Gestational diabetes in pregnant women treatment. Gestational diabetes mellitus (GDM): the danger of a “sweet” pregnancy. Consequences for the child, diet, signs. Gestational diabetes and childbirth

23.05.2024

During pregnancy, chronic diseases may worsen or signs of previously unknown problems may appear. Gestational diabetes can become such a problem.

According to the World Health Organization classification, “gestational diabetes” is diabetes mellitus detected during pregnancy, as well as impaired glucose tolerance (the body’s perception of glucose), also detected during this period. Its cause is reduced sensitivity of cells to their own insulin (insulin resistance), which is associated with high levels of pregnancy hormones in the blood. After childbirth, blood sugar levels most 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.

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

Why is gestational diabetes dangerous?

Gestational diabetes in most clinical situations develops in the interval up to. Disorders of carbohydrate metabolism detected earlier, as a rule, indicate previously undetected pregestational (“pre-pregnancy”) diabetes.

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

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

What threatens mom? Premature birth and stillbirth are possible. There is a high risk of developing (with diabetes it develops more often and earlier - up to 30 weeks), hydramnios, and consequently, fetal malnutrition. It is possible to develop diabetic ketoacidosis (a condition in which there is a sharp increase in glucose levels and the concentration of ketone bodies in the blood), genital tract infections, which are registered 2 times more often and cause infection of the fetus and. It is also possible for microangiopathies to progress, resulting in impairment of vision, kidney function, impaired blood flow through the vessels of the placenta, and others. A woman may develop weakness in labor, which, in combination with a clinically narrow pelvis and a large fetus, will make delivery by cesarean section inevitable. Women with diabetes are more likely to have infectious complications in the postpartum period.

In some cases, pregnant women develop gestational diabetes mellitus (GDM). This form of the disease can appear exclusively during pregnancy and disappear some time after childbirth. But if timely treatment is not carried out, the disease can develop into type 2 diabetes, which has complex consequences.

When pregnancy occurs, every woman must register, where, under the supervision of specialists, the well-being of the expectant mother and the development of the fetus will be monitored.

Every pregnant woman should regularly monitor her sugar by taking urine and blood tests. Isolated cases of increased glucose levels in tests should not cause panic, since such jumps are considered a normal physiological process. But, if, when taking tests, elevated sugar is noticed in two or more cases, then this already signals the presence of gestational diabetes mellitus during pregnancy. It is noteworthy that an increased level is detected when the material is taken on an empty stomach (an increase in blood sugar levels after eating is the norm).

Causes of pathology

The risk group includes women to whom the following parameters can be applied:

overweight or obesity;
if previous births occurred with gestational diabetes;
hereditary factor (transmitted genetically);
ovarian pathologies (polycystic disease);
pregnancy after 30 years of age.

According to statistics, complications during childbearing occur in 10% of women. The cause of gestational diabetes can be called, as with type 2 diabetes, loss of cell sensitivity to insulin. In this case, there is a high level of glucose in the blood due to the high concentration of pregnancy hormones.

Insulin resistance most often appears between 28 and 38 weeks of pregnancy, and is accompanied by weight gain. It is believed that a decrease in physical activity during this period also affects the appearance of GDM.

Symptoms

Symptoms of GDM are not much different from the symptoms of type 2 diabetes:

a constant feeling of thirst, while drinking does not bring relief;
frequent urination, causing discomfort;
There may be a decrease in appetite or a feeling of constant hunger;
jumps in blood pressure appear;
vision suffers, blurred vision appears.

Diagnostics

If at least one of the above signs is present, then a mandatory visit to the gynecologist and testing for sugar levels is required. This analysis is called a glucose tolerance test (GTT). The test helps determine the absorption of glucose by the cells of a pregnant woman’s body and possible disturbances in this process.

To conduct the test, venous blood is taken from the patient (on an empty stomach). If the result shows elevated sugar levels, a diagnosis of gestational diabetes is made. If the indicators are underestimated, GTT is carried out. To do this, glucose in the amount of 75 g is diluted in a glass (250 ml) of slightly warmed water and given to the woman to drink. An hour later, blood is taken again from a vein. If the indicators are normal, then for control the test can be repeated after 2 hours.

Danger of GDM for the fetus

What is the threat of histosis diabetes to the developing fetus? Since this pathology does not pose a direct danger to the life of the expectant mother, but can only be dangerous for the baby, treatment is aimed at preventing perinatal complications, as well as complications during childbirth.

The consequences for a child with gestational diabetes are expressed in its negative impact on blood microcirculation in the tissues of the pregnant woman. All complex processes caused by impaired microcirculation ultimately lead to hypoxic effects on the fetus.

Also, the supply of large amounts of glucose to the baby cannot be called harmless. After all, insulin produced by the mother cannot penetrate the placental barrier, and the baby’s pancreas is not yet able to produce the required amount of the hormone.

As a result of the influence of diabetes mellitus, the metabolic processes in the fetus are disrupted, and it begins to gain weight due to the growth of adipose tissue. Next, the baby experiences the following changes:

an increase in the shoulder girdle is noticed;
the stomach increases significantly;
the liver and heart increase in size;

All these changes take place against the background of the fact that the head and limbs remain the same (normal) sizes. All this can affect the development of the situation in the future, and cause the following consequences:

due to the increase in the fetal shoulder girdle, it becomes difficult to pass through the birth canal during childbirth;
During childbirth, injuries to the baby and the mother’s organs are possible;
premature birth may begin due to the large mass of the fetus, which has not yet fully developed;
in the lungs of a baby in the womb, the production of surfactant, which prevents them from sticking together, decreases. As a result, after birth the baby may have breathing problems. In this case, the child is rescued using an artificial respiration apparatus, and then placed in a special incubator (incubator), where he will remain for some time under the close supervision of doctors.

Also, one cannot fail to mention the consequences of why gestational diabetes mellitus is dangerous: children born from a mother with GDM may have congenital organ defects, and some may develop second-degree diabetes in adulthood.

The placenta also tends to enlarge during GDM, begins to perform its functions insufficiently, and may become edematous. As a result, the fetus does not receive the required amount of oxygen and hypoxia occurs. Namely, at the end of pregnancy (third trimester) there is a danger of fetal death.

Treatment

Since the disease is caused by high sugar levels, it is logical to assume that for the treatment and prevention of pathology it is necessary to control that this indicator is within the normal range.

The main factor influencing the course of diabetes treatment during pregnancy is strict adherence to dietary rules:

Baked goods and confectionery products are excluded from the diet, which can affect the increase in sugar levels. But you shouldn’t completely give up carbohydrates, because they serve as a source of energy. It is only necessary to limit their number throughout the day;
limit the consumption of very sweet fruits high in carbohydrates;
exclude noodles, purees and instant cereals, as well as various semi-finished products;
remove smoked meats and fats from the diet (butter, margarine, mayonnaise, lard);
It is necessary to eat protein foods, it is important for the body of mother and child;
for cooking, it is recommended to use: stewing, boiling, steaming, baking in the oven;
You should eat food every 3 hours, but in small portions.

In addition, a positive effect on the health of the expectant mother has been proven:

a set of physical exercises designed for pregnant women. During physical activity, the concentration of sugar in the blood decreases, metabolic processes in the body and the general well-being of the pregnant woman improve;
regular walks away from highways.

In severe cases of the disease, your doctor may prescribe insulin medications. Other medications that lower sugar are prohibited.

B - category. It includes products whose description states that no harmful effects on the fetus were observed in animal studies. The effect of the drug on pregnancy has not been tested.
C - category. Includes drugs that have been tested to have an effect on fetal development in animals. Tests have not been conducted in pregnant women either.

Therefore, all drugs must be prescribed only by a qualified doctor, with the mandatory indication of the trade name of the drug.

Hospitalization for GDM is relevant only if there is a suspicion of complex obstetric complications.

GDM is not a reason to induce preterm labor or cesarean section.

Postpartum period

After childbirth, a woman should regularly check her sugar level, monitor the presence of symptoms and their frequency (thirst, urination, etc.) until they disappear completely. Testing is usually prescribed by doctors 6 and 12 weeks after birth. By this time, the woman’s blood sugar level should normalize.

But, according to statistics, in 5-10% of women who give birth, sugar levels do not normalize. In this case, medical attention is required, which should not be neglected, otherwise a simple hormonal disorder can develop into a serious incurable disease.

Gestational diabetes mellitus (GDM) is one of the most common complications during pregnancy, which is characterized by an increase in blood glucose above the norm of 3.3-5.0 mmol/l and the absence of obvious clinical signs of the manifest form of this disease.

The pathology is accompanied by a violation of the metabolism of fats and carbohydrates. It can occur in both mild and severe forms, leading to serious complications for the woman and the fetus.

GDM during pregnancy is a disease that is divided into 3 types:

Stages and degrees

Pregnancy in any woman is a risk factor for developing diabetes.

This is due to a violation of carbohydrate and fat metabolism, which develops according to the following mechanism:

These changes occur in both thin women and those who are obese. The situation is also aggravated by eating more calories during pregnancy, decreasing physical activity and gaining weight.

If the patient has a hereditary predisposition to diabetes or obesity, then insulin production becomes insufficient to overcome insulin resistance, so hyperglycemia develops. A change in the nature of insulin production and excretion also leads to an increase in fat synthesis in the pregnant woman and fetus.

Symptoms

GDM during pregnancy is a condition that in the early stages in most cases is asymptomatic. This makes it difficult to identify the disease. As medical statistics show, the delay in its determination is 4-20 weeks from the onset of the disease. In some women, the diagnosis is established after childbirth based on external signs of diabetic fetopathy in the child.

GDM does not have the typical symptoms of hyperglycemia (high glucose levels) in diabetes. These include increased urination, thirst, rapid weight loss, and itchy skin. Even when these symptoms occur, the woman chalks it up to normal symptoms of pregnancy.

Abroad, practice includes active screening for GDM - dividing pregnant women into risk groups and conducting a special oral test. In Russia, this technique has not yet become widespread.

Therefore, early detection of the disease requires timely registration at the antenatal clinic, taking tests prescribed by the doctor, and undergoing an ultrasound, which can reveal characteristic abnormalities in the development of the fetus.

Reasons for appearance

The main causes of gestational diabetes mellitus are an increase in the concentration of contrainsular hormones (especially after 20 weeks), which serve to maintain pregnancy and suppress the action of insulin, as well as a decrease in the sensitivity of tissues to their own insulin.

From a physiological point of view, insulin resistance develops as a natural process to create energy reserves in the form of adipose tissue, which, in case of starvation, can provide the fetus with the necessary nutrition. The maximum level of glucose in the blood is observed approximately 1 hour after a meal and its value should not exceed 6.6 mmol/l.

A healthy pregnant woman undergoes self-regulation - the amount of insulin produced increases approximately 3 times to maintain the required level of glucose in the blood. If this does not happen, then glucose does not have time to be processed, and its concentration increases. As a result, GDM develops.

Risk factors for the occurrence of this condition are:

Diagnostics

The most reliable method for diagnosing GDM is the determination of glucose in venous blood. The study must be carried out in laboratory conditions, using biochemical analyzers. The use of portable devices - glucometers, which are used in everyday life for self-monitoring, is not allowed.

The main parameters determined during diagnosis are listed in the table below:

Parameter	Normal value	Peculiarities
Fasting blood glucose	5.5–6.0 mmol/l, average 3.75±0.49 mmol/l	The diagnosis of GDM is established when the glucose level is >5.1, but<7,0 ммоль/л натощак
Glucose after meals	Does not exceed 7.70 mmol/l	The diagnosis of GDM is established when the glucose level is >10.1 mmol/L after a meal
Glucose tolerance test	See GDM criteria	Prescribed as a second stage of research in the diagnosis of GDM or for women at risk whose glucose levels are<6,1 ммоль/л The criteria for GDM are: fasting glucose level >5.1 mmol/l, after 1 hour after exercise >10.0 mmol/l, after 2 hours – >8.5 mmol/l
Glucose in urine	<8,52 ммоль/л	Auxiliary test

For a more thorough study of GDM during pregnancy, at the first stage, the doctor may prescribe a glycemic profile determination. This technique is a dynamic monitoring of glucose levels throughout the day (blood sampling is performed 6-8 times). Such a study is usually prescribed in an inpatient setting.

A glucose tolerance test cannot be performed in the following cases:

individual glucose intolerance;
early toxicosis (nausea, vomiting);
hyperglycemia (clinically obvious or manifest diabetes);
gastrointestinal diseases accompanied by impaired glucose absorption (accelerated evacuation of stomach contents into the intestines, observed most often in the postoperative period, exacerbation of chronic pancreatitis, malabsorption and others);
strict bed rest;
insufficient nutrition 3 days before the examination;
acute infectious and inflammatory diseases;
during treatment with Ginipral.

The test requires special preparation:

3 days before the test, sugar, flour, pasta, sweets and other refined carbohydrates are excluded from the pregnant woman’s diet;
the amount of carbohydrates during the preparatory period should be at least 150 g per day;
Before donating blood, you must undergo a period of overnight fasting for 8-14 hours (you can drink water);
the last portion of food should include 30-50 g of carbohydrates;
smoking is excluded;
in consultation with the doctor, it is necessary to temporarily stop taking medications that may affect glucose levels and test results (vitamin complexes, iron-containing and hormonal medications, beta-adrenergic agonists, which are used in the treatment of cardiovascular and pulmonary diseases; medications containing carbohydrates);
Immediately before the test, you must avoid physical activity and rest for 15 minutes.

The standard procedure for performing this test is as follows:

An oral test for pregnant women at risk is usually performed at 24-28 weeks. The reliability of this method is confirmed by large-scale studies conducted in 2002-2007. among 25 thousand pregnant women. The average price in paid laboratories is about 1000 rubles.

An ultrasound examination may reveal the following abnormalities:

large size of the fetus, large abdominal girth;
enlargement of the child’s liver, heart and spleen;
double contour of the fetal head;
disproportionate development (large body and small limbs);
thickened subcutaneous fat layer in the fetus;
enlarged neck fold;
polyhydramnios.

When to see a doctor

GDM during pregnancy is a condition that is not accompanied by specific symptoms. Therefore, for early detection of this disease and its correction, it is recommended to undergo a full range of diagnostic measures at the stage of pregnancy planning.

Hospitalization for pregnant women diagnosed with gestational diabetes mellitus is carried out only in the presence of complications. Treatment is carried out on an outpatient basis. Such a violation is also not a direct indication for cesarean section.

It is carried out if the fetus shows signs of diabetic fetopathy listed above. The operation reduces the risk of trauma to the mother and child during the passage of a large fetus through the birth canal.

Prevention

Measures to prevent this disease include the following:

control over body weight gain;
performing physical exercise of moderate intensity (at least 30 minutes every day);
healthy diet with reduced consumption of “fast” carbohydrates and saturated fats;
rejection of bad habits.

Treatment methods

The first stage of treatment after identifying GDM includes the following measures:

diet therapy;
moderate physical activity;
self-monitoring of blood glucose levels.

Insulin therapy is prescribed in the following cases:

Medications

A description of insulin drugs that are used for GDM is given in the table below.

Name	Average dosage	Contraindications	Average price, rub.
Insulin lispro	40 units (one-time)	Blood glucose concentration less than 3.5 mmol/l Individual sensitivity	1800
Insulin aspart	0.5-1 units per 1 kg of weight (per day)		1700
Insulin glisulin (Apidra SoloStar)	0.5-1 units per 1 kg of weight (per day)		2200
Soluble human genetically engineered insulin (Rosinsulin r)	0.3-1 IU per 1 kg of body weight (per day)		1200

The dosage of drugs is selected individually by an endocrinologist. The medication is administered subcutaneously with insulin syringes or dispenser pens.

Antihyperglycemic tablets are contraindicated during pregnancy, as they have a negative effect on the fetus.

During gestation, short-acting insulins are used, since their use allows you to reduce the daily dose and prevent large fluctuations in blood glucose.

In the postpartum period, insulin therapy is discontinued. During the first 3 days, blood glucose must be monitored.

Traditional methods

GDM during pregnancy is a disease that can be treated with herbal medicine.

The following recipes are used in folk medicine:

2 tbsp. l. dry chicory pour ½ liter of boiling water and simmer over low heat for 10 minutes. Then strain and drink ½ tbsp. 3 times a day. Chicory can be drunk instead of regular tea.
2 tbsp. l. Aspen bark pour 0.5 liters of hot water and boil for 15 minutes. Drink the infusion in small portions throughout the day. The course of treatment is 1 week.
Place 10 bay leaves in an enamel bowl and pour 3 tbsp. water. Heat the water until it boils, then turn off the heat and leave for 4 hours. Drink ½ tbsp. 3 times a day.
Soak young dandelion leaves in water for half an hour. Then finely chop with a knife, add chopped parsley, dill and egg yolk. Season the salad with olive oil. It is recommended to eat this salad 2-3 times a week.

Nutrition

Pregnant women diagnosed with GDM should adhere to the following dietary recommendations:

Product group	Not recommended	Featured
Bakery products	White yeast bread, confectionery	Brown bread, baked goods made from wholemeal flour and with bran (no more than 200 g per day)
First meal	Rich meat and fish broths	Vegetable or weak meat broths, soups (cabbage soup, borscht, okroshka without kvass on kefir)
Second courses	Pasta, carrots, beets, semolina, rice, smoked sausages and fish, lard, canned food	Cabbage, eggplant, zucchini, pumpkin, potatoes up to 200 g per day Buckwheat, oatmeal, wheat porridge Lean meats and fish Boiled eggs (or omelet) up to 3 pcs. in Week
Beverages	Sweet fruit juices, carbonated drinks, cream	Low-fat milk and fermented milk drinks, vegetable juices, chicory tea, rose hip decoction
Other	Honey, sugar, ice cream, preserves, jams, sweet fruits, grapes, bananas, candies, sweet dried fruits, mayonnaise	Low-fat cottage cheese and sour cream, vegetable oil for salad dressing

Other methods

Medical research shows that pregnant women who not only follow a diet but also engage in moderate exercise can manage their blood glucose levels more effectively.

Activities shown include:

When conducting classes, it is necessary to exclude those exercises that can cause an increase in blood pressure and uterine tone.

Possible complications

Since insulin resistance develops after the 20th week of pregnancy, GDM does not affect the development of the child’s organs, so this disease itself cannot cause congenital abnormalities.

However, the lack of timely diagnosis and treatment leads to the following disorders in fetal development:

respiratory distress syndrome (in some cases, artificial ventilation is required);
deterioration of the functions of the blood coagulation system;
violation of metabolic processes;
jaundice;
neurological disorders, and subsequently mental retardation;
diabetic fetopathy (40-60% of children), the symptoms of which were described earlier. It can also manifest itself in the form of intrauterine growth retardation and low birth weight of the child.

Excessive weight of the fetus in GDM is explained by the fact that glucose passes from mother to child through the placenta in unlimited quantities, and maternal insulin is destroyed by enzymes.

GDM during pregnancy is a danger to the fetus and mother!

As a result, the baby's pancreas begins to produce large amounts of its own insulin to lower sugar levels. Since it is also a growth hormone, this leads to excessive weight gain in the body and internal organs.

The risk of injury to the baby as it passes through the birth canal also increases. The most frequently observed fractures of the collarbone (19% of babies), injuries of the brachial plexus, which lead to flaccid paralysis of the arms (8% of newborns), and cerebrovascular accident (20%). The risk of mortality in the first days in such children is 1.5-3 times higher compared to healthy ones.

In a pregnant woman, GDM can cause the following complications:

GDM during pregnancy can cause complications and developmental disorders of the fetus. This condition requires, first of all, adjustments to the diet on the part of the pregnant woman. If this measure is ineffective, short-acting insulin drugs are prescribed. A woman’s physical activity also plays a major role in regulating blood glucose.

Article format: Vladimir the Great

Video about gestational diabetes

About gestational diabetes:

Expert: endocrinologist of the highest category, Moscow City Clinical Hospital No. 1, Ph.D., Natalia Arbatskaya

Diabetes in pregnant women (or gestational diabetes mellitus in pregnant women) occurs during the formation of the placenta. The placenta is formed as a temporary organ - a “home” for the fetus: inside this “house” there is its own regulation of metabolism, its own provision of everything necessary (oxygen, nutrients, microelements) and even disposal of waste products.

At approximately 20-24 weeks of pregnancy, the amount of insulin in the blood of the expectant mother increases sharply, since other hormones (estrogen, cortisol, placental lactogen) produced by the placenta block its action. A pregnant woman's pancreas responds to this process by producing more insulin to maintain normal blood sugar levels. Sometimes the pancreas is not able to cope with such a load - and in this case, with a deficiency of insulin, gestational diabetes mellitus occurs.

Symptoms of gestational diabetes in pregnant women

It is difficult to notice signs of gestational diabetes in pregnant women in the early stages: this is why an analysis is carried out to check the sugar level in whole capillary blood, which is taken from a finger.

What is the norm?

the rate in a pregnant woman on an empty stomach is from 4 to 5.2 mmol/l;
the indicator in a pregnant woman two hours after eating is no more than 6.7 mmol/l.

Higher blood sugar levels should raise doubts and suspicions about diabetes during pregnancy.

Symptoms to watch out for:

Thirst has increased, and although you drink enough water, your mouth remains feeling dry;
the number of urinations and the amount of fluid coming out increases sharply;
there are signs of slight weight loss for no apparent reason, or vice versa - a sharp increase in appetite and rapid weight gain;
decreased tone, energy, reluctance to move, increased fatigue;
vision deteriorates, sometimes blurred vision occurs;
increased dryness of the skin and mucous membranes, itching.

Some of these symptoms are difficult to separate from a healthy pregnancy, since increased appetite, thirst and urination, as well as decreased tone, are characteristic of the expectant mother's position. This is why blood sugar control is so important.

Gestational diabetes during pregnancy: risk group

There are certain risk factors that make it possible to develop gestational diabetes:

for obesity, overweight;
if a diagnosis of diabetes mellitus occurs in close relatives of the pregnant woman;
if the pregnant woman is over 35 years old;
at the birth of a large child (more than 4 kg) from a previous pregnancy;
with gestational diabetes in a previous pregnancy;
with miscarriage of previous pregnancies;
for developmental defects in previously born children, in case of stillbirths;
with polyhydramnios.

Diagnostics: analysis for latent diabetes mellitus during pregnancy

Expert consultation:

If you have noted at least one risk factor, inform your gynecologist so that he can conduct a study of your fasting blood sugar level.

If the doctor notices any abnormalities (in the analysis of blood sugar taken from a finger, on an empty stomach the indicators are from 4.8 to 6.0 mmol/l: in the analysis of blood sugar taken from a vein, on an empty stomach the indicators are from 5.3 to 6 .9 mmol/l), he will order a special test.

How is a glucose tolerance test performed?

In the morning, a blood sample is taken on an empty stomach;
after 5 minutes you drink the prepared solution: 75 grams of dry glucose dissolved in 250-300 ml of water;
After 2 hours, a repeat blood sample is taken and the results are assessed.

When will a doctor diagnose gestational diabetes?

if the blood glucose level taken from a finger on an empty stomach is 6.1 mmol/l;
if the blood glucose level taken from a vein on an empty stomach is 7 mmol/l;
if the blood glucose level taken from a finger or from a vein 2 hours after exercise is 7.8 mmol/l.

If your readings are normal, your doctor will suggest you do a glucose tolerance test at 24-28 weeks of pregnancy, as pregnancy hormone levels will rise during this period. At these times, it is possible to prevent the development of defects in the fetus.

Diabetes mellitus during pregnancy: consequences for the child

risk of miscarriage;
heart and brain defects;
diabetic fetopathy: large fetal size or imbalance - large belly, but thin
limbs;
tissue swelling;
excess subcutaneous fat;
respiratory system disorders;
hypoglycemia (abnormally low blood glucose levels) in newborns;
increased viscosity blood and the possibility of blood clots;
insufficient levels of calcium and magnesium in the child’s blood;
jaundice.

Is it possible to cope with gestational diabetes during pregnancy?

It is possible, provided that the pregnant woman:

Monitor blood sugar levels on an empty stomach and after meals daily using a glucometer;
regularly take a urine test and ask your doctor about its results;
follow the diet that the doctor tells you about;
monitor body weight;
give the body daily physical activity on the advice of a doctor;
use insulin therapy if necessary;
control blood pressure.

Diet for gestational diabetes in pregnant women

If you have been diagnosed with gestational diabetes, then the course of pregnancy with diabetes will require a strict review of the menu and diet.

The most important things in the menu and diet:

eat main meals 3 times a day at the same time, have snacks 2-3 times a day;
In your breakfast and last snack in the evening, include about 40% complex carbohydrates, fresh vegetables, unsweetened fruits, herbal teas;
exclude from the menu fatty, fried, sweets, white sugar, baked goods, sweet fruits (banana, grapes, figs, persimmons, etc.), fast food products (freeze-dried food from bags, fast food);
for morning sickness, before getting out of bed, eat a couple of saltine crackers (prepare them in advance);
when preparing a side dish, choose cereals and pasta rich in fiber: diabetics need it to stimulate intestinal function, as well as to prevent the absorption of excess sugar and fat into the blood;
do not abuse saturated and “hidden” fats, which are found in sausages, sausages, pork, lamb, and smoked meats;
choose lean varieties of meat (chicken, beef, turkey) and try to cook them baked or steamed;
drink clean water, at least 8 glasses a day;
try to eat foods high in fat less often: cheese, nuts, butter, sour cream, seeds, etc.;
add a maximum of low-calorie vegetables to the menu: celery, cucumbers, zucchini, mushrooms, radishes, lettuce, tomatoes, green beans, zucchini, cabbage;
introduce Jerusalem artichoke (earthen pear), which is called “vegetable insulin”, into the menu: add it to salads, eat it boiled, drink juice.

When is insulin therapy necessary?

If you follow a diet and it doesn't help: either your blood sugar remains high or your urine test shows ketone bodies. You should not be afraid of getting used to insulin and refuse therapy: there is no addiction to modern human insulin, and after childbirth and the delivery of the placenta, your body will no longer feel the need for therapy.

Childbirth with gestational diabetes

With the birth of the baby and the delivery of the placenta, gestational diabetes most often goes away (although in some cases it can develop into type 2 diabetes). If the diagnosis results in the fetus being too large, a caesarean section is unlikely to be avoided.

Although the sugar level of a newborn from a mother with gestational diabetes is significantly low, breastfeeding can regulate it. To keep the baby's and mother's sugar levels under control, they will be measured before and 2 hours after feeding. When the indicators return to normal, there will be no need for control.

How to avoid gestational diabetes?

if you have already experienced gestational diabetes mellitus during a previous pregnancy, try to bring your weight back to normal by the next pregnancy and accustom your body to regular physical activity;
Warn doctors about your risk and avoid taking medications that can increase insulin resistance - glucocorticoids, niacin, some contraceptives (for example, progestin contraceptives).