Risk group according to GSD. How is the diet different for this disease? Causes and Risk Factors for Gestational Diabetes

Gestational diabetes mellitus- one of the variants of diabetes that occurs or is first diagnosed during pregnancy. The basis of the disease is a violation of carbohydrate metabolism of varying degrees, namely, a decrease in glucose tolerance in the body of a pregnant woman. It is also commonly called gestational diabetes.

The results of studies of epidemiologists conducted in the United States showed that gestational diabetes develops in 4% of all pregnant women. European researchers voiced data according to which prevalence of gestational diabetes fluctuates in the range of 1-14% of the total number of pregnancies. About 10% of women after childbirth remain with signs of the disease, which subsequently transforms into type 2 diabetes mellitus. According to statistics, half of women who have had gestational diabetes during pregnancy develop type 2 diabetes over the next 10-15 years.

Such high prevalence rates of this pathology and possible complications indicate a low awareness of women about the possible risks of developing gestational diabetes mellitus and its consequences, and, as a result, late access to diagnosis and qualified care. For the timely detection of the disease in the reproductive centers for family planning and antenatal clinics, active educational work is currently being carried out, which allows maintaining the health of a woman and contributing to the birth of healthy offspring.

What is the risk of diabetes during pregnancy?

First of all, in a negative effect on the growth and development of the fetus. When gestational diabetes mellitus occurs in the early stages of pregnancy, a significant increase in the risk of spontaneous abortion and the appearance of congenital malformations of the heart and brain structures of the fetus was noted. If diabetes mellitus begins later in pregnancy (2-3 trimesters), this leads to excessive fetal growth (macrosomia) and hyperinsulinemia, and after birth it can be complicated by diabetic fetopathy. Signs of diabetic fetopathy of the newborn are overweight of the child (exceeding 4 kg), body disproportion, excess subcutaneous fat, respiratory disorders, hypoglycemia, increased blood viscosity with the risk of thrombosis.

How is gestational diabetes different from other types of diabetes?

Diabetes mellitus is a disease that is characterized by a gross violation of carbohydrate metabolism due to insufficiency of the pancreatic hormone - insulin - in the blood, which can be absolute or relative. Diabetes mellitus is almost always accompanied by an increased content of glucose in the blood - hyperglycemia and the detection of sugar in the urine - glucosuria. According to WHO, there are several types of diabetes.

Type 1 diabetes mellitus occurs in childhood and adolescence as a result of autoimmune breakdown of specific pancreatic cells that produce insulin, which leads to a decrease or complete cessation of its production. Type 1 diabetes occurs in 15% of all diabetic patients. The disease is detected when a high initial blood glucose level is detected at a young age, while antibodies to β-cells and insulin can also be detected in the blood. The level of insulin in the blood in these patients is reduced. For the treatment of patients with type 1 diabetes, insulin injections are used - unfortunately, there are no other ways.

Type 2 diabetes is more likely to develop in overweight people in the second half of life against the background of genetic defects, past infectious diseases, acute and chronic pancreatitis, and taking certain medications and chemicals. The disease is characterized by hereditary predisposition. In laboratory diagnostics, an increase in glucose levels (> 5.5 mmol / l) is noted in the blood of patients. Treatment of such patients consists of prescribing a special diet, physical activity, and taking medications that reduce blood glucose levels.

Causes of gestational diabetes

Gestational diabetes mellitus during pregnancy develops as a result of a decrease in the sensitivity of cells and tissues of the body to its own insulin, i.e., insulin resistance develops, which is associated with an increase in the blood level of hormones produced by the body during pregnancy. In addition, in pregnant women, glucose levels decrease more rapidly due to the needs of the fetus and placenta, which also affects homeostasis. The consequence of the above factors is a compensatory increase in insulin production by the pancreas. That is why in the blood of pregnant women, insulin levels are most often elevated. If the pancreas cannot produce insulin in the amount required by the body of the pregnant woman, gestational diabetes mellitus develops. The deterioration of the function of pancreatic β-cells in gestational diabetes mellitus can be judged by an increased concentration of proinsulin.

Often, immediately after delivery, a woman's blood sugar levels return to normal. But it is not necessary to completely exclude the possibility of developing diabetes mellitus in this case.

Who is most at risk of developing diabetes during pregnancy?

Gestational diabetes mellitus during pregnancy develops in the case of a genetic predisposition realized under the influence of a number of risk factors, such as:

Overweight, obesity with signs of metabolic syndrome;

Other disorders of carbohydrate metabolism;

Increased sugar in the urine;

Diabetes mellitus type 2 in direct relatives;

The woman's age is over 30;

Arterial hypertension other diseases of the cardiovascular system;

Severe toxicosis and gestosis in history;

Hydramnion, the birth of a previous overweight child (more than 4.0 kg), stillbirth in previous pregnancies;

Congenital malformations of the cardiovascular and nervous systems in previous children;

Chronic miscarriage of previous pregnancies, characterized by spontaneous abortions in the first two trimesters;

Gestational diabetes in previous pregnancies.

Diabetes during pregnancy: symptoms and signs

There are no specific manifestations in gestational diabetes mellitus, so the only criterion for making a diagnosis is laboratory screening of pregnant women. Women at risk, at the first visit to the antenatal clinic, should be tested for fasting blood sugar against the background of a normal diet and physical activity. If the level of sugar in the blood taken from a finger is 4.8-6.0 mmol / l, it is recommended to undergo a special test with a glucose load.

To detect gestational diabetes mellitus, all pregnant women undergo an oral glucose tolerance test between the sixth and seventh months, which shows the quality of glucose absorption by the body. If the level of glucose in blood plasma taken on an empty stomach exceeds 5.1 mmol / l, an hour after eating - more than 10.0 mmol / l, and after a couple of hours - more than 8.5 mmol / l, then the doctor has reason to diagnose GSD. If necessary, the test can be carried out repeatedly.

With timely diagnosis of the disease and subsequent observation and implementation of all doctor's recommendations, the risk of having a sick child is reduced to 1-2%.

Treatment of diabetes during pregnancy

The course of pregnancy with diabetes is complicated by the fact that a woman will have to constantly monitor blood glucose levels (at least 4 times a day). In addition, to correct gestational diabetes, it is necessary to follow a diet that includes three main meals and two or three snacks, while limiting the daily amount of calories consumed to 25-30 per kilogram of body weight. It is very important to control that the diet is as balanced as possible in terms of the content of essential nutrients (proteins, fats and carbohydrates), vitamins and microelements, since the full growth and development of the fetus directly depends on this.

Taking medications that lower blood glucose levels during pregnancy is contraindicated. If the diet prescribed by the doctor, along with moderate physical activity, does not give the expected results, you will have to resort to insulin therapy.

Diet for patients with gestational diabetes

Diabetes mellitus during pregnancy involves mandatory diet therapy, since it is proper nutrition that can be the key to successful treatment of this disease. When developing a diet, it is important to remember that the emphasis must be on reducing the calorie content of food, without lowering its nutritional value. Doctors recommend following a number of simple but effective dietary recommendations for GDM:

Eat in small portions at the same hours;

Exclude from the diet fried, fatty foods saturated with easily digestible carbohydrates (cakes, pastries, bananas, figs), as well as fast food and fast food;

Enrich the diet with cereals from various cereals (rice, buckwheat, pearl barley), salads from vegetables and fruits, whole grain bread and pasta, i.е. foods rich in fiber;

Eat lean meats, poultry, fish, exclude sausages, sausages, smoked sausages that contain a lot of fat

Cook food using a small amount of vegetable oil;

Drink enough liquid (at least one and a half liters per day).

Physical activity in gestational diabetes of pregnant women

Physical exercise is very beneficial for pregnant women, because, in addition to maintaining muscle tone and maintaining a cheerful state of health, it improves the action of insulin and prevents the accumulation of excess weight. Naturally, physical activity for pregnant women should be moderate and consist of walking, gymnastics, and water exercises. Do not abuse active physical activity, such as cycling or skating, horseback riding, as this is fraught with injuries. It is important to regulate the number of loads, based on the current state of health at a given time.

Preventive measures to prevent the development of diabetes during pregnancy

It is very difficult to prevent the development of gestational diabetes mellitus with a high degree of probability. Often, women at risk do not develop diabetes during pregnancy, and pregnant women who do not have any prerequisites may develop the disease. However, pregnancy planning in case of gestational diabetes mellitus already suffered once should be responsible and possibly not earlier than 2 years after the previous birth. To reduce the risk of re-development of gestational diabetes in the months before the expected pregnancy, you should start monitoring your weight, include exercise in your daily routine, and monitor blood glucose levels.

The intake of any medications must be agreed with the attending physician, since the uncontrolled use of certain medications (birth control pills, glucocorticosteroids, etc.) can also provoke the development of gestational diabetes mellitus in the future.

1.5-2 months after childbirth, women who have had gestational diabetes should be tested to determine the level of glucose in the blood and conduct a glucose tolerance test. Based on the results of these studies, the doctor will recommend a specific diet and exercise regimen, as well as determine the timing for the control tests.

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
• Burdened obstetric history:
• The previous child was born weighing more than 4000 grams
• GDM in a 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 develops in the range up to. Early-detected carbohydrate metabolism disorders usually indicate previously unnoticed 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 preparation for pregnancy, a woman will undergo all the basic examinations, including those for the detection of diabetes mellitus. If violations of carbohydrate metabolism are detected, the doctor will prescribe treatment, give recommendations, and the 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. It is possible to develop diabetic ketoacidosis (a condition in which there is a sharp increase in the level of glucose and the concentration of 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. A woman may develop weakness in labor, which, combined with a clinically narrow pelvis and a large fetus, will make delivery by caesarean section inevitable. In women with diabetes, infectious complications are more common in the 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 the 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:

Parameters	high risk	moderate risk	low risk
Woman's age over 30	Well no	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	Well no	No
History of hydramnios and large fetus	Well no	Yes	No
Birth of a child weighing more than 4000 g or a history of stillbirth	Well no	Yes	No
Rapid weight gain during this pregnancy	Well no	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 when the hormonal background changes. 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 a higher risk of developing the disease, therefore, it is necessary to strictly control blood counts, follow the doctor's recommendations and follow the diet prescribed by the specialist.

A few words about the treatment of gestational diabetes

A pregnant woman who is faced with diabetes needs 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 are overweight are given recommendations for its reduction or stabilization. It is necessary to reduce the caloric content of food with 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 fruit.
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 probability of gestational diabetes (if it was already during the previous pregnancy) in the next pregnancy is 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 an endocrinologist told me*** unborn child. 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, the mother’s high blood sugar affects the child, even though “everything is already laid down”).
I endured two pregnancies with GDM (the second with twins), the first time I found out about it at 28 weeks after the glucose tolerance test, the second time, immediately after the pregnancy was established, I went on a diet and began to control my blood. At the ultrasound, she always asked to see signs of 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 it can grow very large on high sugar, 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, caesarean 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 go to the 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 blood sugar. 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 chances you have to give birth to a 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 on 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.

If many of us have heard about ordinary diabetes mellitus, few people know what gestational diabetes is. Gestational diabetes is an increase in blood glucose (sugar) that is first noticed during pregnancy.

The disease is not so common - only 4% of all pregnancies - but, just in case, you need to know about it, if only because this disease is far from harmless.

Diabetes during pregnancy can adversely affect the development of the fetus. If it arose in the early stages pregnancy, the risk of miscarriage increases, and, even worse, the appearance of congenital malformations in the baby. Most often, the most important organs of the crumbs are affected - the heart and brain.

Gestational diabetes onset in the second and third trimesters pregnancy, causes overfeeding and overgrowth of the fetus. This leads to hyperinsulinemia: after childbirth, when the child will no longer receive such an amount of glucose from the mother, his blood sugar levels drop to very low levels.

If this disease is not detected and treated, it can lead to the development diabetic fetopathy- a complication in the fetus that develops due to a violation of carbohydrate metabolism in the mother's body.

Signs of diabetic fetopathy in a child:

• large sizes (weight more than 4 kg);
• violation of body proportions (thin limbs, large belly);
• swelling of tissues, excessive deposits of subcutaneous fat;
• jaundice;
• respiratory disorders;
• neonatal hypoglycemia, increased blood viscosity and risk of blood clots, low levels of calcium and magnesium in the blood of the newborn.

How does gestational diabetes occur during pregnancy?

During pregnancy, not just a hormonal surge occurs in the female body, but a whole hormonal storm, and one of the consequences of such changes is violation of the body's tolerance to glucose Some are stronger, some are weaker. What does this mean? The blood sugar level is high (above the upper limit of normal), but still not enough to make a diagnosis of diabetes mellitus.

In the third trimester of pregnancy, as a result of new hormonal changes, gestational diabetes may develop. The mechanism of its occurrence is as follows: the pancreas of pregnant women produces 3 times more insulin than other people - in order to compensate for the action of specific hormones on blood sugar levels.

If she does not cope with this function with an increasing concentration of hormones, then there is such a thing as gestational diabetes mellitus during pregnancy.

Risk group for developing gestational diabetes during pregnancy

There are certain risk factors that make a woman more likely to develop gestational diabetes during pregnancy. However, the presence of even all these factors does not guarantee that diabetes will still occur - just as the absence of these adverse factors does not guarantee 100% protection against this disease.

1. Overweight observed in a woman before pregnancy (especially if the weight exceeded the norm by 20% or more);
2. Nationality. It turns out that there are certain ethnic groups in which gestational diabetes is observed much more often than others. These include Blacks, Hispanics, Native Americans, and Asians;
3. High blood sugar on urinalysis;
4. Violation of the body's tolerance to glucose (as we have already mentioned, the sugar level is above normal, but not enough to make a diagnosis of "diabetes");
5. Heredity. Diabetes is one of the most serious hereditary diseases, its risk is increased if someone close to you in your line was diabetic;
6. Previous birth of a large (over 4 kg) child;
7. Previous birth of a stillborn child;
8. You have already been diagnosed with gestational diabetes during a previous pregnancy;
9. Polyhydramnios, that is, too much amniotic fluid.

Diagnosis of gestational diabetes

If you find yourself with several signs that are at risk, tell your doctor about it - you may be prescribed an additional examination. If nothing bad is found, you will be tested again along with all the other women. All others pass screening examination for gestational diabetes between the 24th and 28th weeks of pregnancy.

How would this happen? You will be asked to do a test called an oral glucose tolerance test. You will need to drink a sweetened liquid containing 50 grams of sugar. After 20 minutes, there will be a less pleasant stage - taking blood from a vein. The fact is that this sugar is quickly absorbed, after 30-60 minutes, but individual indications vary, and this is what doctors are interested in. In this way, they find out how well the body is able to metabolize the sweet solution and absorb glucose.

In the event that in the form in the column "analysis results" there is a figure of 140 mg / dl (7.7 mmol / l) or higher, this is already high level. You will be given another test, but this time after several hours of fasting.

Treatment of gestational diabetes

The life of diabetics, frankly, is not sugar - both literally and figuratively. But this disease can be controlled if you know how and strictly follow medical instructions.

So, what will help to cope with gestational diabetes during pregnancy?

1. Blood sugar control. This is done 4 times a day - on an empty stomach and 2 hours after each meal. You may also need additional checks - before meals;
2. Urinalysis. Ketone bodies should not appear in it - they indicate that diabetes mellitus is not controlled;
3. Compliance with a special diet that the doctor will tell you. We will consider this issue below;
4. Reasonable physical activity on the advice of a doctor;
5. Control over body weight;
6. Insulin therapy as needed. At the moment, during pregnancy, only insulin is allowed to be used as an antidiabetic drug;
7. Blood pressure control.

Diet for gestational diabetes

If you have been diagnosed with gestational diabetes, you will have to reconsider your diet - this is one of the conditions for the successful treatment of this disease. Weight loss is usually recommended for diabetics (this contributes to increased insulin resistance), but pregnancy is not the time to lose weight, because the fetus must receive all the nutrients it needs. So, you should reduce the calorie content of food, while not reducing its nutritional value.

1. Eat small meals 3 times a day and 2-3 more snacks at the same time. Don't skip meals! Breakfast should be 40-45% carbohydrates, the last evening snack should also contain carbohydrates, about 15-30 gr.

2. Avoid fried and fatty, as well as foods rich in easily digestible carbohydrates. These include, for example, confectionery, as well as pastries and some fruits (banana, persimmon, grapes, cherries, figs). All these foods are quickly absorbed and provoke a rise in blood sugar levels, they are few in nutrients, but high in calories. In addition, to offset their high glycemic effect, they require too much insulin, which is a luxury in diabetes.

3. If you feel sick in the morning, keep a cracker or cracker on your bedside table and eat a few before you get out of bed. If you're on insulin and feel sick in the morning, make sure you know how to deal with low blood sugar.

4. Don't eat fast foods. They are industrially pre-processed to reduce their preparation time, but their effect on increasing the glycemic index is greater than that of their natural counterparts. Therefore, exclude freeze-dried noodles, soup-lunch “in 5 minutes” from a bag, instant porridge, freeze-dried mashed potatoes from the diet.

5. Pay attention to foods rich in fiber: cereals, rice, pasta, vegetables, fruits, whole grain bread. This is true not only for women with gestational diabetes - every pregnant woman should eat 20-35 grams of fiber per day. Why is fiber so good for diabetics? It stimulates the intestines and slows down the absorption of excess fat and sugar into the blood. Also, fiber-rich foods contain many essential vitamins and minerals.

6. Saturated fat in the daily diet should not be more than 10%. In general, eat less foods containing "hidden" and "visible" fats. Eliminate sausages, wieners, sausages, bacon, smoked meats, pork, lamb. Lean meats are much preferable: turkey, beef, chicken, and also fish. Remove all visible fat from meat: lard from meat, and skin from poultry. Cook everything in a gentle way: boil, bake, steam.

7. Cook food without fat, but in vegetable oil, but it should not be too much.

8. Drink at least 1.5 liters of fluid per day(8 glasses).

9. Your body does not need such fats like margarine, butter, mayonnaise, sour cream, nuts, seeds, cream cheese, sauces.

10. Tired of bans? There are also products that you can have no limit They are low in calories and carbohydrates. These are cucumbers, tomatoes, zucchini, mushrooms, radishes, zucchini, celery, lettuce, green beans, cabbage. Eat them in the main meals or as snacks, preferably in the form of salads or boiled (boil in the usual way or steamed).

11. Make sure your body is provided with a full range of vitamins and minerals needed during pregnancy: ask your doctor if you need extra vitamins and minerals.

If diet therapy does not help, and blood sugar remains at a high level, or if ketone bodies are constantly detected in the urine at a normal sugar level, you will be prescribed insulin therapy.

Insulin is only injected because it is a protein, and if you try to put it in tablets, it will be completely destroyed by our digestive enzymes.

Disinfectants are added to insulin preparations, so do not wipe the skin with alcohol before injection - alcohol destroys insulin. Naturally, you need to use disposable syringes and follow the rules of personal hygiene. All other subtleties of insulin therapy will be told to you by your doctor.

Exercise for gestational diabetes in pregnancy

Do you think it's not needed? On the contrary, they will help maintain good health, maintain muscle tone, and recover faster after childbirth. In addition, they improve the action of insulin and help not to gain excess weight. All this contributes to maintaining optimal blood sugar levels.

Engage in the usual activities that you enjoy and enjoy: walking, gymnastics, exercising in the water. No stress on the stomach - for now, you will have to forget about your favorite “abs” exercises. You should not engage in sports that are fraught with injuries and falls - horseback riding, cycling, skating, skiing, etc.

All loads - according to well-being! If you feel bad, there are pains in the lower abdomen or in the back, stop and catch your breath.

If you are on insulin therapy, it is important to be aware that hypoglycemia can occur during exercise, as both physical activity and insulin lower blood sugar levels. Check your blood sugar levels before and after your workout. If you started exercising an hour after eating, you can eat a sandwich or an apple after class. If more than 2 hours have passed since the last meal, it is better to have a snack before training. Be sure to bring juice or sugar with you in case of hypoglycemia.

Gestational diabetes and childbirth

The good news is that gestational diabetes usually goes away after childbirth – it only develops into diabetes in 20-25% of cases. True, the birth itself due to this diagnosis can be complicated. For example, due to the already mentioned overfeeding of the fetus, the child may be born very large.

Many, perhaps, would like a “hero”, but the large size of the child can be a problem during labor and childbirth: in most such cases, it is carried out, and in the case of natural delivery, there is a risk of injury to the child’s shoulders.

Children with gestational diabetes born with low levels blood sugar, but this is fixable simply by feeding.

If there is no milk yet, and the child does not have enough colostrum, the child is supplemented with special mixtures to raise the sugar level to a normal value. Moreover, the medical staff constantly monitors this indicator, measuring the glucose level quite often, before feeding and 2 hours after.

As a rule, no special measures to normalize the blood sugar level of the mother and child will be needed: in the child, as we have already said, sugar returns to normal thanks to feeding, and in the mother - with the release of the placenta, which is the “irritating factor”, because produces hormones.

The first time after childbirth still have to follow for nutrition and periodically measure the level of sugar, but over time everything should return to normal.

Prevention of gestational diabetes

There is no 100% guarantee that you will never encounter gestational diabetes - it happens that women who, according to most indicators, fall into the risk group, do not get sick when they become pregnant, and vice versa, this disease happens to women who, it would seem, did not have no preconditions.

If you already had gestational diabetes during a previous pregnancy, the chances of it coming back are very high. However, you can reduce your risk of developing gestational diabetes during pregnancy by maintaining a healthy weight and not gaining too much during those 9 months.

Physical activity can help keep your blood sugar at a safe level, as long as it's regular and doesn't cause you discomfort.

You also remain at risk of developing a permanent form of diabetes called type 2 diabetes. You will have to be more careful after childbirth. Therefore, it is undesirable for you to take drugs that increase insulin resistance: nicotinic acid, glucocorticoid drugs (these include, for example, dexamethasone and prednisolone).

Please note that some birth control pills may increase the risk of diabetes - for example, progestin, but this does not apply to low-dose combination drugs. In choosing a contraceptive after childbirth, be guided by the recommendations of your doctor.

Answers

During pregnancy, transformations occur in the female body in all systems and organs: some of them are a variant of the norm, others are pathological. Gestational diabetes mellitus is a fairly common abnormal condition that disappears on its own in the vast majority of clinical situations after childbirth. Below we will consider what causes lead to the development of gestational diabetes, why this syndrome is dangerous, how the disease is treated.

About gestational diabetes

Gestational diabetes is an increase in the amount of glucose in the plasma. Endocrinologists believe that this pathology can become an additional risk factor for the appearance of full-fledged diabetes in women in the future. Doctors recommend that patients who have been diagnosed with GDM maintain a stable plasma glucose level throughout their lives and adhere to a balanced diet.

Normally, sugar levels will stabilize on their own after childbirth, but in some situations this does not happen. Gestational diabetes requires clinical control and responds well to diet and other non-drug therapies.

A characteristic feature of GDM is an increase in the level of carbohydrate compounds immediately after a meal. On an empty stomach, the amount of glucose often remains normal. Any metabolic disorders during pregnancy are a risk factor. To give birth to a healthy child, women need to strive to normalize sugar levels and stabilize carbohydrate metabolism.

Pathogenesis and risk factors

During pregnancy, the female body is exposed to pronounced hormonal changes. One of the consequences of a hormonal surge is a violation of glucose tolerance. GDM usually develops in the second or third trimester.

The mechanism of occurrence of the pathology is as follows: the pancreas in pregnant women begins to produce an excess amount of insulin. This happens in order to compensate for the influence of specific hormones on the amount of sugar. Not always the body successfully copes with an excess of insulin, which leads to the typical symptoms of diabetes.

The likelihood of developing GDM increases with the presence of additional factors, including:

• overweight, which was observed even before pregnancy;
• ethnic factors - diabetic pathologies often occur in representatives of the Asian and Negroid races;
• prediabetic state before pregnancy;
• genetic predisposition - the presence of diabetes in close relatives;
• previous large pregnancy;
• - excessive amount of amniotic fluid;
• the presence of miscarriages in history;
• stillbirth in a previous pregnancy;
• age over 30.

The risk increases if gestational endocrine pathology was diagnosed during a previous pregnancy. Sometimes GDM occurs without the presence of the above factors.

Symptoms

In a number of clinical situations, metabolic disorders are present, but do not manifest themselves in any way. Only a full diagnostic examination in the clinic allows to identify the pathology. Self-diagnosis of blood sugar indicators is also allowed.

Moderate and severe manifestations of metabolic disorders cause symptoms typical of diabetes:

• thirst (polydipsia);
• violation of diuresis - increased amount of urine, frequent and profuse urination;
• constant feeling of hunger;
• visual impairment.

In rare cases, diabetic complications develop - neuropathy, vascular pathologies, diseases associated with malnutrition of tissues and cells. Thirst and hunger do not always necessarily indicate the presence of diabetes, so only laboratory diagnostics can detect the disease.

Impact on the fetus and childbirth

Elevated sugar levels have a negative effect on the fetus and the mother's body. The most dangerous complications and consequences of pathology:

• macrosomia - abnormal growth of the fetus and its excessive weight (this negatively affects the activity of the internal organs of the child and acts as an additional risk factor during childbirth);
• the presence of congenital heart disease;
• fetal brain anomalies;
• risk of spontaneous miscarriage;
• neonatal jaundice;
• swelling of tissues, excessive lipid deposits;
• disturbed proportions of the fetus - a large belly, thin limbs;
• hypoglycemia, abnormal blood viscosity, increased risk of thrombosis;
• low levels of magnesium and calcium;
• respiratory pathologies.

The higher the plasma glucose concentration, the higher the likelihood of macrosomia. A large fetus in this case is not an indicator of congenital health, but a sign of an anomaly. Often the head and brain of a newborn remain normal in size, but the shoulder girdle and body of the baby increase, which makes it difficult to pass through the birth canal. The most appropriate solution in this situation is a caesarean section.

Macrosomia often leads to spontaneous abortion. Childbirth with gestational diabetes is more difficult and dangerous. The risk of birth injuries and complications increases. An additional danger is that a large fruit may not be mature enough. Such situations require urgent resuscitation procedures or the use of a pressure chamber and an incubator.

But even if the birth was relatively normal, it is still too early for mothers and doctors to relax. Late gestational diabetes often causes permanent hypoglycemia in the newborn. The child no longer receives the required amount of glucose from the mother through the placenta, which leads to a decrease in the level of sugar in his body.

Women who survive gestational diabetes should continue treatment after delivery. The main danger is that their pancreas continues to work at the limit of its functionality. The level of insulin may decrease or there is an excessive tolerance of tissues and cells to this hormone, and this is a direct risk of developing full-fledged type II diabetes.

Diagnostics

High sugar levels in pregnant women are the reason for a more complete and detailed examination. The most accurate diagnostic method is a glucose tolerance test. The level of carbohydrates is measured not only on an empty stomach, but also after drinking a glass of water with dissolved glucose. The fact is that in pregnant women, fasting sugar levels often remain normal.

Another indicative test is a test for glycated hemoglobin. This study displays the plasma glucose level for the previous 7-9 days. The test also allows you to monitor the effectiveness of therapeutic procedures.

Therapy Methods

Diabetic pathology requires complex and phased therapy. The most effective method of treatment is diet therapy. The menu for gestational diabetes is compiled by a specialist, taking into account the current condition of the patient and the presence of additional diseases.

The list of therapeutic measures includes other procedures:

• constant monitoring of glucose levels (the ideal option is to measure indicators four times a day: after meals and on an empty stomach);
• conducting urine tests for the presence of ketone bodies - if any are present, then the treatment is ineffective;
• dosed physical activity;
• body weight stabilization;
• insulin therapy (if necessary);
• blood pressure control.

The presence of insulin resistance requires more radical drug therapy, but usually a drug course is prescribed after childbirth, since any drugs can affect the health of the fetus. After the birth of a child, the pancreas of women requires protection and prevention. Re-testing for the presence of diabetic pathology is carried out 6-8 weeks after birth and every 6 months for 3 years.

Moderate physical activity of pregnant women will not only avoid problems with being overweight, but will have a beneficial effect on the joints and blood vessels that suffer during pregnancy. Full-fledged classes in the fitness room are unlikely to work, but swimming, exercises with a fitball (a special ball for pregnant women), aerobics are ideal options to stabilize carbohydrate metabolism. Exercise helps to use up the increased amount of sugar, turning it into energy.

Insulin therapy is prescribed if conservative methods do not produce a pronounced therapeutic effect. The drugs are administered exclusively in the form of injections: if patients do it on their own, they must master the correct injection technique and strictly observe the dosage.

Diet

The basic rule of nutrition in diabetes is limiting the amount of carbohydrates, especially those that are called "fast". These include sweets, muffins, carbonated drinks, some fruits (bananas, persimmons), fast food. Fast carbohydrates require an increased amount of insulin, which further overloads the pancreas.

Preference should be given to dietary protein foods (poultry, veal, fish) and healthy fats. A complete low-carbohydrate diet is rarely prescribed during pregnancy because both the mother and the fetus need energy, but after childbirth, such nutrition is an excellent method of preventing diabetes.

For GSD, follow these guidelines:

• eat fractionally: eat in small portions and do not skip meals;
• eat the main portion of carbohydrates during breakfast;
• exclude from the diet fried, pickled, spicy and fatty;
• if you feel sick in the morning, keep a cracker by the bed and eat a few slices before getting out of bed;
• do not eat convenience foods and fast food (cereals, noodles, mashed potatoes from bags) - such foods dramatically increase the glycemic index and increase the risk of metabolic disorders;
• give preference to foods rich in vegetable fiber - cereal cereals, vegetables, pasta from high-quality raw materials (fiber is useful for all pregnant women - it stimulates the digestive tract and slows down the absorption of lipid compounds into the blood);
• the preferred source of protein is dietary meat (turkey, chicken, fish);
• reduce the amount of animal fat;
• steam, boil, bake, but do not use a frying pan;
• cook in vegetable oil;
• make sure that the body receives the required amount of fluid - at least 2 liters per day (drink green tea, juices, mineral water);
• food should be as varied and healthy as possible: if there are not enough vitamins and other useful compounds, use special vitamin complexes.

Low-calorie foods (fresh vegetables in pure form or as part of salads) can be consumed during snacks and in situations where you need to satisfy hunger without adding extra calories. A more detailed menu is compiled by dietitians or endocrinologists.

Daily calorie content is reduced due to lipids and easily digestible carbohydrates. If the level of ketone bodies in the urine increases as a result of such a diet, then the reduction in carbohydrate compounds was too drastic. Your doctor will help you calculate the exact amount of carbohydrates in your diet.

Any violations of metabolic processes during pregnancy is a reason to go to the clinic and undergo a full examination. You should not think that the condition will stabilize by itself: even if this happens, in the future, endocrine pathologies can again make themselves felt and develop into full-fledged type II diabetes. Therefore, it is better to eliminate violations of metabolic processes in their debut stage.

Gestational diabetes (gestational diabetes mellitus, GDM, diabetes mellitus in pregnancy) is a violation of carbohydrate metabolism. Usually occurs or is first recognized in women during their pregnancy. The prevalence of GDM most commonly ranges from 1% to 14% depending on the female population. This type of diabetes develops when the body does not produce enough insulin, a pancreatic hormone that regulates the level of sugar needed by the body and serves as a source of energy for blood sugar. Sugar, which is not currently used by the body, is stored thanks to insulin as a spare.

The body of a woman during pregnancy has to produce more insulin to meet the needs of the child. This is especially true in the second half of pregnancy. If a woman's pancreas fails, her blood sugar levels will be higher than normal, and then gestational diabetes can develop. This type of diabetes usually resolves on its own after childbirth, unlike other types of diabetes, which are chronic conditions. High blood sugar (glucose) is usually first diagnosed during a woman's pregnancy.

Causes and risk factors gestational diabetes

Hormones produced by a woman's body during pregnancy can block insulin and prevent it from doing its job. When this happens, a pregnant woman's blood glucose levels may rise.

A patient is at greater risk of gestational diabetes if:

During pregnancy, she is over 25;
- she has a family history of diabetes;
- she gave birth to a child who weighs more than 4 kg or has a birth defect;
- she has high blood pressure;
- she has too much amniotic fluid;
- she had an unexplained miscarriage or stillbirth;
- she was overweight before pregnancy, etc.

Usually, gestational diabetes does not have any pronounced symptoms or the symptoms are mild and not life threatening for the pregnant woman.

Symptoms of gestational diabetes

Symptoms may include:

blurred vision;
- fatigue;
- frequent infections, including infections of the bladder, vagina and skin;
- increased thirst;
- frequent urination;
- nausea and vomiting;
- weight loss despite increased appetite.

Diagnostics gestational diabetes

Gestational diabetes usually begins in mid-pregnancy. All pregnant women should have a glucose tolerance test between the 24th and 28th weeks of pregnancy. Women who have risk factors for gestational diabetes can have this test very early in their pregnancy.

Treatment gestational diabetes

The goals of treatment are to keep blood sugar (glucose) levels within normal limits during pregnancy and to make sure that the growing baby is healthy.

Is it dangerous gestational diabetes for baby

There is no direct threat to the life and health of the baby with moderate gestational diabetes in a pregnant woman. It only causes the baby to be overweight, which can lead to birth complications, as women with gestational diabetes tend to have large newborn babies. This can increase the chance of problems during childbirth, including: birth trauma due to the large size of the baby; painful or poorly fused stitches or other problems in a woman. after

For a woman in labor, the risk of a Caesarean section and high blood pressure is increased.

The baby of a woman with gestational diabetes is likely to have periods of hypoglycemia - low blood sugar - during the first few days of life.

There is a slightly increased risk of infant death when the mother has advanced gestational diabetes. Managing blood sugar (glucose) levels reduces this risk.

The attending physician should observe the patient and her child well throughout her pregnancy. Fetal monitoring will help check the size and health of the fetus. The test is very simple, painless for the patient and her child. A device that hears and displays the baby's heartbeat (electronic fetal monitor) is placed on the belly of a pregnant woman. The attending physician can compare the child's heartbeat pattern with movements and find out if the child is feeling well.

Nutrition with gestational diabetes

The best way to fight gestational diabetes is to eat a variety of wholesome and healthy foods. You need to learn how to read ingredient labels on foods and consult with doctors and nutritionists when making nutritional decisions. We recommend that the patient talk to their doctor or nutritionist if the patient is a vegetarian or if she is on some other special diet. In general, the diet should be moderate in fat and protein.

In general, when a patient has gestational diabetes, her diet should be moderate in fat and protein.
We recommend getting the carbohydrates you need through foods that include fruits, vegetables, and complex carbohydrates (such as bread, cereals, pasta, and rice).

Eat less foods that contain a lot of sugar - soft drinks (lemonade, syrups, cocktails, compotes, kvass, fruit drinks, etc.), fruit juices and cakes.

If the diet of a person with gestational diabetes does not control their blood sugar (glucose) levels, they may be prescribed diabetes medications or insulin therapy. However, most women who develop gestational diabetes will not need diabetes medication or insulin.

Prognosis of gestational diabetes and its consequences

Most women with gestational diabetes are able to control their blood sugar (glucose) levels and avoid harm to themselves or their baby.

High blood sugar (glucose) often returns to normal after childbirth. However, women with gestational diabetes after childbirth should be closely monitored for regular follow-up of doctor's orders for possible signs of diabetes. Many women with gestational diabetes develop it more severely within 5 to 10 years of being diagnosed.

The patient should certainly and immediately consult a doctor if she is pregnant and if she also has symptoms of gestational diabetes.

Prevention of gestational diabetes

Prenatal care should be started as early as possible. Regular prenatal visits to the doctor will help improve the health of both the pregnant woman and the baby.

Prenatal screening at 24-28 weeks of gestation will help detect gestational diabetes at an early stage.

If the patient is overweight, we advise you to reduce weight and body mass index (BMI) to normal levels before becoming pregnant. This will greatly reduce the risk of developing gestational diabetes.