The diagnosis of diabetes mellitus sounds threatening to any person.
Even people who are completely unfamiliar with the theoretical foundations of medicine know about the dangerous consequences of pathology. And if diabetes is diagnosed during pregnancy, anxiety doubles. And not in vain.
After all, changes in the body with diabetes threaten not only a pregnant woman, but also an unborn child.
Only exact adherence to the recommendations of doctors with diabetes during pregnancy will allow you to safely endure and give birth to a healthy baby.
Causes of diabetes during pregnancy
Glucose - an indispensable element that is required for normal functioning of all organs of the human body. It provides energy, nourishes the brain, regulates muscle activity. However, an excess of undigested glucose negatively affects both general well-being and the work of almost all systems.
For rational metabolism, including glucose uptake, insulin is responsible, which is able to open any cell and give way to glucose as a "magic key". The pancreas produces insulin, which simultaneously performs the digestive and endocrine functions.
Diabetes is diagnosed in the presence of a large level of undigested glucose.
Such a pathology occurs if:
• an excess amount of glucose-containing products enters the body, with which the pancreas is not able to cope, which with prolonged and frequent repetitions leads to pathology;
• with low production of insulin, insufficient for sugar processing, which is associated with problems of the pancreas itself.
During pregnancy, cardinal changes in the hormonal background occur. The production of certain hormones is essential for the successful bearing of the fetus, but at the same time, these fluctuations can adversely affect other processes that occur in the pregnant body.
Factors contributing to the appearance of pathology include:
1. Increased production of the formed placenta hormones estiol and lactogen. These hormones are essential for the further successful development of the fetus. But they have a contra -insulin property, which inhibits the functional abilities of the pancreas.
2. Elevated levels of cortisol and progesterone, which are reflected in carbohydrate metabolism. These hormones are considered diabetic.
3. Features of a pregnant woman’s lifestyle. Many women are fond of high-calorie nutrition, trying to feed themselves and the baby, reduce physical activity, become clumsy and difficult to lift. All these factors lead to weight gain and inhibition of metabolic processes.
Therefore, in pregnant women after 16 weeks, due to a combination of all the unfavorable factors, increased insulin resistance is observed. When laboratory tests confirm high sugar levels, pregnant women are diagnosed with gestational diabetes. If the diagnosis of diabetes mellitus during pregnancy was made earlier than this period, then the ailment was present even before pregnancy and was not associated with changes in the body.
This does not mean that every pregnant woman is faced with diabetes problems. But there is a risk group when the likelihood of pathology is quite high.
The likelihood of gestational diabetes during pregnancy is high:
• overweight women;
• with a hereditary predisposition;
• during late pregnancy after 35 years;
• if there have been previous pathological pregnancies with fetal sinking, miscarriages, pathologies;
• if the previous pregnancy was accompanied by polyhydramnios, gestational diabetes;
• at the previous delivery, a large fetus above 4 kg or with malformations;
• with polycystic ovary.
Diagnosis of diabetes during pregnancy
First of all, a pregnant woman herself may suggest the presence of high sugar for vivid symptoms:
• excessive fatigue;
• general malaise;
• weight loss;
• lack of appetite;
• intense thirst;
• frequent urination;
• dry mouth.
However, such signs are given little importance. Feeling sick is attributed to the features of the course of pregnancy.
Laboratory blood tests can determine the level of sugar.
For all pregnant women from 24 to 28 weeks, mandatory glucose tolerance screening.
During the examination, oral test, which takes place in several stages:
1. An analysis of venous blood for the presence of fasting sugar. Prior to the examination, the woman is advised not to eat food in the evening. Results should not exceed 5.3 mmol / L. However, such a survey is not informative.
2. At the next stage, the pregnant woman is given a glucose-containing drink, which is prepared from 200 ml of water and 75 g. dry glucose. An hour later, venous blood is drawn. In this case, indicators not exceeding 10 mmol / L are considered normal.
3. Repeated analysis is carried out two hours after glucose intake. Sugar levels should be below 8 mmol / L.
If the test results differ from the norm, the pregnant woman is diagnosed with gestational diabetes. For reinsurance, it is recommended to repeat the examination after two weeks.
For a risk group, it is advisable to do testing twice during pregnancy: at 16-18 weeks and at 24-28 weeks.
Treatment for diabetes during pregnancy
It would be regrettable, but the life of a woman with diabetes during pregnancy becomes completely subject to this problem. You will have to constantly keep your finger on the pulse and prevent sugar surges. The endocrinologist will surely select an acceptable course of therapy, which will need to be clearly followed in order to avoid negative consequences.
With low sugar levels, it is enough to change the lifestyle to keep the disease within the acceptable range. For this, pregnant women with diabetes are recommended a special way of eating. In addition, it is imperative to include in your life motor activity, which helps to cope with the manifestations of pathology.
Exercise helps keep sugar normal.
Nutrition of a pregnant woman with diabetes
When choosing a diet, a pregnant woman with diabetes should strictly follow the requirements:
1. You need to eat quite often. The ideal option is fractional nutrition. Long breaks between meals should not be allowed.
2. Each meal should contain slow carbohydrates, which will maintain sugar levels.
3. Half of the diet should consist of healthy carbohydrates, on proteins account for up to 20% and fats up to 30%.
4. From the diet completely exclude foods with empty calories. These include sweets, fatty foods, convenience foods, instant meals, industrial juices and drinks.
5. The combination of sugar and fat is the worst enemy diabetics. Therefore, you have to forget about cakes and pastries.
6. An important role in clinical nutrition plays cellulose. The diet should have a sufficient amount of vegetables, unsweetened fruits, cereals.
And only in the absence of positive dynamics and at high, threatening levels of blood sugar doctor may recommend insulin injections. Do not be afraid of such an appointment. The drug is not harmful to either the mother or the fetus. During pregnancy, it is forbidden to take tablets to reduce sugar. Therefore, even those women who took such drugs before pregnancy are transferred to insulin.
Artificial insulin - it's still protein. It can be administered only by injection. If insulin entered the body through the stomach, the enzymes present in the gastric juice would completely destroy it along the way. There is a special scheme for the use of injections, which is developed individually by the doctor.
Pregnant with diabetes recommended keep a diary of observations, in which it is necessary to fix:
• daily sugar readings determined using a glucometer;
• time and type of injection;
• changes in well-being and its dependence on food intake and physical activity.
How dangerous is diabetes during pregnancy for an unborn baby?
When diabetes occurs during pregnancy the risks of various pathologies fetus. But they are associated with uncompensated diabetes. If you control the sugar level and maintain its content within acceptable limits, the possibility of deviations is minimal.
Negative pathologies in the fetus are manifested:
1. In the early stages, when the child’s own pancreas has not yet been formed, the constantly high level of glucose that the fetus receives with the mother’s blood provokes a lack of energy. This affects the development and manifests itself in the improper development of systems and organs.
2. When the pancreas is formed, which occurs in the second trimester, insulin production is too high. This is due to the fact that the endocrine system of the fetus works both for itself and to compensate for the deficiency of the hormone in the mother. Hyperinsulinemia, resulting from inadequate work of the pancreas of the fetus, threatens the hypoglycemic state of the child after childbirth, the appearance of pathologies of the respiratory tract and asphyxiation.
3. Hypoglycemia (low sugar) causes a slowdown in the mental development of the baby.
4. The presence of a high level of glucose provokes obesity of the fetus. Often children are born with a weight exceeding 4 kg.
In addition, there are threats to the pregnant woman with diabeteswhich appear in the form:
• development of gestosis with pathologies of the vascular system and malnutrition of the fetus;
• the occurrence of polyhydramnios;
• frozen pregnancy;
• the occurrence of ketoacidosis with poisoning of the body;
• development of pathologies of the kidneys, vision.
Diabetes during pregnancy and the specificity of childbirth
Risks during delivery appear if the fetus has reached a fairly large size under the influence of diabetes during pregnancy. In this case, the likelihood of birth injuries in both the child and the woman is high. Therefore, in such situations, doctors resort to a cesarean section, for which a woman is hospitalized in advance. The operation is carried out at 37-38 weeks.
Cesarean section can also be resorted to in the presence of severe insulin-dependent diabetes mellitus. This helps to prevent the appearance of unforeseen changes in the state of a woman in childbirth, which is associated with an emotional factor affecting the production of hormones.
With good compensation for diabetes during pregnancy, a woman is able to deliver the baby before the due date and give birth without surgery.
In the postpartum period, sugar levels are monitored in both the mother and the newborn. In a baby, sugar deficiency is compensated by nutrition and gradually returns to normal. In a woman with gestational diabetes, in most cases, the symptomatology disappears, since with the release of the placenta, the factor provoking the pathology disappears. However, there are cases when gestational diabetes of pregnant women after childbirth develops into normal diabetes.
For a woman, there remains a risk of type 2 diabetes in the future. But compliance with diet and physical activity avoids this unpleasant disease.
