What is dangerous for gestational diabetes?
Pregnant women with diabetes, or gestational diabetes mellitus, usually get sick during pregnancy. And after childbirth the disease can, how to go, and stay for life.
The risk factors for developing gestational diabetes include:
- The age of a pregnant woman is over 40 years old.
- Presence of relatives with this disease. Especially if one of the parents is sick in a pregnant woman.
- Belonging to the dark race.
- Excess body weight. If the body mass index before pregnancy was from 25 to 29.9, then the risk of development will be 2 times greater than with a normal body weight of a woman.
- Smoking.
- If a child weighing more than 4.5 kg was born in the previous pregnancy or was stillborn.
Causes and Symptoms of Gestational Diabetes Mellitus
The emergence of diabetes during pregnancy is facilitated by the fact that the placenta-produced hormones for fetal development can withstand the action of insulin, which produces the pancreas of the mother. In this case, the sensitivity of cells to insulin decreases and the level of glucose in the blood rises.
With sufficient amount of its own maternal insulin, gestational diabetes does not develop.
The causes of the occurrence are not yet fully understood. Of the known reasons, you can call:
- hereditary factor;
- the presence of autoimmune diseases, when the body's own immune system destroys pancreatic cells responsible for producing insulin;
- lesions of the pancreas by viruses;
- wrong lifestyle and nutrition.
The severity of the symptoms of diabetes depends on how much the blood sugar level is elevated. It happens that the pregnant woman does not notice any symptoms until it is found out in the laboratory examination.
The main symptoms of diabetes are: dry mouth, thirst, frequent and profuse urination, weight gain with moderate appetite.
Diagnosis of the disease
Early diagnosis of diabetes during pregnancy will help to avoid serious consequences: damage to the mother's vessels, increased blood pressure, eye problems, impaired placental blood flow, the birth of a child with malformations or the dead.
The main method for diagnosing diabetes in pregnant women is measuring blood sugar. In the women's consultation, such an analysis is carried out on schedule and at the 30th week of pregnancy.
If the blood sugar level taken fasting from the finger exceeds 6.1 mmol / l, and from the vein - 7 mmol / l, the doctor can diagnose "diabetes mellitus."The fasting blood sugar values in the range 4.8-6.0 mmol / l from the finger and 5.3-6.9 mmol / l - from the vein can cause doubts in the doctor. Therefore, he can prescribe a test for impaired glucose tolerance. After taking blood on an empty stomach, the examined patient drinks 75 grams of dissolved glucose in water and 2 hours later the blood sugar level is measured again. With blood glucose levels greater than 7.8 mmol / l, a pregnant woman is diagnosed with diabetes mellitus. At rates from 6.8 to 7.8 mmol / l - there is a tendency to the disease.
Another method of diagnosis is to measure the level of glycated hemoglobin in the blood. This is the average level of blood glucose in the past three months. The norm is considered to be glycated hemoglobin to 6%, from 6% to 6.5% - at risk, from 6.5% and above - to diagnose diabetes.
Treatment of the disease
The main effective and safe for the fetus treatment of gestational diabetes is insulin therapy. The goal of the treatment is to maintain blood glucose levels within normal limits. On an empty stomach, before each meal and before going to bed in the blood taken from the finger - 5.0 mmol / l and from the vein - 5.5 mmol / l, 2 hours after eating - less than 6.7 mmol / l - from the finger, andless than 7,3 mmol / l - from the vein.
To pick up the insulin doses necessary to maintain blood glucose within the normal range, the patient undergo a regular check of blood sugar level several times a day. Insulin injections can be prescribed before each meal, at bedtime and after sleep. Tablets medicines during pregnancy are contraindicated, since they poorly affect the development of the fetus.
In addition to insulin therapy, a woman with gestational diabetes should follow a diet.
During the whole pregnancy, a woman with this ailment is observed in an endocrinologist, often gives tests and attends a women's consultation. Every 2 months the level of glycated hemoglobin is monitored. In addition, the patient is sent to study at the school "Gestational diabetes", where she is taught self-monitoring, proper nutrition, the right choice of physical activity and adjusting doses of insulin.
Nutrition for gestational diabetes
In the presence of diabetes in a pregnant woman, it is recommended that she restrict the intake of easily digestible carbohydrates. At a normal body weight, the daily calorific value is calculated based on the requirement of 30 kcal for 1 kg of weight, if there is excess weight - from 25 kcal per 1 kg of weight. With a high degree of obesity, the need for caloric content should decrease to 15 kilocalories per 1 kg of weight.
In addition, it is recommended to consume carbohydrates with an average and low glycemic index up to 45% of the total caloric intake, proteins - 25% and fats - 30%.
Carbohydrates should be distributed evenly throughout the day for 6 meals. For breakfast, it is recommended to eat less carbohydrates than other meals.