caesarean section?
• Prevention of gestational diabetes in pregnant women

Pregnancy - a provocateur?

The American Diabetes Association reports that 7% of pregnant women develop gestational diabetes. In some of them, after childbirth, glucosemia returns to normal. But in 60%, type 2 diabetes (DM2) manifests in 10-15 years.

Gestation acts as a provocateur of impaired glucose metabolism. The mechanism of development of the gestational form of diabetes is closer to type 2 diabetes. A pregnant woman develops insulin resistance due to the following factors:

• synthesis in the placenta of steroid hormones: estrogen, placental lactogen;
• an increase in the formation of cortisol in the adrenal cortex;
• violation of insulin metabolism and a decrease in its effects in tissues;
• increased excretion of insulin through the kidneys;
• activation of insulinase in the placenta (an enzyme that breaks down the hormone).

The condition worsens in those women who have physiological resistance (immunity) to insulin, which did not manifest itself clinically. These factors increase the need for the hormone, pancreatic beta cells synthesize it into increased amount. Gradually, this leads to their depletion and persistent hyperglycemia - an increase in the level of glucose in the blood plasma.

What are the types of diabetes during pregnancy?

Pregnancy may be accompanied different types diabetes. The classification of pathology according to the time of occurrence implies two forms:

1. diabetes that existed before pregnancy (DM 1 and DM type 2) - pregestational;
2. gestational diabetes (GDM) in pregnancy.

Depending on the necessary treatment GSD happens:

• compensated by diet;
• compensated by diet therapy and insulin.

Diabetes can be in the stage of compensation and decompensation. The severity of pregestational diabetes depends on the need to apply various methods treatment and severity of complications.

Hyperglycemia that develops during pregnancy is not always gestational diabetes. In some cases, this may be a manifestation of type 2 diabetes.

Who is at risk for developing diabetes during pregnancy?

Hormonal changes that can disrupt insulin and glucose metabolism occur in all pregnant women. But the transition to diabetes is not for everyone. This requires predisposing factors:

• overweight or obesity;
• existing impaired glucose tolerance;
• episodes of rising sugar before pregnancy;
• Type 2 diabetes in parents of a pregnant woman;
• age over 35;
• a history of miscarriages, stillbirths;
• birth in the past of children weighing more than 4 kg, as well as with malformations.

But which of these causes affects the development of pathology to a greater extent is not fully known.

What is gestational diabetes

GDM is considered to be the pathology that has developed after - bearing a child. If hyperglycemia is diagnosed earlier, then there is latent diabetes mellitus that existed before pregnancy. But the peak incidence is observed in the 3rd trimester. A synonym for this condition is gestational diabetes.

It differs from gestational overt diabetes in pregnancy in that after one episode of hyperglycemia, sugar gradually increases and does not tend to stabilize. This form of the disease is more likely to progress to type 1 or type 2 diabetes after childbirth.

To determine the further tactics, all puerperas with GDM in the postpartum period determine the level of glucose. If it does not normalize, then it can be considered that type 1 or type 2 diabetes has developed.

Impact on the fetus and consequences for the child

The danger to the developing child depends on the degree of compensation of the pathology. The most severe consequences are observed in the uncompensated form. The effect on the fetus is expressed as follows:

1. Malformations of the fetus elevated level glucose early. Their formation occurs due to energy deficiency. In the early stages, the child's pancreas has not yet been formed, so the mother's organ must work for two. Violation of work leads to energy starvation of cells, disruption of their division and the formation of defects. This condition can be suspected by the presence of polyhydramnios. Insufficient intake of glucose into cells is manifested by intrauterine growth retardation, low weight of the child.
2. Uncontrolled sugar levels in a pregnant woman with gestational diabetes in the 2nd and 3rd trimester leads to diabetic fetopathy. Glucose crosses the placenta in unlimited quantities, the excess is deposited as fat. If there is an excess of own insulin, accelerated growth fetus, but there is a disproportion of body parts: big belly, shoulder girdle, small limbs. It also enlarges the heart and liver.
3. A high concentration of insulin disrupts the production of surfactant, a substance that coats the alveoli of the lungs. Therefore, after birth, respiratory disorders may occur.
4. Tying the umbilical cord of a newborn disrupts the supply of excess glucose, the child's glucose concentration drops sharply. Hypoglycemia after childbirth leads to neurological disorders, impaired mental development.

Babies born to mothers with gestational diabetes also have an increased risk of birth injury, perinatal death, cardiovascular diseases, pathology of the respiratory system, disorders of calcium and magnesium metabolism, neurological complications.

Why high sugar is dangerous for a pregnant woman

GDM or pre-existing diabetes increases the possibility of late toxicosis (), it manifests itself in various forms:

• dropsy of pregnant women;
• nephropathy 1-3 degree;
• preeclampsia;
• eclampsia.

The last two conditions require hospitalization in the intensive care unit, resuscitation and early delivery.

Immune disorders that accompany diabetes lead to infections of the genitourinary system - cystitis, pyelonephritis, as well as recurrent vulvovaginal candidiasis. Any infection can lead to infection of the child in utero or during childbirth.

The main signs of gestational diabetes during pregnancy

Symptoms of gestational diabetes are not expressed, the disease develops gradually. Some signs of a woman are taken for normal changes in the condition during pregnancy:

• increased fatigue, weakness;
• thirst;
• frequent urination;
• insufficient weight gain with pronounced appetite.

Hyperglycemia is often an incidental finding during a mandatory blood glucose screening test. This serves as an indication for further in-depth examination.

Grounds for diagnosis, tests for latent diabetes

The Ministry of Health has determined the deadlines for a mandatory blood test for sugar:

• when registering;

In the presence of risk factors in - a glucose tolerance test is performed. If symptoms of diabetes appear during pregnancy, then a glucose test is performed according to indications.

One analysis, which revealed hyperglycemia, is not enough to make a diagnosis. You need to check after a few days. Further, with repeated hyperglycemia, an endocrinologist consultation is prescribed. The doctor determines the need and timing of the glucose tolerance test. Usually it is at least 1 week after the recorded hyperglycemia. The test is also repeated to confirm the diagnosis.

Talk about GSD following results test:

• fasting glucose more than 5.8 mmol / l;
• an hour after taking glucose - above 10 mmol / l;
• after two hours - above 8 mmol / l.

Additionally, according to indications, research is carried out:

• glycosylated hemoglobin;
• urinalysis for sugar;
• cholesterol and lipid profile;
• coagulogram;
• blood hormones: estrogen, placental lactogen, cortisol, alpha-fetoprotein;
• urinalysis according to Nechiporenko, Zimnitsky, Reberg's test.

Pregnant women with pregestational and gestational diabetes undergo fetal ultrasound from the 2nd trimester, doplerometry of the vessels of the placenta and umbilical cord, regular CTG.

Management of pregnant women with diabetes mellitus and treatment

The course of pregnancy with existing diabetes depends on the level of self-control on the part of the woman and the correction of hyperglycemia. Those who had diabetes before conception must go through the "School of Diabetes" - special classes that teach the right eating behavior, self-monitoring of glucose levels.

Regardless of the type of pathology, pregnant women need the following observations:

• visiting a gynecologist every 2 weeks at the beginning of gestation, weekly - from the second half;
• consultations with an endocrinologist once every 2 weeks, in a decompensated state - once a week;
• observation of the therapist - every trimester, as well as when extragenital pathology is detected;
• ophthalmologist - once a trimester and after childbirth;
• neurologist - twice during pregnancy.

Mandatory hospitalization is provided for examination and correction of therapy for a pregnant woman with GDM:

• 1 time - in the first trimester or when diagnosing a pathology;
• 2 times - in - to correct the condition, determine the need to change the treatment regimen;
• 3 times - with type 1 and type 2 diabetes - in, GDM - in to prepare for childbirth and the choice of the method of delivery.

In a hospital, the frequency of studies, the list of analyzes and the frequency of the study is determined individually. Daily monitoring requires a urine test for sugar, blood glucose, blood pressure control.

Insulin

The need for insulin injections is determined individually. Not every case of GDM requires this approach; for some, a therapeutic diet is sufficient.

Indications for starting insulin therapy are the following blood sugar levels:

• fasting blood glucose on the background of a diet of more than 5.0 mmol / l;
• one hour after eating above 7.8 mmol / l;
• 2 hours after a meal, glycemia is above 6.7 mmol / l.

Attention! In pregnant and lactating women, the use of any hypoglycemic drugs, except for insulin, is prohibited! Long-acting insulins are not used.

The basis of therapy is short- and ultrashort-acting insulin preparations. In type 1 diabetes, basal bolus therapy is performed. For type 2 diabetes and GDM, it is also possible to use the traditional scheme, but with some individual adjustments that are determined by the endocrinologist.

In pregnant women with poor hypoglycemic control, insulin pumps can be used to facilitate hormone administration.

Diet for gestational diabetes during pregnancy

Nutrition of a pregnant woman with GDM should comply with the following principles:

• Little and often. It is better to have 3 main meals and 2-3 small snacks.
• The amount of complex carbohydrates is about 40%, protein - 30-60%, fats up to 30%.
• Drink at least 1.5 liters of liquid.
• Increase the amount of fiber - it is able to adsorb glucose from the intestines and remove it.

Actual video

Diet for gestational diabetes in pregnancy

Products can be divided into three conditional groups presented in Table 1.

Table 1

It is forbidden to use	Limit Quantity	You can eat
Sugar sweet pastries Honey, sweets, jam Fruit juices from the store Carbonated sweet drinks Semolina and rice porridge Grapes, bananas, melon, persimmon, dates Sausages, sausages, any fast food Sweeteners	Durum wheat pasta Potato Animal fats ( butter, pork fat), fatty Margarine	All kinds of vegetables, including Jerusalem artichoke Beans, peas and other legumes Wholemeal bread Buckwheat, oatmeal, barley, millet Lean meat, poultry, fish Low fat dairy products Fruits, except prohibited Vegetable fats

Sample menu for a pregnant woman with gestational diabetes

The menu for the week (table 2) may have approximately next view(table number 9).

Table 2.

Day of the week	Breakfast	2 breakfast	Dinner	afternoon tea	Dinner
Monday	Millet porridge with milk, bread with unsweetened tea	Apple or pear or banana	Fresh vegetable salad with vegetable oil; Chicken broth with noodles; Boiled meat with stewed vegetables	Cottage cheese, unsweetened cracker, tea	Braised cabbage with meat, tomato juice. Before going to bed - a glass of kefir
Tuesday	Omelet for a couple with, Coffee/tea, bread	Any fruit	Vinaigrette with butter; milk soup; barley porridge with boiled chicken; dried fruits compote	Unsweetened yogurt	Steamed fish with vegetable garnish, tea or compote
Wednesday	Cottage cheese casserole, tea with cheese sandwich	Fruits	Vegetable salad with vegetable oil; low-fat borscht; mashed potatoes with beef goulash; dried fruits compote	Low fat milk with crackers	Buckwheat porridge with milk, egg, tea with bread
Thursday	Oatmeal in milk with raisins or fresh berries, tea with bread and cheese	Yogurt without sugar	Cabbage and carrot salad; pea soup; Mashed potatoes with boiled meat; tea or compote	Any fruit	Stewed vegetables, boiled fish, tea
Friday	Millet porridge, boiled egg, tea or coffee	Any fruit	Vinaigrette in vegetable oil; milk soup; baked zucchini with meat;	Yogurt	Vegetable casserole, kefir
Saturday	Milk porridge, tea or coffee with bread and cheese	Any permitted fruit	Vegetable salad with low-fat sour cream; buckwheat soup with chicken broth; boiled pasta with chicken;	Milk with crackers	Cottage cheese casserole, tea
Sunday	Oatmeal with milk, tea with a sandwich	Yogurt or kefir	Bean and tomato salad; cabbage soup; boiled potatoes with stew;	Fruits	Grilled vegetables, chicken fillet, tea

ethnoscience

Methods traditional medicine offer many recipes on how to use herbal remedies to reduce blood sugar and replace sugary foods. For example, stevia and its extracts are used as a sweetener.

For diabetics, this plant is not dangerous, but use in pregnant women and lactating women is not recommended. Studies on the effect on the course of pregnancy and the formation of the fetus have not been conducted. In addition, the plant can cause allergic reaction, which is highly undesirable during pregnancy against the background of gestational diabetes.

Natural birth or caesarean?

How the delivery will take place depends on the condition of the mother and child. Hospitalization of pregnant women with gestational diabetes is carried out in -. To avoid birth trauma, they try to induce labor with a full-term baby during this period.

In a serious condition of a woman or fetal pathology, the issue of a caesarean section is decided. If, according to the results of ultrasound, a large fetus is determined, the correspondence of the size of the woman's pelvis and the possibility of childbirth are determined.

At sharp deterioration the state of the fetus, the development of severe preeclampsia, retinopathy and nephropathy of the pregnant woman, a decision can be made on early delivery.

Prevention methods

It is not always possible to avoid the disease, but it is possible to reduce the risk of its occurrence. Women who are overweight or obese should start planning their pregnancy with diet and weight loss.

Everyone else should adhere to the principles of a healthy diet, control weight gain, reduce the consumption of sweets and starchy foods, fatty foods. We must not forget about sufficient physical activity. Pregnancy is not a disease. Therefore, in its normal course, it is recommended to perform special sets of exercises.

Women with hyperglycemia should take into account the recommendations of the doctor, be hospitalized in deadlines for examination and treatment. This will help prevent the development of complications of gestational diabetes. Those who had GDM in a previous pregnancy have a significantly increased risk of developing diabetes when they re-gestate.

All nine months from the moment of conception of a baby are a rather stressful period in the life of absolutely every woman. With the advent of the fetus in the womb, the mother's body needs more strength and energy. Very often it is during this period that the course of all metabolic processes in organism. Moreover, gestational insulin dependence often appears.

Adipose tissue, liver, muscles become less susceptible to the hormone insulin. When adverse conditions occur, blood sugar rises, which very often leads to the appearance of diabetes. This disease, as a rule, is detected during the next examination in the antenatal clinic. For up to 24 weeks, only venous blood is taken for analysis, and in the third trimester, special test -

general information

Gestational diabetes during pregnancy is quite serious illness, which requires a competent approach in treatment. The basis of this disease is the wrong metabolism of carbohydrates, or rather, a decrease in glucose tolerance.

In the United States, studies have been repeatedly conducted on this issue. According to available information, gestational diabetes in pregnant women is diagnosed in 4% of cases. European scientists announced other information. It is known that the prevalence this disease varies from 1 to approximately 14% of total pregnancies. About 10% of women after childbirth remain with symptoms of this disease, which subsequently transforms into type 2 diabetes.

Such relatively high performance The prevalence of pathology around the world testifies, first of all, to the lack of awareness of women about the possible consequences of this disease. As a result, only a few turn to doctors for qualified help.

What is the risk of diabetes during pregnancy?

Firstly, it is a negative effect on the fetus inside the mother's womb. In the early stages, diabetes can provoke or lead to various kinds of defects in the development of the baby's brain structures and heart. If the disease was diagnosed at a later date (2-3 trimesters), the likelihood of excessive fetal growth is very high, which leads to diabetic fetopathy. The main signs of this pathology are overweight (more than 4 kg), respiratory distress, body imbalances, hypoglycemia.

How is the pregnancy going?

IN this case It is impossible to answer this question precisely, since each case is individual. A woman, as a rule, is hospitalized three times. First time on early term she undergoes a full examination, according to the results of which the doctor decides on the preservation and management of pregnancy, and also prescribes preventive treatment. The second time hospitalization is carried out for a period of 20 weeks, since it is at this time that the first complications may appear. At 32 weeks, the doctor chooses the method and timing of future births.

Who is most susceptible to this disease?

Gestational diabetes mellitus during pregnancy, as a rule, develops in the presence of a genetic predisposition, which is realized under the influence of several factors at once, such as:

Excess body weight;

Inflated level indicators;

Various kinds of disorders of carbohydrate metabolism;

Age (over 30 years old);

Previous toxicosis and gestosis;

Various types of disruption at work of cardio-vascular system;

Chronic miscarriage.

Main reasons

Gestational diabetes in women develops due to a decrease in the usual sensitivity of body cells to their own insulin. This is due to an increase in the level of hormones in the blood, which is very often observed during pregnancy. In addition, in women, glucose levels are rapidly decreasing, since both the fetus and the placenta now need it. The consequence of all the above factors is considered to be a compensatory increase in insulin production directly by the pancreas itself. So, that is why often in the blood of women in position, these indicators are slightly increased. If the pancreas on its own does not cope with its direct duties, namely with the production required amount insulin, gestational diabetes mellitus develops.

Symptoms

The increase in sugar levels in this disease is usually insignificant. That's why it's bright pronounced signs very rare in pregnant women. In some cases, there is thirst and frequent urination, as well as dry skin. However, all these symptoms are perceived by women as specific features of their situation.

How is the disease confirmed?

Diagnosis of gestational diabetes mellitus involves a blood test for glucose levels and a special glucose tolerance test.

In medicine, two types of GTT are distinguished depending on the method of glucose administration: intravenous and oral. In the second version of the test, the patient is asked to drink a sweetened liquid that contains exactly 50 g of sugar. After 20 minutes, venous blood is taken from her for analysis (the content of glucose in it is determined). If the sugar level exceeds 140 mg/dl, you will also need to pass an intravenous glucose tolerance test.

When conducting this study, it is very important to observe certain conditions. First of all, patients are advised to adhere to the usual rules for five days before the expected date of the test. physical activity and nutrition, however, the carbohydrate content in the diet should exceed 150 g. It is important to remember that blood sampling is carried out only in the morning and on an empty stomach. The patient is advised to fast for 14 hours before the test. During the study itself, it is better to be in a calm state.

What should be the treatment?

Gestational diabetes during pregnancy is very often complicated by the fact that a woman has to measure her glucose level about four times a day. It is important to note that drug therapy in this case is categorically contraindicated, since it can adversely affect the development of the baby in the womb.

As for the issue of treatment, in this case, experts recommend adhering to a special diet, regularly checking sugar levels. If all of the above advice fails desired results prescribed insulin therapy.

How is the diet different for this disease?

Gestational diabetes during pregnancy involves following a certain diet. As noted above, it is proper nutrition most often becomes the key to successful treatment of the disease. Experts recommend in no case to reduce the nutritional value of food, it is better to slightly reduce its calorie content. Below we give effective advice concerning a diet at this diagnosis.

You should eat in small portions and always at a certain time.

What can you eat? It is better to enrich the diet with various kinds of cereals, fresh vegetables and fruits, pasta (only from whole grains). All of these products contain a large amount of fiber, which is very useful during pregnancy.

In the diet, you can use lean meats and fish, it is better to limit the consumption of smoked meats, sausages and sausages.

Cooking food should be steamed or baked in the oven, using a minimum amount of oil.

Exercise stress

Daily exercise is very beneficial for pregnant women as it supports muscle tone, improve well-being and the action of insulin, prevent the appearance of excess body fat. Of course, the load in this case should be moderate. Women are encouraged to attend yoga classes, take small walks every day, swim in the pool. Active physical exercises (horse riding, skating and skiing) should not be abused, as they can lead to injuries. It is important to regulate the number of loads each time, based on the well-being of the pregnant woman herself.

Postpartum care

Gestational diabetes in women usually resolves immediately after delivery, but in some cases it can lead to complications. As noted above, the baby is born very large, so you often have to resort to the help of a caesarean section. The whole point is that when natural childbirth there is a possibility of birth trauma.

The child is born with reduced level sugar, but no special measures are taken to normalize it. Glucose levels return to normal on their own if the mother breastfeeds the baby. This indicator should be constantly monitored by specialists from the maternity hospital.

If a woman strictly follows all the prescriptions from the doctor during pregnancy, then her baby will not be threatened by gestational diabetes, the birth will go smoothly.

If a woman will neglect complex therapy during pregnancy, this violation can lead to the fact that the newborn will appear. It is characterized by the following symptoms:

Jaundice;

Increased blood clotting;

tissue swelling;

Violation of the natural proportions of the body (for example, excessively thin limbs);

Various kinds of disorders of the respiratory system.

To finally overcome such an ailment as gestational diabetes, the diet must continue after childbirth. It is recommended to stick to a strict diet until the blood sugar finally returns to normal.

Experts advise all women with this diagnosis to do a test annually. It is believed that one in five women who have had the disease actually have undiagnosed type 2 diabetes.

Preventive measures

According to experts, it is actually very difficult to prevent the development of this disease. Often women who are at risk do not suffer from diabetes at all.

It is important to note that pregnancy planning after this diagnosis should take place under the supervision of a doctor and not earlier than 2 years after the previous birth. A few months before this period, it is recommended to start monitoring your own weight, introduce physical exercises into your daily routine, and ask your doctor what to eat with diabetes.

Reception of absolutely any medicines must always be consulted with a specialist. The thing is that the uncontrolled use of medications, including birth control pills, can result in the development of such an ailment as gestational diabetes mellitus.

Pregnancy means abrupt change hormone balance. And this natural feature can lead to the fact that the components secreted by the placenta will prevent the mother's body from taking insulin. A woman has an abnormal concentration of glucose in her blood. Gestational diabetes during pregnancy occurs more often from the middle of the term. But his earlier presence is also possible.

Read in this article

Causes of diabetes in pregnant women

Experts cannot name a clear culprit for the violation of tissue response to glucose in expectant mothers. Undoubtedly, not the last importance in the appearance of diabetes belongs to hormonal changes. But they are common for all pregnant women, and, fortunately, not everyone is diagnosed in this position. Those who suffered it noted:

• hereditary tendency. If there is a history of diabetes in the family, there is also a higher probability of its occurrence in a pregnant woman compared to others.
• Autoimmune diseases that, due to their characteristics, disrupt the functions of the insulin-producing pancreas.
• Frequent viral infections. They are also capable of upsetting the functions of the pancreas.
• Passive lifestyle and high-calorie diet. They lead to overweight, and if it existed before conception, the woman is at risk. This also includes those whose body weight has increased by 5-10 kg in adolescence behind a short time, and her index went above 25.
• Age from 35 years. Those who are under 30 at the time of pregnancy are less likely to get gestational diabetes than others.
• Previous birth of an infant weighing more than 4.5 kg or stillbirth for unexplained reasons.

Women of Asian or African descent are more susceptible to gestational diabetes than those of European descent.

Signs that you might suspect you have gestational diabetes

On early stage diabetes mellitus during pregnancy practically does not show symptoms. That is why it is important for expectant mothers to control the concentration of sugar in the blood. Initially, they may notice that they began to drink a little more water, lost some weight, although there are no visible reasons. Some find that it is more pleasant for them to lie or sit than to move.

With the development of malaise, a woman may feel:

• The need for a large amount of liquid. Despite her satisfaction, dry mouth worries.
• The need to urinate more often, the liquid comes out much more than usual.
• Increased fatigue. Pregnancy already takes a lot of energy, and now a woman’s desire to take a break arises faster than before, with diabetes, her self-awareness does not correspond to the received load.
• Deterioration in the quality of vision. Blurring may occasionally occur in the eyes.
• Skin itching, and mucous membranes can also itch.
• Significant increase in the need for food and rapid weight gain.

First and latest signs diabetes during pregnancy is difficult to separate from itself. After all, and healthy women expecting babies, appetite and thirst often increase.

How to get rid of diabetes during pregnancy

At the first stage of development, gestational diabetes is treated by streamlining lifestyle and. Indispensable is the control of the quantitative content of glucose on an empty stomach, as well as 2 hours after each meal. Sometimes a blood sugar measurement may be required before it.

You will need to periodically do a urine test. This is necessary to make sure that there are no ketone components in the liquid, that is, the containment of pathological processes.

Diet and physical activity are key at this stage.

Diet for gestational diabetes

it is impossible for a pregnant woman, the fetus must have everything necessary, and sugar from a lack of food grows. Future mother will have to stick healthy principles in food:

• Portions should be small and meals should be frequent. If you eat 5-6 times a day, you can maintain optimal weight.
• The largest amount of slow carbohydrates (40 - 45% of the total food) should be for breakfast. These are cereals, rice, pasta, bread.
• It is important to pay attention to the composition of products, postponing sugary fruits, chocolate, pastries until better times. Fast food, and seeds are excluded. We need vegetables, cereals, poultry, rabbit meat. Fat must be removed, no more than 10% of the total amount of food should be eaten per day. Fruits, berries, and greens that do not contain a large amount of sugar will be useful.
• Do not eat instant food. Having the same names as natural ones, they contain more glucose. We are talking about freeze-dried cereals, mashed potatoes, noodles.
• Food must not be fried, only boiled or steamed. If stewed, then with a small amount of vegetable oil.
• You can fight morning sickness with dry, unsweetened biscuits. It is eaten in the morning without getting out of bed.
• Cucumbers, tomatoes, zucchini, lettuce, cabbage, beans, mushrooms can be eaten in large quantities. They are low in calories and have a low glycemic index.
• Vitamin-mineral complexes are taken only on the recommendation of a doctor. Many of them contain glucose, the excess of which is now harmful.

Water at this style You need to drink up to 8 glasses of food per day.

Medications

If changes in nutrition do not work, that is, the glucose level remains elevated, or the urine test is poor with normal sugar, insulin will have to be administered. The dose in each case is determined by the doctor, based on the weight of the patient and the duration of pregnancy.

Insulin is administered intravenously, usually divided into 2 doses. The first prick before breakfast, the second - before dinner. Diet at drug therapy persists, as does regular monitoring of blood glucose levels.

Physical exercise

Physical activity is needed regardless of whether the rest of the treatment was limited to diet or the pregnant woman injects insulin. Sport helps to spend excess energy, normalize the balance of substances, increase the effectiveness of the hormone missing in gestational diabetes.

The movement should not be to the point of exhaustion, the possibility of injury must be excluded. Walking, exercises in the gym (except for swinging the press), swimming are suitable.

Prevention of gestational diabetes

For women at risk, a specialist will explain how dangerous gestational diabetes is during pregnancy. Pathology in the mother creates many threats to her and the fetus:

• At an early date increases the likelihood. With gestational diabetes, a conflict is created between her body and the fetus. He seeks to reject the embryo.
• Thickening of the vessels of the placenta due to gestational diabetes leads to circulatory disorders in this area, therefore, a decrease in the supply of oxygen and nutrients to the fetus.
• Having arisen from 16 to 20 weeks, the disease can lead to defective formation of the cardiovascular system and the brain of the fetus, stimulate its excessive growth.
• Childbirth may begin prematurely. And the large size of the fetus forces a caesarean section. If the birth is natural, it will create a risk of injury to the mother and baby.
• A newborn baby may be at risk of jaundice, respiratory distress, hypoglycemia, and increased blood clotting. These are signs of diabetic fetopathy, which also causes other pathologies in the child in the postnatal period.
• A woman is more likely to develop preeclampsia and eclampsia. Both problems are dangerous with high blood pressure, convulsions, which during childbirth can kill both mother and child.
• Subsequently, a woman has an increased risk of developing diabetes.

For these reasons, prevention of the disease is needed at an early stage, which includes:

• Regular. It is important to register early, to do everything necessary tests especially if you are at risk.
• Maintain optimal body weight. If she was more normal before pregnancy, it is better to lose weight first and plan later.
• . High pressure may indicate a tendency to increase sugar and stimulate it.
• To give up smoking. The habit affects the functions of many organs, including the pancreas.

A woman with gestational diabetes is quite capable of giving birth to more than one healthy child. It is necessary to identify the pathology in time and make efforts to contain it.