Unfortunately, pregnancy does not always go smoothly for everyone.

Sometimes during this period, chronic diseases worsen against the background of a general decrease in immunity and hormonal changes in the body, or completely new problems and diseases appear that the woman has not even encountered before.

For example, if a pregnant woman’s blood sugar suddenly rises, she is diagnosed with gestational diabetes mellitus. Statistics say that it manifests itself in only 3-5% of cases, besides, if you have not suffered from diabetes before, then after giving birth this problem should disappear on its own. However, you should not neglect it, because the disease also carries certain risks.

Gestational diabetes mellitus is also called “diabetes during pregnancy”, since this disease is considered one of the variants of diabetes, which can occur or be first diagnosed only during pregnancy.

The problem manifests itself if a carbohydrate metabolism disorder occurs: the child develops and grows, demanding and taking more and more from the mother’s body. As a result, all a woman’s organs work under increased load.

The pancreas, which secretes the hormone insulin to control blood sugar levels, often cannot cope with its function. In addition, some hormones secreted by the placenta work to increase blood sugar, that is, their effect is exactly the opposite of the action of insulin. At some point, blood glucose levels exceed normal levels and diabetes begins to develop.

Symptoms: how does the disease manifest itself?

Often, this type of diabetes is detected at the beginning of the second trimester of pregnancy (no earlier than 15-16 weeks) or later, since only by this period the placenta will be fully formed, which will begin to produce estriol and lactogen (hormones with counter-insulin properties).

Also in the maternal body the level of diabetogenic hormones increases: estrogens, cortisol,.

Another reason for the occurrence of the disease is increased insulin resistance, which can be provoked by a decrease in a woman’s physical activity, sudden weight gain, excessive consumption of high-calorie foods, etc.

At the same time, if the disease was detected at the very beginning of pregnancy or in its early stages, then doctors will be inclined to conclude that the woman began to develop regular or type diabetes even before conceiving the child.

If the hormone insulin begins to increasingly regulate blood sugar levels and its effect on your body is disrupted, this may manifest itself in the following signs (usually there are no symptoms characteristic of a normal disease):

• vision deteriorates, its sharpness decreases;
• the woman feels increased fatigue, fatigue;
• there are complaints about frequent and copious urination;
• severe hunger or, conversely, loss of appetite and weight;
• A pregnant woman may experience severe dry mouth and constant thirst.

Very often a woman perceives these signs as features of her situation, and therefore does not attach due importance to them. As a result of this, the disease is diagnosed and detected too late, when it is already in the phase of active development, which means it can lead to complications and irreversible consequences.

Who is at risk?

Almost any woman can experience the onset and development of the disease.

In addition to a sharp decrease in the sensitivity of cells and tissues to insulin, which is produced by the body, there are other causes or risk factors that can provoke the disease (almost all of them depend on genetics and the individual characteristics of the female body):

• the risk of diabetes, as a rule, directly depends on the severity of obesity, that is, the greater it is, the more likely it is to develop the disease;
• heredity can be considered almost the main factor, therefore, if your direct line relatives had (or are suffering from) type 2 diabetes, then you are at risk;
• Women who are carrying a child over the age of 33-35 also need to be careful;
• gestational diabetes can occur again (that is, if you had it in a previous pregnancy), and doctors also note a high percentage of the disease in those women who were bothered or worried during a previous pregnancy;
• As for previous pregnancies, doctors take into account their course (the presence or pathologies - miscarriage, spontaneous abortions or miscarriages, stillbirth, etc.), as well as delivery (the birth of a child weighing more than four kilograms, children with congenital malformations of the cardiovascular or nervous systems);
• a high risk of developing the disease in women suffering from various disorders of carbohydrate metabolism, problems with the cardiovascular and endocrine systems;
• unhealthy lifestyle (bad habits - alcohol, smoking, low level of physical activity, unbalanced diet, etc.).

Among the causes that provoke the onset of the disease may be viral infections that damage the pancreas, autoimmune processes, and some other triggering factors.

You can assess your risk of developing the disease. If you are at risk, it is better to undergo the necessary examinations and detect carbohydrate metabolism disorders as early as possible.

How is the problem diagnosed?

Based on medical standards, a woman undergoes blood and urine tests for sugar throughout her pregnancy. But to determine the risk or detect gestational diabetes mellitus, an oral glucose tolerance test is performed between 24 and 28 weeks.

Tests (blood is taken from a vein) are taken on an empty stomach, and at least eight hours must pass after your last meal.

Then you need to dilute 50-75 g of dry glucose in a glass of water and drink. After consuming glucose, a repeat test is taken an hour later and two hours later.

It should be noted that sugar tests taken on an empty stomach are usually not very informative, since the blood sugar level in such cases is almost always normal. Therefore, a “load” of glucose is done so that the study shows the real picture.

Normal indicators for pregnant women during analysis:

• if blood is taken on an empty stomach, then the sugar level can fluctuate between 4.0-5.0 mmol/l, but not exceed 5.1 mmol/l;
• after an hour after the “load” - no higher than 10.0 mmol/l;
• after two hours – no more than 8.5 mmol/l.

If a pregnant woman's blood sugar level exceeds these numbers, the doctor diagnoses gestational diabetes. You may be referred to repeat the test in 10-14 days.

How dangerous is this disease for a child?

Diabetes mellitus can have a very negative impact on the growth and development of the baby. Because of this and due to the peculiarities of carbohydrate metabolism between the mother’s body and the child’s body, the fetus will receive glucose, but will be without insulin.

This condition is a threat to his health and life, especially if gestational diabetes manifests itself in the first trimester, when the baby does not yet produce its own insulin hormone. It is for this reason that hyperglycemia or an excess amount of glucose develops, which leads to the emergence and development of various defects and pathologies in the child (as a rule, brain structures and the heart suffer).

The development of diabetes in the second and third trimesters, when the baby’s own pancreas is already functioning, leads to hyperinsulinemia (that is, too much of the hormone is produced in order not only to utilize glucose in the body, but also to help normalize its level in the mother’s body) .

If this disease is not detected in time and the necessary measures are not taken, then complications arise in the form of a hypoglycemic state in the newborn, or diabetic fetopathy develops.

Here are the signs that characterize this complication:

• breathing difficulties or respiratory disorders, asphyxia;
• jaundice;
• blood with increased viscosity, a high probability of blood clots, magnesium and calcium deficiency in a newborn baby;
• the child’s tissues are very swollen, and subcutaneous fat is deposited in great excess;
• development occurs with a violation of proportions (very large belly, too thin and small limbs);
• very large size of the child (over four kilograms).

If a pregnant woman has a high concentration of glucose in her blood, then at the end of the third trimester there is a very high risk of developing macrosomia, that is, an excessive increase in fetal weight and growth (and although the size of the head may be normal, the shoulder girdle becomes too large, and this becomes a serious difficulty during childbirth).

Many children are at high risk of becoming obese and developing type 2 diabetes in adulthood.

What are the dangers of gestational diabetes during pregnancy?

Gestational diabetes can be very dangerous for women too.

• Firstly, the disease poses a serious threat to the normal course of pregnancy. It can provoke the development of polyhydramnios and the occurrence of gestosis, which is fraught with various complications for the child.
• Secondly, high blood sugar levels lead to disorders in the vascular system (retinopathy, nephropathy, neuropathy).
• Thirdly, as the disease develops, genital tract infections may worsen, which leads to intrauterine infection of the baby.
• Blood flow may also be disrupted, which means that it will develop and the child will suffer from.
• Cases of premature birth, stillbirth or intrauterine fetal death are very common.

As mentioned above, uncontrolled diabetes sometimes leads to the development of a very large baby, which makes natural childbirth impossible and forces doctors to resort to cesarean section.

Complications are possible in the form of diabetic kidney damage, heart disease, and vision disorders. There are cases when, after pregnancy with gestational diabetes, a woman developed regular diabetes mellitus (usually type 2).

If the diagnosis is verified and confirmed, the doctor will prescribe individual complex therapy, which you will have to strictly adhere to.

As a rule, it includes:

• correction of diet and strict adherence to diet rules;
• Regular monitoring of blood sugar levels (daily);
• continuous blood pressure measurement;
• constant monitoring of body weight;
• moderate physical activity (exercise, walking, etc.);
• healthy lifestyle, adherence to daily routine;
• regular testing (urine for the presence of ketone bodies, blood for sugar).

If the results of this therapy are unsatisfactory, the doctor will be forced to prescribe additional drug treatment.

Diet therapy or proper balanced nutrition is one of the most important points of treatment, compliance with which in most cases is sufficient to lower blood sugar levels and prevent the progression of the disease.

The basic rule of the diet is to make it complete, balanced and dietary at the same time, without reducing the energy value of the food.

1. Your menu should not contain easily digestible carbohydrates, which can cause a sharp rise in blood sugar.

These include: baked goods, confectionery, baked goods, honey, some very sweet fruits and dried fruits (figs, bananas, grapes).

1. Make your meals fractional - it is better to eat less, but more often (up to 5-6 times a day in small portions).
2. Limit or completely eliminate fat intake.

This applies not only to butter or margarine, but also to sour cream or high-fat milk, cream cheese, mayonnaise, etc., since the ketone bodies that these products contain will poison your body due to a lack of insulin.

When cooking, you can use vegetable oil in small quantities.

1. Eat plenty of high-fiber foods rich in vitamins and beneficial elements.

These are greens, vegetables, bran, grains, cereals, fruits.

1. Eliminate fast food products, semi-finished products, as well as fried, spicy, salted and smoked foods from the menu.

Instead, eat poultry, fish and lean meats.

1. Drink enough fluids.

If you have problems with excess weight, carefully monitor the calorie content of your foods.

Physical exercise

If you have never played sports or any physical exercise, you should be especially careful during pregnancy.

Be sure to consult your doctor to determine the severity of the load and intensity of exercise.

Doctors insist that walking, swimming, water aerobics and other moderate physical activity are very beneficial for pregnant women, as they help maintain good health, maintain muscle tone, prevent weight gain and improve the effect of insulin.

Do not overuse exercises - they must be performed in good health. Check your blood sugar before and after exercise.

Do you need medications?

Insulin therapy may be prescribed by a doctor if diet and exercise have failed to bring sugar levels back to normal. There are special insulin therapy regimens, and only your doctor will be able to calculate or adjust it for you.

Women who take insulin also have to measure their blood sugar levels with a glucometer several times a day.

All readings must be recorded so that the doctor can later look at them and assess the dynamics of the disease.

There are special diabetes pills that lower sugar, but taking them during pregnancy is strictly prohibited.

How will the birth proceed?

If there are appropriate obstetric indications (hypoxia, developmental delay, etc.), then the woman will have a cesarean section.

If there are no prerequisites for the operation, then a natural birth will occur, during which specialists will constantly monitor sugar levels (regulate it with glucose or insulin injections if necessary), and check other indicators.

A baby may be born with low blood sugar, but this problem should resolve itself during breastfeeding. Doctors will monitor glucose levels and, if necessary, advise you to supplement your baby with formula.

After giving birth, a woman's blood sugar is monitored: as a rule, elevated levels should return to normal within a few days. Also, after a month and a half, you should do a glucose test and then be observed by an endocrinologist for some more time to exclude the development of type 2 diabetes.

Instead of a conclusion

If you have gestational diabetes during pregnancy, this may indicate your body's poor sensitivity to insulin, that is, insulin resistance. This means that you should take care of diabetes prevention and undergo medical examinations and testing from time to time so as not to encounter the disease in the future.

Pregnancy means a dramatic change in the balance of hormones. And this natural feature can lead to the fact that the components secreted by the placenta prevent the mother’s body from receiving insulin. A woman has abnormal levels of glucose in her blood. Gestational diabetes mellitus during pregnancy occurs more often from the middle of pregnancy. But its earlier presence is also possible.

Read in this article

Causes of diabetes in pregnant women

Experts cannot name the obvious culprit for the disruption of tissue response to glucose in expectant mothers. There is no doubt that hormonal changes play an important role in the development of diabetes. But they are common for all pregnant women, and the disease, fortunately, is not diagnosed in this position in everyone. Those who suffered it noted:

• Hereditary tendency. If there are cases of diabetes in the family, there is a higher probability of its occurrence in the pregnant woman compared to others.
• Autoimmune diseases that, due to their characteristics, disrupt the functions of the insulin-producing pancreas.
• Frequent viral infections. They can also disrupt the functions of the pancreas.
• Passive lifestyle and high-calorie diet. They lead to excess weight, and if it existed before conception, the woman is at risk. This also includes those whose body weight increased by 5-10 kg in adolescence in a short time, and its index became above 25.
• Age from 35 years. Those who are under 30 at the time of pregnancy have a lower risk of developing gestational diabetes than others.
• Previous birth of a baby weighing more than 4.5 kg or a stillbirth for unknown reasons.

Women of Asian or African descent are more likely to have gestational diabetes than Caucasian women.

Signs to suspect you have gestational diabetes

At an early stage, diabetes mellitus during pregnancy shows virtually no symptoms. This is why it is important for expectant mothers to control their blood sugar levels. Initially, they may notice that they began to drink a little more water and lost a little weight, although there are no visible reasons for the weight loss. Some people find that they find it more pleasant to lie down or sit than to move.

As the illness develops, a woman may feel:

• Need for large amounts of fluid. Despite her satisfaction, she is bothered by dry mouth.
• The need to urinate more often, and much more fluid comes out than usual.
• Increased fatigue. Pregnancy already takes a lot of energy, but now a woman’s desire to rest arises faster than before; with diabetes, her sense of self does not correspond to the load she receives.
• Deterioration in the quality of vision. Cloudiness may occur in the eyes from time to time.
• Itchy skin, and mucous membranes may also itch.
• A significant increase in the need for food and rapid weight gain.

The first and last signs of diabetes during pregnancy are difficult to separate from the diabetes itself. After all, even in healthy women expecting babies, appetite and thirst often increase.

How to get rid of diabetes during pregnancy

At the first stage of development, gestational diabetes is treated by streamlining lifestyle and. It is imperative to monitor the quantitative glucose content on an empty stomach, as well as 2 hours after each meal. Sometimes measuring your sugar level may be required beforehand.

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

The main things at this stage are diet and physical activity.

Nutrition for gestational diabetes

a pregnant woman cannot, the fetus must have everything it needs, and sugar increases from lack of food. The expectant mother will have to adhere to healthy eating principles:

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

With this style of eating, you need to drink up to 8 glasses of water per day.

Medicines

If dietary changes do not have an effect, that is, the glucose level remains elevated, or the urine test is poor with normal sugar levels, insulin will have to be administered. The dose in each case is determined by the doctor, based on the patient’s weight and gestational age.

Insulin is administered intravenously, usually dividing the dose by 2 times. The first is injected before breakfast, the second before dinner. The diet during drug therapy is maintained, as is regular monitoring of blood glucose concentrations.

Physical exercise

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

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

Preventing Gestational Diabetes

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

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

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

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

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

- a type of diabetes that occurs exclusively in women during pregnancy. After giving birth, after some time, it usually goes away. However, if such a disorder is not treated and left untreated, then the problem can turn into a serious disease - type 2 diabetes (and this is a lot of difficulties and unpleasant consequences).

Every woman who becomes pregnant registers with the antenatal clinic at her place of residence. Thanks to this, throughout the entire period of gestation, the health of the woman and her fetus is monitored by specialists, and periodic blood and urine tests are mandatory for monitoring.

If suddenly an increase in glucose levels is detected in the urine or blood, then a single such case should not cause panic or any fears, because for pregnant women this is considered a physiological norm. If the test results show more than two such cases, and glucosuria (sugar in the urine) or hyperglycemia (sugar in the blood) are detected not after meals (which is considered normal), but in tests done on an empty stomach, then we can already talk about gestational diabetes mellitus in the pregnant woman.

Causes of gestational diabetes, its risk and symptoms

According to statistics, approximately 10% of women suffer from complications during pregnancy, and among them there is a certain risk group who may develop gestational diabetes mellitus. These include women:

• with a genetic predisposition,
• overweight or obese
• with ovarian diseases (for example),
• with pregnancy and childbirth after 30 years of age,
• with previous births accompanied by gestational diabetes mellitus.

There may be several reasons for the occurrence of GDM, but this is mainly due to a violation of loyalty to (as with type 2 DM). This is explained by the increased load on the pancreas during pregnancy, which may not be able to cope with the production of insulin, which controls normal sugar levels in the body. The “culprit” of this situation is the placenta, which secretes hormones that resist insulin, thereby increasing glucose levels (insulin resistance).

“Resistance” of placental hormones to insulin usually occurs at 28-36 weeks of pregnancy and, as a rule, this occurs due to a decrease in physical activity, which is also explained by natural weight gain during gestation.

Symptoms of gestational diabetes during pregnancy are the same as for type 2 diabetes:

• increased feeling of thirst,
• lack of appetite or constant feeling of hunger,
• discomfort from frequent urination,
• possible increase in blood pressure,
• blurred vision.

If any of the above symptoms are present, or you are at risk, be sure to inform your gynecologist so that he can examine you for GDM. The final diagnosis is made not only by the presence of one or more symptoms, but also on the basis of tests that must be taken correctly, and for this you need to eat foods that are included in your daily menu (do not change them before taking the test!) and lead a normal lifestyle .

The norm for pregnant women is:

• 4-5.19 mmol/liter- on an empty stomach,
• no more than 7 mmol/liter- 2 hours after eating.

If the results are questionable (i.e. the increase is insignificant), a glucose load test is performed (5 minutes after taking the test on an empty stomach, the patient drinks a glass of water in which 75 g of dry glucose is dissolved) to accurately determine a possible diagnosis of GDM.

How dangerous is gestational diabetes mellitus (GDM) for a child?

For the safety of the fetus in the placenta, hormones such as cortisol, estrogen and lactogen are necessary. However, these hormones are forced to resist insulin, which disrupts the normal functioning of the pancreas, and because of this, not only the mother suffers, but also her baby.

The formation of the fetus occurs in the first trimester of pregnancy, and therefore GDM that appears after 16-20 weeks cannot lead to any abnormalities in organ development. Moreover, timely diagnosis is quite capable of helping to avoid complications, but there remains the danger of diabetic fetopathy (DF) - “feeding” of the fetus, the symptoms of which are associated with impaired development.

The most common symptom of DF deviation in GDM is macrosomia - an increase in fetal size in weight and height. This happens due to the large amount of glucose supplied for fetal development. The child’s pancreas, which is not yet fully developed at this moment, produces its own insulin in excess, which converts excess sugar into fat. As a consequence of this, with normal sizes of the head and limbs, the shoulder girdle, heart, liver, and abdomen increase, and the fat layer is expressed. And what are the consequences of this:

• due to obstructed passage of the child’s shoulder girdle through the birth canal, a difficult birth occurs;
• for the same reason - damage to the mother’s internal organs and possible injuries to the child;
• due to the enlargement of the fetus (which may not yet fully develop) causing premature birth.

Another symptom of DF is difficulty breathing in the newborn after birth. This happens due to a decrease in surfactant, a substance in the lungs (this is due to GDM in a pregnant woman), and therefore, after the birth of the child, they can be placed in a special incubator (incubator) under constant monitoring, and if necessary, they can even perform artificial respiration using a ventilator.

Treatment and prevention of gestational diabetes mellitus

As we have already said, the main cause of GDM is an increase in sugar, and therefore treatment, as well as the prevention of the disease, is based on controlling this indicator in the body.

The task of a pregnant woman is to undergo regular tests and strictly follow the recommendations of the attending gynecologist. In addition, you should monitor (or even change) your diet and lifestyle.

As doctors’ practice and statistical data show, the main key to the health of a mother and her child is proper nutrition, which is needed not for weight loss (losing weight), but to normalize glucose levels. And here it is important to eat less calorie, but at the same time nutritious food. And this means:

• exclude baked goods and confectionery from your diet, but do not exclude carbohydrates from your diet altogether (this is a source of energy);
• limit or exclude certain types of fruits that contain easily digestible carbohydrates;
• stop eating semi-finished and instant foods (noodles, soups, cereals, purees, sausages);
• stop eating smoked meats, margarine, mayonnaise, butter, pork;
• do not forget about protein foods: they are very important for the body;
• when preparing food, it is preferable to boil, stew, bake or steam food;
• Meals should be in small portions, but every 3 hours.

In addition, the expectant mother will benefit from:

• special classes,
• walking in the fresh air away from the roadway.

Physical activity promotes effective neutralization of sugars (less glucose accumulates in the blood and its level decreases), good metabolism and has a beneficial effect on overall well-being.

In every woman’s mind, the period of waiting for a child seems to be something rosy, airy and serene, but it happens that this idyll is disrupted by serious health problems.

Gestational diabetes mellitus during pregnancy, why it is dangerous, what indicators and signs do pregnant women have, diet and menu, consequences for the child, analysis for hidden blood sugar is the topic of this article.

The material will be useful to any woman of fertile age who has risk factors and heredity for the disease.

Gestational diabetes in pregnant women: what is it?

Gestational or preeclampsia diabetes is a disease of increased blood sugar that occurs during pregnancy at any stage. Many people confuse the name and call it remote. Before pregnancy, the woman was completely healthy and showed no signs of illness. This disease is also called “diabetes mellitus in pregnancy.”

As a rule, this type of diabetes occurs in the second half of gestation, when the woman is at a decent age. After delivery, gestational diabetes may disappear, or it may develop into full-blown type 1 or type 2 diabetes.

However, there are studies that show a strong link between diabetes during pregnancy and type 2 diabetes later in life. In other words, if a woman had gestational diabetes at a young age, then in adulthood she has a greater risk of developing type 2 diabetes if there are risk factors such as obesity, poor nutrition and others.

The incidence of this type of diabetes is about 2.5 - 3.0%. There are certain risk factors that contribute to this, which I list below:

• overweight and obesity
• age over 30 years
• heredity for diabetes
• large baby from previous pregnancy
• detection of glucose in urine in a previous pregnancy
• gestational diabetes in the past
• polycystic ovary syndrome (PCOS)

Diabetes in pregnant women: dangers and consequences for the child

Diabetes is always a pathology and it cannot but affect the course of pregnancy and the health of the fetus. But with good compensation, it is possible to safely carry and give birth to a healthy baby. I’ll tell you what you need for good compensation below, but now I’ll list what the expectant mother can expect.

• high risk of fetal death in utero or in the first week of life after birth
• birth of a child with developmental defects
• high risk of various diseases of the newborn baby in the first month of life (for example, infections)
• the birth of a large fetus and the risk of complications associated with this (injuries to the child’s skull and limbs, maternal ruptures during childbirth, etc.)
• your child's risk of developing diabetes in the future
• late complications of pregnancy (eclampsia and preeclampsia, arterial hypertension, edema syndrome)
• polyhydramnios
• intrauterine infection

What are the signs of diabetes during pregnancy?

Quite often, an increase in glucose levels is asymptomatic, and if there are any signs, they are usually attributed to the pregnancy itself. The symptoms of gestational diabetes are no different from those of any other type of diabetes. The severity of these manifestations depends on the level of sugar in the blood.

Symptoms of diabetes during pregnancy

• dry mouth
• frequent urination
• skin itching and perineal itching
• thrush
• rapid weight gain
• general weakness and drowsiness

As you can see, the manifestations are often a manifestation of pregnancy itself, and therefore every woman regularly undergoes blood and urine tests for early diagnosis of carbohydrate disorders.

Blood sugar levels in gestational diabetes

As I already described in the article, in order to make a diagnosis of Gestational Diabetes, you need to conduct a special analysis - an oral glucose tolerance test. Based on the results of this test, you can accurately diagnose and choose the right management tactics.

I also said there that during pregnancy not only gestational diabetes can occur, which is caused directly by the state of pregnancy, but also manifest diabetes mellitus, which is caused by other reasons, and pregnancy only provoked its development.

The difference between these types is that gestational diabetes is more sluggish and goes away after childbirth, and with overt diabetes, glycemic indicators are higher, the clinical picture is more pronounced, and it remains forever and does not disappear with childbirth.

Below you can see a table that displays the diagnostic indicators for gestational diabetes. Anything that exceeds these indicators indicates manifest diabetes mellitus type 1 or 2. Click to make it larger.

So, you see that the diagnosis of Gestational Diabetes Mellitus (GDM) is made when fasting sugar is above 5.1 mmol/L, but less than 7.0 mmol/L.

After the glucose test, after 1 hour, blood glucose should not exceed 10.0 mmol/L, and after 2 hours - no more than 8.5 mmol/L.

What are the normal indicators for a pregnant woman I mentioned in the article. I recommend reading it.

How to properly take an analysis (test) for latent diabetes in pregnant women

The test is performed at 24-26 weeks of gestation. First of all, you need to wait for a 10-12 hour period of fasting and get a good night's sleep the night before. No smoking. For the procedure you will need 75 grams of glucose powder and 200 ml of warm water.

1. First, fasting blood sugar is tested
2. After this, dissolve the glucose powder in the brought water and drink it.
3. We sit down in a chair or on a couch in the laboratory reception area and don’t go anywhere.
4. After 1 and 2 hours we donate blood from a vein again.
5. After the third fence you can be free.

Treatment and diet for gestational diabetes in pregnant women

In some cases, nutrition and dieting are already powerful tools in the treatment of gestational diabetes. During pregnancy, all tablet medications are contraindicated, so the only way to lower blood sugar, besides diet, is insulin injections.

But in most cases, it is possible to do without it only by properly adjusting your diet, creating a rational menu, and also increasing feasible physical activity in the form of walking, for example.

Only a few are prescribed insulin and only in two cases:

• failure to achieve target glycemic values ​​within 1-2 weeks with diet alone
• presence of signs of fetal distress according to ultrasound data

What is the diet and nutrition of a woman with diabetes?

While a low-carbohydrate diet is an effective method to normalize blood sugar in a non-pregnant woman, this method is not suitable for a pregnant woman.

Such a woman should not completely deprive herself of carbohydrates, as this will lead to the formation of ketone bodies, which can negatively affect the development of the fetus. But there are still some restrictions. These restrictions are imposed on carbohydrates with a high glycemic index, namely any sweets, bread and flour, potatoes, cereals, sweet fruits (banana, persimmon, grapes).

What can you eat if you have gestational diabetes during pregnancy?

All types of meat and fish, any vegetables except potatoes, whole grains, seasonal local fruits and berries, nuts, mushrooms, and herbs are allowed. Maintain the following protein/fat/carbohydrate ratio. It is important to get high-quality proteins and healthy fats, both plant and animal in equal proportions.

• proteins 30 - 25%
• fats 30%
• carbohydrates 40 - 45%

Various cooking sites offer many recipes and menus, so I won’t go into more details. In addition, it is not always possible to satisfy the tastes of an audience of thousands of blog readers.

What should a pregnant woman's sugar level be (normal)

How do you know if you're doing everything right? Frequent monitoring of blood glucose will help you with this. Be sure to check your blood sugar before each meal, as well as 1 hour after eating; after 2 hours you don’t have to check it. If necessary, you will have to check your sugar at night at 2-3 o'clock.

• fasting sugar should be less than 5.1 mmol/l
• 1 hour after eating should not exceed the level of 7.0 mmol/l
• before going to bed and at night, sugar should be no more than 5.1 mmol/l
• the level of glycated hemoglobin should not be more than 6.0%

Tactics for managing women after childbirth

If a woman has received insulin therapy, then immediately after childbirth this insulin is discontinued. During the first three days, blood glucose is monitored to identify disturbances in carbohydrate metabolism. If your sugar is normal, then you can be calm.

All women who have had GDM should be monitored because they are at increased risk of recurrent GDM or developing type 2 diabetes in the future.

• after 6-12 weeks, a repeat glucose test is performed, only in its classic version (sugar is checked only on an empty stomach and 2 hours after exercise)
• It is recommended to adhere to a low-water diet (but not ketosis) in order to lose weight, if any.
• increased physical activity
• planning subsequent pregnancies

That's all for me. Good sugars and easy labor. Click on the social buttons. networks if you liked the article and found it useful. so as not to miss the release of new articles. See you again!

With warmth and care, endocrinologist Lebedeva Dilyara Ilgizovna

Gestational diabetes is a type of disease that occurs only in pregnant women. Its appearance is explained by the fact that a carbohydrate metabolism disorder occurs in the body of the expectant mother. Pathology is often diagnosed in the second half of the term.

How and why gestational diabetes occurs during pregnancy

The disease develops due to the fact that the female body reduces the perception of tissues and cells to its own insulin.

The reason for this phenomenon is said to be an increase in the level of hormones in the blood that are produced during pregnancy.

During this period, sugar decreases due to the fact that the fetus and placenta need it.

The pancreas begins to produce more insulin. If the body does not have enough of it, gestational diabetes mellitus develops during pregnancy.

In most cases, after the birth of a child, a woman's blood pressure returns to normal.

Studies in the United States show that this disease develops in 4% of pregnant women.

In Europe, this figure ranges from 1% to 14%.

It is worth noting that in 10% of cases, after the birth of a baby, signs of pathology develop into type 2 diabetes mellitus.

Consequences of GDM during pregnancy

The main danger of the disease is that the fruit is too large. It can be from 4.5 to 6 kilograms.

This can lead to a difficult birth, during which it will be necessary. Large children have an increased risk of obesity later in life.

Even more dangerous consequences of diabetes in pregnant women include an increased risk of developing diabetes.

This complication is characterized by high blood pressure, a large amount of blood, and swelling.

All this poses a threat to the life of mother and child. Sometimes doctors have to be called.

If the fetus is overweight, breathing problems may develop and muscle tone decreases. The sucking reflex is also suppressed, swelling and jaundice appear.

This condition is called diabetic fetopathy. It can lead in the future to heart failure and retardation in mental and physical development.

What causes gestational diabetes

This disease is more likely to occur in women with:

• extra pounds;
• carbohydrate metabolism disorders;
• diseases of the cardiovascular system;
• heavy;
• carrying twins or triplets;
• GDM in previous pregnancies.

The age of the expectant mother also influences the development of the disease. Most often it occurs in women giving birth over 30 years of age. The cause of the pathology can also be diabetes in one of the parents.

The birth of a previous child can also influence the formation of pathology. The fetus could be overweight or stillborn.

Chronic miscarriage from previous pregnancies may also be affected.

Diagnosis of the disease

The diagnosis of gestational diabetes mellitus during pregnancy indicates that before conception, blood glucose levels were normal.

Symptoms

There are no main symptoms of gestational diabetes mellitus during pregnancy.

The disease can also manifest itself with frequent urination. But you shouldn't rely too much on these symptoms.

Laboratory readings

To perform a glucose tolerance test, blood is taken several times over a couple of hours. Next, a study is carried out using a solution of 50, 75 or 100 grams of glucose.

When carrying a child, a woman should have a fasting level of 5.1 mmol/l. An hour after eating - 10 mmol/l. And after two - 8.5 mmol/l.

If the indicator is higher, then a diagnosis is made - gestational diabetes mellitus during pregnancy.

Once the disease is detected, you will need to monitor your blood pressure and kidney function.

To check for violations, additional and are prescribed.

Your doctor may recommend purchasing a blood pressure monitor to measure your blood pressure at home.

Principle of treatment of GDM in pregnant women

At the first signs of gestational diabetes during pregnancy, the main treatment is prescribed - diet.

If necessary, it is supplemented with insulin injections. The dose is calculated individually.

For this disease, doctors mainly prescribe.

If a disease is detected, the patient should be monitored by an endocrinologist and a nutritionist. If she experiences psychological outbursts, it would be a good idea to consult with a psychologist.

It is important to remember that you should not take medications that lower your sugar.

Diet and daily routine during pregnancy with GDM

During the diet, the caloric content of the diet decreases.

You need to eat 5-6 times in small portions or eat main portions 3 times a day, making snacks 3-4 times between them.

Main courses include soups, salads, fish, meat, cereals, and snacks include vegetables, fruits, various desserts or low-fat dairy products.

When choosing food products, the expectant mother needs to ensure that her baby receives the microelements necessary for its development. Therefore, if a pregnant woman decides to create a menu herself, then she should study information about how people with type 1 and type 2 diabetes eat.

During the diet, carbohydrates should be replaced with proteins and healthy fats.

For the entire period of bearing the baby, it is necessary to exclude sweets, bread, buns, pasta and potatoes from the diet. You should also avoid rice and some types of fruits.

Dishes must be simple. This will help avoid overloading the pancreas.

Try to eat as little fried food, canned food, and everyone’s favorite fast foods as possible. It is worth giving up semi-finished products.

Calorie intake per day

Typically this is 35-40 calories per kilogram of a woman's weight. For example, if her weight is 70 kg, then the norm will be 2450-2800 kcal.

It is advisable to keep a food diary throughout the entire period. This can track at the end of the day whether the norm has been exceeded.

If you feel hungry between meals, you should drink water in small sips. Every day you should drink at least 2 liters of ordinary water.

Course of labor and postpartum control in GDM

Types 1 and 2 diabetes are not contraindications to labor; therefore, even with GDM, delivery occurs without problems.

The only risk is an overly large fetus, which may require a caesarean section.

Independent childbirth is allowed if the situation has not worsened over the past 24 hours.

Only if there are no natural births or the pregnant woman is past her due date.

After birth, your baby may have low blood sugar. It is compensated by nutrition.

Medication treatment is often not required.

For some time the child will be under the supervision of doctors. This is necessary to identify whether there are any disorders due to glucose failure in the mother.

Usually, after the placenta is delivered, the woman’s condition returns to normal. There are no spikes in blood glucose levels. But still, during the first month, you need to stick to the diet that was before the birth of the child.

It is better to plan the next birth only after a couple of years. This will help the body recover and prevent the occurrence of serious pathologies.

Before conception, you should undergo an examination and tell your gynecologist about GDM during your first pregnancy.

The appearance of this disease during pregnancy indicates that the woman has poor sensitivity to insulin. This increases the risk of developing diabetes and vascular pathologies after childbirth. Therefore, it is important to prevent the disease.

After giving birth, at 6-12 weeks you need to take a sugar test again. Even if it is normal, it should be checked every 3 years in the future.

Video: gestational diabetes mellitus during pregnancy