Gestational diabetes

Gestational diabetes is characterized by slow development without pronounced symptoms. There may be a slight thirst, severe fatigue, increased appetite, but at the same time weight loss, frequent urge to go to the toilet. Most women do not pay attention to this, blaming everything on pregnancy. But any unpleasant sensations should be reported to the doctor, who will prescribe an examination.

Factors that increase the risk of developing gestational diabetes

1. The presence of diabetes in parents or close relatives.

2. If a woman is obese.

3. A history of gestational diabetes mellitus in previous pregnancies, premature pregnancies, large fetuses over 4 kg, stillborn children, polyhydramnios, spontaneous abortions.

4. Arterial hypertension (increased blood pressure).

Diagnostics

Pregnant women at risk for gestational diabetes mellitus are examined at their first visit to a doctor. Pregnant women without obvious risk factors undergo an O'Sullivan test or glucose tolerance test at 24-28 weeks of pregnancy. To do this, 50 grams of glucose is taken orally, regardless of the time of the last meal, and after an hour the glucose level in the venous blood is assessed. The glucose concentration should not exceed 7.8 mmol/liter (140 mgr%). In case of abnormalities, a three-hour glucose tolerance test with an oral dose of 100 grams of glucose is performed in order to confirm or deny the diagnosis of gestational diabetes mellitus.

Constant hyperglycemia (high sugar) causes a lack of energy for normal fetal development. In the second trimester, the fetus develops its own pancreas, which, in addition to utilizing glucose in the child's body, is forced to normalize glucose levels in the mother's body. This causes the production of large amounts of insulin, hyperinsulinemia develops, which threatens hypoglycemic conditions of newborns (since the pancreas is used to working for two), respiratory disorders and the development of asphyxia.

Not only high sugar is dangerous for the fetus, but also low sugar. Frequent hypoglycemia causes brain nutritional disorders, which threatens to slow down the child's mental development.

Treatment

If the diagnosis is made on time, the woman's treatment is correct, and the pregnant woman herself follows all the doctor's instructions, then the probability of having a healthy child is 98-99%. Hence, it is necessary to determine the concentration of glucose in the blood during the period of 24-28 weeks. Oral hypoglycemic drugs should not be used during pregnancy. If glucose does not exceed the following values, then the patient is recommended to have a diet and exercise. If the glucose level exceeds the following values, then insulin therapy is necessary.

Criteria for normoglycemia:

• On an empty stomach: 5.5 mmol/L (60-100 mgr%)

• An hour after eating: 5.5-7.8 mmol/L (100-140 mgr%)

• 2 hours after eating: 4.44 – 6.7 mmol/L (80-120 mgr%)

• At night: 4.44 – 5.5 mmol/L (80-100 mgr%)

Diet therapy during pregnancy

The diet of pregnant women diagnosed with diabetes must be coordinated with an endocrinologist. It contains fewer carbohydrates (200-250 grams), fats (60-70 grams) and a normal or even increased amount of protein (1-2 grams per 1 kg of body weight). It is very important to consume the same amount of carbohydrates daily. Nutrition of a pregnant woman suffering from diabetes should be divided from 5 to 8 times a day.

To compensate for diabetes, the diet must include plant fiber, which gives a feeling of fullness with minimal calories. Among other things, fresh berries are also recommended. Especially gooseberries, cranberries and cherries, as the fructose contained in them prevents obesity and the development of diabetes. But do not overdo it with sweet, carbohydrate–rich fruits: melon – only one slice, grapes – only a tassel, banana – no more than half, potatoes - no more than two tubers per day. Limit the bread to three pieces per day. Give preference to varieties of bread made from coarse flour.

Among the prohibited products are all refined, that is, purified from fiber. For example, white bread, sugar, sweets (jams, syrups, sweet juices, ice cream, cakes, pastries, waffles, biscuits, sweets, other confectionery and pastries), honey, dates.

Also, try to eat as little as possible salt (no more than 4 grams per day), eggs, fish caviar, animal fats (including butter), liver. Sweet lovers are offered xylitol, fructose and sorbitol instead. Up to 30 g of sweetener per day is allowed.

Your diet, first of all, should include:

• boiled beans

• lean fish, lean beef and skinless chicken, preferably boiled or baked in the oven

• cabbage in any form

• hard low-fat cheeses

• grapefruits, lemons, oranges, cranberries, gooseberries, cherries

• tomato juice, tea

• gray bread without coarse flour

• low-fat milk and cottage cheese

• buckwheat, oatmeal, pearl barley

It is important to remember that your individual menu must be coordinated with your doctor. Consult with an endocrinologist or nutritionist, do not self-medicate.

After the birth of a child, most women's blood sugar levels return to normal, even if she injected insulin during pregnancy. But diabetes during pregnancy still increases the risk of developing it in the future. This can be avoided if you strictly monitor your weight.