Gestational diabetes in pregnancy: symptoms, causes and treatment
Gestational diabetes differs from ordinary diabetes in that it occurs for the first time during pregnancy.And this is not so rare, because during this period, the woman's metabolism is fundamentally confounded, and not always for the better.
The incidence of gestational diabetes is 4-6% of the total number of pregnant women.Already after birth, the metabolism usually comes back to normal, but the likelihood of developing a "classic" diabetes remains higher than that of women who do not experience similar problems during childbearing.Table of Contents: Causes of gestational diabetes What is dangerous for gestational diabetes? Diabetes mellitus in pregnancy: symptoms and diagnosis Treatment of diabetes in pregnant women Preventing diabetes in pregnancy
Causes of gestational diabetes
Why in the course of pregnancy earlier normal metabolism may changeSo that there are manifestations of diabetes? The risk of detecting this formidable disease is increased due to hormonal adjustment, most often in the second or third trimester.
However, gestational diabetes does not develop in all future mothers, but only in the presence of separate prerequisites.
The most common factors for the development of the disease are:
- obese woman.The body mass index from 25 to 29 raises the probability of diabetes in pregnant women by half, and more than 30 - by three times;
- presence of diabetes in relatives, i.e.Genetic predisposition.This factor increases the risk of developing the disease by 1.5 times;
- the age of the pregnant is over 30 years.After a 40-year-old age, the risk of gestational diabetes is approximately doubled compared to women in the 25-29 age group;
- birth of the previous baby with a body weight of more than 4 kg;
- development of gestational diabetes in a previous pregnancy;
- cases of miscarriages or stillbirths in previous pregnancies.
In the presence of such prerequisites, you should closely monitor your condition and regularly use the meter.
What is dangerous is gestational diabetes
Diabetes, which develops during pregnancy, is dangerous for its extremely serious complications.And it's not just an increase in the level of glucose in the bloodstream, but in the development of late gestosis - a condition in which swelling arises, kidney work is disrupted, blood pressure is excessively increased, and the state of vision is disturbed.
In case of untimely care, the occurrence of a state of pre-eclampsia may occur, when the pregnant woman suddenly rises pressure to the highest values, "flies" appear before her eyes, there is a headache, and the risk of losing consciousness increases.Soon, an even more dangerous critical condition may occur-eclampsia, accompanied by convulsions, fainting, and even the risk of a fatal outcome.
Diabetes is dangerous in pregnancy and for the fetus.
Possible violations in the condition and development of the developing child:
- risk of miscarriage or certain congenital malformations( if diabetes occurs at a relatively early period);
- excessive increase in fetal body weight.A child can be born so large that the birth in a natural way will be a danger to the life of a woman.In such cases, caesarean section can not be avoided, so a woman should better control her weight and the condition of the baby when she visits the doctor;
- violation of body proportions: too thin limbs and a fairly large belly;
- excessive deposition of subcutaneous fat;
- swelling of the tissues;
- jaundice of the skin;
- respiratory disorders;
- baby hypoglycemia immediately after birth;
- risk of blood clots due to increased blood viscosity;
- inadequate magnesium and calcium in the fetal blood.
These signs indicate the development of diabetic fetopathy - a violation of the fetus, and later - a newborn baby.Similar manifestations arise because of a pathological change in carbohydrate metabolism in the mother's body.
Diabetes mellitus in pregnancy: symptoms and diagnosis
Gestational diabetes usually develops between 16 and 32-33 weeks of gestation.The earlier manifestations of pathological disorders, the more severe the disease.
The guile of gestational diabetes is that it occurs in many cases asymptomatically.This is why a glucose tolerance test is prescribed for all future mothers at the time between 6 and 7 months of pregnancy to detect this disease.This study shows how qualitatively and fully absorbed glucose by the body of a woman.
Important! If the test results show that the sugar level during fasting analysis already exceeds 5.1 mmol / l, and one hour after eating - more than 10 mmol / l, then 2 hours later - over 8.5 mmol / l, Then with high probability it can be said that the woman has gestational diabetes.
This analysis is prescribed even for healthy women who are not prone to diabetic manifestations. If there are risk factors, glucose analysis should be submitted more often.
If the disease is not diagnosed in a timely manner, such symptoms may develop, so an increase in thirst, an increase in the volume of urine, a general weakness.
Further complications may occur, in particular, signs of gestosis.These are high blood pressure, impaired kidney function, hyper- or hypoglycemia, visual impairment.
Treatment of diabetes in pregnant women
Combating diabetes, diagnosed for the first time in pregnancy, consists of the following:
- Compliance with the diet.
- Blood glucose monitoring.
- Moderate physical activity.
- Admission of special drugs( in consultation with the endocrinologist).
In 70% of pregnant women, diabetes can be eliminated by changing the diet.
The menu should meet the following requirements:
- the share of carbohydrates is 35-40%, proteins - 20-25%, and fats - 35-40%;
- caloric intake is about 25 kcal per 1 kg of body weight of a pregnant woman in the presence of obesity or 30-35 kcal per 1 kg of weight - with a normal build;
- food - in small portions, but often to avoid too sudden jumps in sugar levels;
- an exception or a noticeable restriction of digestible carbohydrates, primarily sweets;
- rejection of fast food, fried and too fatty food;
- inclusion in the menu of a sufficient amount of foods rich in fiber.
Regular use of the meter will allow even at home to notice the alarming signs of hyperglycemia in time and consult a doctor.
Of course, intensive maternity exercises are contraindicated, but regular walks in the absence of contraindications are simply irreplaceable. It is also useful swimming in the pool, but about the exercises "on the press" should be forgotten for the entire period of pregnancy.It is also necessary to take care of safety during classes, therefore, traumatic sports or exercise should be avoided.With a deterioration in the state of health from any motor activity should be abandoned. It should also be taken into account that during exercise, the level of sugar may decrease due to the increased work of muscles, so on the eve of training you should eat an apple or a small sandwich, and also have a bag of juice or another sweet drink with you.
If the glucose level can not be adjusted by a special diet, injecting medications are prescribed to normalize this indicator.It is not necessary to take such medications on their own - this can lead to the opposite state - hypoglycemia, i.e.An abnormally dangerous decrease in the level of sugar, which is fraught with loss of consciousness.It should be borne in mind that during pregnancy, insulin-containing drugs in the form of tablets are prohibited, only an injection method of administration is allowed.
In case of complications, the pregnant woman is subject to urgent hospitalization.In this case, measures are taken to stabilize the level of glucose, normalize blood pressure, restore the kidneys, eliminate edema and get rid of other manifestations of gestosis, often accompanying diabetes.
Prevention of diabetes in pregnancy
The implementation of preventive measures to prevent the development of diabetes during childbearing is especially important for women at risk, but such advice will not be superfluous for all expectant mothers.
To minimize the risk of a pathological increase in glucose levels during pregnancy, it is recommended that:
- observe moderation in nutrition to prevent excessive weight gain during the period of gestation;
- regular physical activity, characterized by moderation.This is physical work at home( except for lifting weights), walking, exercise for pregnant women;
- refusal from abuse of honey, refined sugar, animal fats and salt;
- if the first pregnancy has already been diagnosed with gestational diabetes, then the second child should be planned later than two years after the previous birth.
Important ! Even if the emergence of dangerous gestational diabetes could not be avoided, after the birth, everything should come back to normal.But in order to significantly reduce the likelihood of gradual development of ordinary diabetes in the future, for some time after the appearance of the baby the woman should continue to follow the prescribed diet.Thanks to a balanced diet, the metabolism soon normalizes.
Do not forget about the subsequent control of the sugar level so as not to miss the possible appearance of symptoms of type 2 diabetes.However, if you follow all the recommendations on nutrition and physical activity, the risk of developing the disease will be minimal.
Chumachenko Olga, medical reviewer