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 can be identified violation of the sensitivity of body cells to insulin, associated with a high content of hormones in the blood.
After delivery, sugar 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 the birth.
Disease feature
Gestational diabetes - a disease associated with an increase in sugar, can occur at any time in pregnant women. Basically, such a problem is observed in the second half of pregnancy, while exerting a great influence on the condition of the fetus and woman.
Studies have shown a close relationship between the gestational type of the disease and the development of type 2 diabetes in adulthood. The risk is especially high if there are additional risk factors, in particular such as malnutrition, obesity and others.
What are the types of disease
It is possible to determine whether diabetes is gestational or true, only after the birth of a child. Before identifying a feature 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 their varieties.
Type 1 diabetes is a typical autoimmune disease that often occurs as a result of a virus infection. As a result of this, inflammation develops, which leads to the destruction of the pancreas. It is she who produces insulin. When more than 80% of thyroid cells are affected, signs of type 1 diabetes appear.
Type 2 pathology is formed against the background of a genetic predisposition. Provoking factors include:
- overweight;
- sedentary lifestyle;
- violation of the rules and diet;
- stresses.
In this type of diabetes, the insulin index remains normal, but the body cannot perceive it. This leads to many health problems. Excessive body weight is characteristic enough. Obesity is associated with impaired fat metabolism as a result of increased insulin levels.
Gestational diabetes is inherently similar to type 2 disease. High levels of hormones during pregnancy lead to insulin resistance. However, it is worth noting that this disease does not develop in all women.
Development reasons
A pregnant woman experiences various hormonal changes, which can provoke a variety of disturbances 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 hormonal disorders and changes in the body. During this same period, the pancreas begins to more actively produce insulin in order to maintain normal glucose readings. If a woman’s body does not cope with such a volume, then a diagnosis of gestational diabetes is established.
At risk are women suffering from various disorders, in particular, they include:
- excessive body weight;
- increased 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 contact a doctor to prevent the occurrence of dangerous complications.
The main symptoms
Quite often, excess 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 other types of diabetes. The degree of complexity of these manifestations depends largely on the performance of sugar. Among the main features can be identified such as:
- dry mouth
- itchy skin;
- 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 performed to determine it. This is necessary to determine the tactics of the treatment. It mainly proceeds not too pronounced and passes after childbirth.
Diagnostics
In order to accurately establish the diagnosis of gestational diabetes mellitus, an appropriate study should be conducted. Initially, you need to assess the risk of developing the disease. When a woman is registered for 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 of pregnancy. Be sure to take a blood sampling to determine the amount of sugar. In gestational diabetes, fasting glucose values are 5.3 mmol / L. That is why it is often prescribed to conduct a special test, since exceeding only one indicator does not give a basis for a final diagnosis.
With gestational diabetes, 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 24-28th week of pregnancy, when there is a change in hormonal levels. Concurrently with the glucose tolerance test, regular urine tests for sugar are also indicated.
Treatment features
Treatment of gestational diabetes in pregnant women requires compliance with certain rules so as not to harm the baby and minimize harm to the woman herself. Be sure to have a daily glucose test. Measurements need to be made on an empty stomach, as well as 2 hours after eating.
Pregnant women are prescribed a certain diet for gestational diabetes, and they also need to follow a dietary regimen selected by the doctor. It is necessary to take certain medications prescribed by a doctor. If necessary, pregnant women are injected with 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 prevent its increase.
It is important to regularly monitor your blood pressure, and immediately report all changes in the body to the doctor.
Drug treatment
With gestational diabetes in pregnant women, treatment should be started as soon as possible. Therapy should be prescribed only by the attending doctor. It is much easier to stop the course of the disease and prevent the occurrence of complications if you notice symptoms in a timely manner. In some cases, insulin therapy may be required.
Many medications that help ease the course of 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 administration of insulin is required, then do not wipe the injection site with alcohol, since it destroys this hormone.
Physical exercise
Physical activity helps to slightly lower the sugar content, which is why you need to constantly monitor its level so that there is no attack of hypoglycemia. Positive effect on the well-being of swimming and walking.
Classes must necessarily bring great pleasure, it is important to exclude the possibility of injury. Unacceptable strain on the stomach, as well as strength exercises. After physical activity, a woman should feel alert, 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 to convey the child without special consequences. First of all, a woman needs to take care of her own weight in order to slightly increase the production of insulin.
However, starvation is strictly contraindicated, since it is important that the fetus receives all the required nutrients, pay attention to the nutritional value of products, but at the same time you need to refuse high-calorie foods. You need to eat in small portions, but often.
Nutrition for gestational diabetes must necessarily be correct, so you need to give up fried and fatty foods, as well as foods that include a lot of easily digestible carbohydrates. After absorption into the blood, they can dramatically increase glucose values. Moreover, such products have almost no nutritional value. To cope with their processing, you will need a lot of insulin, which is not enough for diabetes.
With morning toxicosis, it is recommended that before you get out of bed, eat a few salty crackers, and then you can perform all morning procedures. Diet for gestational diabetes during pregnancy should not be too strict, but it is necessary to abandon instant foods. After their use, sugar levels increase sharply.
During pregnancy, you need to eat a lot of fiber-rich foods. These include fresh vegetables, fruits, bread, cereals, cereal dishes. Fiber is very useful for pregnant women, not only patients with diabetes. 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 decrease in the amount of fat entering the body. Fatty foods should be completely eliminated from the usual diet. It is also undesirable to eat smoked meats and sausages. Meat must be cooked exclusively in vegetable oil, boiled or baked in the oven. Fat must first be removed.
During pregnancy with gestational diabetes, a diet implies a properly organized drinking regimen. A day you need to drink at least 1.5 liters of any liquid without gas. To replenish the amount of vitamins without harm to health, salads prepared from fresh vegetables will help. If a diet for gestational diabetes does not help regulate blood sugar, the doctor may prescribe insulin injections. In the event of adverse effects, treatment of the pregnant woman can be continued in a hospital.
If gestational diabetes mellitus 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 products such as:
- sweets and pastries;
- jam;
- honey;
- juices and syrups;
- sweet fruits;
- carbonated drinks.
The total weight gain for the entire pregnancy should be no more than 12 kg for a woman with a normal weight and not more than 8 kg for obesity.
Possible complications
Gestational diabetes in pregnant women can cause many 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 can develop due to pre-existing diabetes.
Often there may be a complication in the form of placental insufficiency, which often happens 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 fetal oxygen starvation. In addition, this can lead to a delay in the development of the baby.
One of the most serious complications is premature placental abruption. The occurrence of this pathology leads to a violation of microcirculation, observed against a background of vasospasm. This condition can lead to heavy bleeding and even fetal death.
Gestational diabetes during pregnancy can be quite acute, and as a result, gestosis develops. This is a kind of complication, characterized by increased pressure and impaired renal function. Many women already at a period of 24-26 weeks notice signs of the course of this disease. Gestosis in combination with diabetes provokes many problems throughout pregnancy.
In most expectant mothers, gestational diabetes during pregnancy leads to polyhydramnios. With the occurrence of this pathology, the amount of amniotic fluid increases sharply. This very badly affects the general condition of the fetus, disrupting its normal location in the uterus. Often, a child occupies a transverse or oblique position, and it can only be removed using cesarean section.
Effects on childbirth
After childbirth and subject to a diet, gestational diabetes mellitus gradually disappears and only in 20% of cases develops into a disease of type 1 or 2. 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. Larger sizes can cause certain problems during childbirth. Often in such cases, caesarean section is indicated. If the birth occurs naturally, then there is a high risk of injury to the shoulder joint of the infant. In addition, these children may develop diabetes in the future.
In such children, blood sugar is almost always lowered, but gradually this lack is compensated for by properly organized feeding. The baby should be closely monitored and glucose measured regularly.
Effect on the fetus
The 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 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, the child's body develops its own insulin, and if it is not enough, then asphyxiation, respiratory disorders, hypoglycemic state may occur. With increased blood sugar in the mother, the child will suffer from a lack of oxygen and important nutrients throughout her pregnancy. The brain suffers greatly from a regular lack of oxygen, leading to encephalopathy and many other serious disorders.
A special complication is diabetic fetopathy. Children born with a similar pathology have a appearance that is quite characteristic for this violation, namely:
- heavy weight;
- a lot of cheese-like grease on the skin;
- crimson or cyanotic shade of the skin;
- soft tissue swelling;
- minor subcutaneous hemorrhages;
- puffiness of the face.
Despite their large size, such children are born very weak. Many have shortness of breath and even respiratory arrest literally immediately after birth. Long jaundice associated with damage and pathological changes in liver cells is also characteristic. Most babies have various kinds of neurological disorders, in particular such as:
- decreased muscle tone;
- excessive excitability;
- oppression of reflexes.
A particularly dangerous condition is a decrease in glucose. It can threaten a coma or even the death of the baby.
Birth management
With gestational diabetes, the optimal term for delivery is 37-38 weeks of gestation. Delaying beyond the prescribed period is very dangerous, as there may be insufficient functioning of the placenta and the depletion of its resources. Specialists recommend pre-planning births in a specialized hospital, as it has the necessary equipment for timely assistance to the newborn.
Basically, childbirth occurs naturally, with the exception of only the large size of the fetus, nephropathy, gestosis and other disorders. Often during the delivery or operation, insulin therapy is performed.
Prophylaxis
For women who are at the highest risk for gestational diabetes, diet is indicated as a preventative measure first. In addition, you need to register as soon as possible and be very responsible to all the doctor's recommendations. .
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