Gestational diabetes during pregnancy is not so common, but it is very dangerous, as it provokes various complications. It is a violation of the perception of glucose by the body. Among the main reasons, one can single out a violation of the sensitivity of body cells to insulin, associated with a high content of hormones in the blood.
After delivery, the sugar level often returns to normal. However, the possibility of developing type 1 and type 2 diabetes cannot be ruled out. Diagnosis of these diseases is carried out after childbirth.
Feature of the disease
Gestational diabetes - a disease associated with an increase in sugar levels, can occur at any time in pregnant women. Basically, such a problem is observed in the second half of pregnancy, while having a great impact on the condition of the fetus and woman.
Ongoing studies have shown a strong link between gestational disease and the development of type 2 diabetes later in life. The risk is especially high if there are additionalrisk factors, such as malnutrition, obesity and others.
What are the types of disease
Determining whether diabetes is gestational or true, is possible only after the birth of the child. Before you designate the peculiarity of the course of the disease, it is worth understanding exactly how it manifests itself outside of pregnancy. The causes, development and principle of therapy are determined by the type of diabetes. Their symptoms are similar, and only a thorough diagnosis will distinguish between their varieties.
Type 1 diabetes is a typical autoimmune disease that often results from infection with viruses. As a result, inflammation develops, which leads to the destruction of the pancreas. It is she who produces insulin. If more than 80% of the thyroid cells are affected, signs of type 1 diabetes appear.
Pathology type 2 is formed against the background of a genetic predisposition. Provoking factors include:
- excessive weight;
- sedentary lifestyle;
- violation of the rules and diet;
- stress.
In this type of diabetes, the level of insulin remains normal, but the body cannot perceive it. This leads to many he alth problems. Quite characteristic is excessive body weight. Obesity is associated with a violation of fat metabolism as a result of high levels of insulin.
Gestational diabetes is essentially similar to type 2 diabetes. High hormone levels during pregnancy lead to insulin resistance. However, it is worthIt should be noted that not all women develop this disease.
Reason for development
A pregnant woman experiences various hormonal changes, which can provoke a variety of disorders in the functioning of the body. Among these manifestations, there may be a decrease in the absorption of sugar by body tissues.
Gestational diabetes often occurs much later in pregnancy due to ongoing hormonal imbalances and changes in the body. During this very period, the pancreas begins to more actively produce insulin in order to maintain the changed glucose levels in a normal state. If a woman's body cannot cope with such a volume, then a diagnosis of gestational diabetes is made.
At risk are women suffering from various disorders, in particular, they include:
- excessive body weight;
- elevated glucose;
- prediabetes;
- hereditary predisposition;
- stillbirth in a previous pregnancy;
- polyhydramnios.
Knowing all these reasons for the formation of gestational diabetes in pregnant women, you can consult a doctor to prevent the occurrence of dangerous complications.
Main symptoms
Quite often, the excess of glucose during this period is almost asymptomatic, and if any signs appear, they are often attributed to the pregnancy itself. The main symptoms of gestational diabetes are exactly the same as those ofanother type of diabetes. The degree of complexity of these manifestations depends largely on the indicators of sugar. Among the main signs, one can distinguish such as:
- dry mouth;
- skin itching;
- frequent urination;
- quick weight gain;
- thrush;
- drowsiness and weakness.
Such manifestations are often the norm during pregnancy, and therefore absolutely every woman takes urine and blood tests for early diagnosis of an existing carbohydrate disorder.
With gestational diabetes, sugar rises slightly, which is why a special test is carried out to determine it. This is necessary to determine the tactics of treatment. It is mostly mild and goes away after childbirth.
Diagnostics
To accurately establish the diagnosis of "gestational diabetes", you need to conduct an appropriate study. Initially, you need to assess the degree of risk of developing the disease. When registering a woman for a consultation, a number of indicators are evaluated, in particular, such as:
- age and weight;
- obstetric history;
- family history.
Having determined the degree of risk of developing disorders, the doctor selects the required tactics for managing pregnancy. Be sure to take a blood sample to determine the amount of sugar. In gestational diabetes, fasting glucose levels are 5.3 mmol/L. That is why a special test is often prescribed, since exceeding only oneindicator does not provide a basis for the final diagnosis.
When gestational diabetes occurs, sugar levels are exceeded for a long time. If the results of the study remain normal, then the second test is carried out at about the 24-28th week of pregnancy, when a change in hormonal levels is observed. Simultaneously with the glucose tolerance test, a regular urine test for sugar is also indicated.
Features of treatment
Treatment of gestational diabetes mellitus in pregnant women requires compliance with certain rules in order not to harm the child and minimize harm to the woman herself. Be sure to test your glucose daily. Measurements should be taken on an empty stomach, as well as 2 hours after eating.
Pregnant women are prescribed a certain diet for gestational diabetes, and they also require compliance with the diet selected by the doctor. You need to take certain medications prescribed by the doctor. If necessary, pregnant women are given insulin for the normal maintenance of all body functions. Also, do not forget about physical activity and fitness. It is important to monitor your own weight and not allow it to increase.
It is important to regularly monitor your blood pressure, and immediately report any changes in the body to the doctor.
Medicated treatment
Gestational diabetes in pregnant women should be treated as soon as possible. Therapy should be prescribed only by the attending physician. Much easier to stopthe course of the disease and prevent the occurrence of complications if symptoms are noticed in a timely manner. In some cases, insulin therapy may be required.
Many medications that help relieve gestational diabetes during pregnancy are prohibited, which is why only a qualified doctor selects them. It is strictly forbidden to self-medicate.
It is worth noting that not all women need insulin therapy, but only those suffering from a very severe form of the disease. If insulin is required, then do not wipe the injection site with alcohol, as it destroys this hormone.
Physical activity
Physical activity helps to lower the sugar content somewhat, which is why you need to constantly monitor its level so that there is no attack of hypoglycemia. Swimming and walking have a positive effect on well-being.
Classes must bring great pleasure, it is important to exclude the possibility of injury. Loads on the abdomen, as well as strength exercises, are unacceptable. After physical activity, a woman should feel cheerful, not exhausted.
Diet food
Be sure to follow a special diet for gestational diabetes during pregnancy. Only proper nutrition and adherence to a strict regimen will help to cope with the course of the disease and carry the child without any special consequences. First of all, a woman needs to take care of her own weight in order to slightly increase the productioninsulin.
At the same time, fasting is strictly contraindicated, as it is important that the fetus receives all the required nutrients, pay attention to the nutritional value of foods, but at the same time you need to give up high-calorie foods. You need to eat small portions, but often.
Nutrition for gestational diabetes must be correct, so you need to avoid fried and fatty foods as much as possible, as well as foods that contain a lot of easily digestible carbohydrates. After being absorbed into the blood, they can dramatically increase glucose levels. At the same time, such products have almost no nutritional value. To cope with their processing, you will need a lot of insulin, which is not enough in diabetes.
With morning sickness, it is recommended to eat a few s alty crackers before getting out of bed, and after that you can do all the morning procedures. The diet for gestational diabetes during pregnancy should not be too strict, but you should definitely give up fast food. After eating them, sugar levels rise sharply.
During pregnancy, you need to eat a lot of foods rich in fiber. These include fresh vegetables, fruits, bread, cereals, cereal dishes. Fiber is very useful for pregnant women, not just diabetics. In addition, it normalizes the functioning of the intestines, reducing the flow of excess glucose and fat into the blood. Such products contain all the required vitamins and minerals.
Diet for gestational diabetes implies a reduction in the amount of fat entering the body. It is desirable to completely eliminate fatty foods from the usual diet. It is also undesirable to use smoked meats and sausages. Meat should be cooked exclusively in vegetable oil, boiled or baked in the oven. Fat must first be removed.
During pregnancy with gestational diabetes, the diet implies a properly organized drinking regimen. You need to drink at least 1.5 liters of any liquid without gas per day. Salads made from fresh vegetables will help replenish the amount of vitamins without harm to he alth. If the diet for gestational diabetes does not help regulate blood sugar levels, the doctor may prescribe insulin injections. In the event of adverse effects, treatment of a pregnant woman can be continued in a hospital.
If gestational diabetes is observed during pregnancy, the diet is developed strictly individually, while the needs of the woman and the fetus must be taken into account in accordance with the gestational age. From the diet it is desirable to exclude foods such as:
- sweets and pastries;
- jam;
- honey;
- juices and syrups;
- sweet fruits;
- carbonated drinks.
Total weight gain over the entire pregnancy should be no more than 12 kg for a woman of normal weight and no more than 8 kg for obese women.
Possible Complications
Gestational diabetes in pregnant women can triggermany different complications. With the course of the disease in the first trimester, there is a high risk of miscarriage. Such a complication often occurs after 6 weeks and is due to ongoing pathological processes in the altered vessels. This disorder may develop due to pre-existing diabetes.
Often there may be a complication in the form of placental insufficiency, which often occurs after 20 weeks. This complication is associated with a violation of blood microcirculation, which ultimately leads to insufficient supply of oxygen and nutrients to the child. In the third trimester, gestational diabetes often leads to oxygen starvation of the fetus. In addition, it can lead to a delay in the development of the baby.
One of the most serious complications is placental abruption. The occurrence of this pathology leads to a violation of microcirculation, observed against the background of vasospasm. This condition can lead to profuse bleeding and even death of the fetus.
Gestational diabetes during pregnancy can be quite acute, and as a result, preeclampsia develops. This is a kind of complication, characterized by an increase in pressure and a violation of the functioning of the kidneys. Many women already for a period of 24-26 weeks notice signs of the course of this disease. Preeclampsia combined with diabetes provokes many problems throughout pregnancy.
In most expectant mothers, gestational diabetes during pregnancy leads to polyhydramnios. During this pathologythe amount of amniotic fluid increases sharply. This is very bad for the general condition of the fetus, disrupting its normal location in the uterus. Often the baby is in a transverse or oblique position and can only be removed by caesarean section.
Impact on childbirth
Gestational diabetes gradually disappears after childbirth and if the diet is followed, and only in 20% of cases develops into type 1 or 2 disease. However, it is worth noting that such a violation can have an adverse effect on childbirth. Often, when overfeeding the fetus, the baby is born too large. Large sizes can cause certain problems during childbirth. Often in such cases, a caesarean section is indicated. If childbirth occurs naturally, then there is a high risk of injury to the shoulder joint of the baby. In addition, these children may develop diabetes in the future.
These children almost always have low blood sugar, but gradually this shortage is replenished with properly organized feeding. The baby should be closely monitored and glucose measurements should be taken regularly.
Effect on fetus
Features of the ongoing carbohydrate metabolism between the fetus and the pregnant woman are such that the child receives glucose from the mother, but does not receive insulin at all. Thus, an increase in sugar levels is very dangerous, especially in the first trimester, when the fetus does not yet have its own insulin. This provokes the formation of various kinds of defects.
Starting from the 12th week, inthe child's body produces its own insulin, and if it is not enough, then asphyxia, respiratory disorders, and a hypoglycemic state may occur. With high blood sugar in the mother, the child will suffer from a lack of oxygen and important nutrients throughout pregnancy. The brain suffers greatly from a regular lack of oxygen, which leads to encephalopathy and many other serious disorders.
Diabetic fetopathy is considered a special complication. Children born with a similar pathology have a fairly characteristic appearance for this disorder, namely:
- heavy weight;
- lots of cheese lube on skin;
- purple or bluish tint of the skin;
- soft tissue swelling;
- small subcutaneous hemorrhages;
- puffy face.
Despite their large size, these babies are born very weak. Many experience shortness of breath and even respiratory arrest literally immediately after birth. Prolonged jaundice is also characteristic, associated with damage and pathological changes in liver cells. Most babies develop various kinds of neurological disorders, in particular such as:
- decrease in muscle tone;
- excessive excitability;
- inhibition of reflexes.
A particularly dangerous condition is a decrease in glucose levels. It can threaten coma or even death of the baby.
Birth Management
With gestational diabetes, the optimal delivery time will be 37-38 weeks of pregnancy. Tightenlonger than the due date is very dangerous, as there may be insufficient functioning of the placenta and the depletion of its resources. Experts recommend planning childbirth in advance in a specialized hospital, as it has the required equipment to provide timely assistance to the newborn.
Basically, childbirth takes place naturally, with the exception of only the large size of the fetus, nephropathy, preeclampsia and other disorders. Insulin therapy is often given during childbirth or surgery.
Prophylaxis
Women who are in the main risk group for the formation of gestational diabetes, the diet as a preventive measure is shown in the first place. In addition, you need to register as early as possible and take all the recommendations of the doctor very responsibly. The main methods of prevention are the control of sugar and blood pressure.
It is important to organize proper nutrition during pregnancy so that the body of the mother and child receives all the required nutrients, but at the same time does not gain excess weight. In addition, you need to consult a doctor about the need to take vitamin complexes. From the first weeks of pregnancy, you need to be physically active and take time to walk in the fresh air.
