Gestational diabetes mellitus in pregnancy. Diagnosis, manifestations, treatment and diet

All nine months from the moment of conception of the kidare quite a busy period in the life of absolutely every woman. With the appearance of the fetus in the womb, the mother's body needs more strength and energy. Very often it is during this period that the course of all metabolic processes in the body changes. Moreover, often there is gestational insulin dependence.

Fatty tissue, liver, muscles become smallare susceptible to the hormone insulin. If unfavorable conditions arise, sugar in the blood rises, which often leads to the appearance of diabetes. This disease, as a rule, is revealed during the next examination in the women's consultation. At a period of up to 24 weeks for analysis, only venous blood is taken, and in the third trimester a special test is performed - a sugar curve.

general information

Gestational diabetes mellitus in pregnancy -this is a fairly serious disease that requires a competent approach in the treatment. At the heart of this ailment lies the wrong metabolism of carbohydrates, or rather, a decrease in glucose tolerance.

In the US, there have been severalresearch on this issue. According to available information, gestational diabetes mellitus in women is diagnosed in 4% of cases. European scientists announced other information. It is known that the prevalence of this disease varies from 1 to about 14% of the total number of pregnancies. About 10% of ladies after childbirth remain with the symptoms of this ailment, which is subsequently converted into type 2 diabetes.

Such relatively high ratesthe prevalence of pathology around the world testifies, first of all, to the lack of awareness of women about the possible consequences of this disease. As a consequence, only a few seek qualified help from doctors.

What is the threat of diabetes during pregnancy?

First, this negative effect on the fetusinside the mother's womb. In the early stages of diabetes, it can provoke spontaneous miscarriage or lead to the appearance of various vices in the development of the brain structures and the heart of the baby. If the disease was diagnosed at a later date (2-3 trimesters), the probability of excessive fetal growth is very high, which leads to diabetic fetopathy. The main signs of this pathology are the excess body weight (more than 4 kg), respiratory distress, body disproportion, hypoglycemia.

How is pregnancy?

In this case, one can not accurately answer this question.question, since each case is individual. A woman, as a rule, is hospitalized in a hospital three times. For the first time in the early period, she undergoes a full examination, according to which the doctor decides to maintain and manage pregnancy, and prescribes preventive treatment. The second time hospitalization is carried out at a period of 20 weeks, since it is at this time that the first complications may appear. At week 32, the doctor chooses the method and timing of future births.

Who is most affected by this disease?

Gestational diabetes mellitus in pregnancy, as a rule, develops in the presence of a genetic predisposition, which is realized under the influence of several factors, such as:

• Overweight;

• excessive levels of sugar in the urine;

• various kinds of violations of carbohydrate metabolism;

• age (over 30 years);

• previous toxicosis and gestosis;

• various kinds of disorders in the work of the cardiovascular system;

• chronic miscarriage.

Main reasons

Gestational diabetes mellitus in women developsdue to the decrease in the habitual sensitivity of the cells of the body to its own insulin. This is due to the increase in the level of hormones in the blood, which is very often observed during pregnancy. In addition, women are rapidly declining glucose levels, because now it needs both the fetus and the placenta. A consequence of all the above factors is the compensatory increase in the production of insulin directly by the pancreas itself. So, that's why often in the blood of women in the position of these indicators are slightly increased. If the pancreas alone does not cope with its direct duties, namely with the production of the necessary amount of insulin, gestational diabetes mellitus develops.

Symptoms

Increase in the level of sugar in this disease, asthe rule is insignificant. That is why pronounced signs in pregnant women are very rare. In some cases, there is thirst and frequent urination, as well as dry skin. However, all these symptoms are perceived by women as specific features of their situation.

How does the disease confirm?

Diagnosis of gestational diabetes involves a blood test for glucose and a special glucose tolerance test (GTT).

In medicine, there are two types of GTT in dependencefrom the mode of administration of glucose: intravenous and oral. In the second test, the patient is encouraged to drink a sweetened liquid that contains exactly 50 g of sugar. After 20 minutes, her venous blood is taken for analysis (determine the glucose content in her). If the sugar level exceeds the 140 mg / dl level, an intravenous glucose tolerance test will be required.

In carrying out this study, it is very importantobserve certain conditions. First of all, patients are recommended to adhere to usual physical loads and nutrition within five days before the expected date of the test, but the carbohydrate content in the diet should exceed 150 g. It is important to remember that blood sampling is carried out only in the morning and on an empty stomach. The patient is recommended fasting for 14 hours before taking the test. During the research it is better to be quiet.

What should be the treatment?

Gestational diabetes mellitus in pregnancyis often complicated by the fact that a woman has to measure about four times a day the level of glucose. It is important to note that the drug therapy in this case is strictly contraindicated, since it can adversely affect the development of the baby in the womb.

Regarding the issue of treatment, in this caseexperts recommend to adhere to a special diet, regularly check the indicators of sugar. If all of the above tips do not give the desired results, insulin therapy is prescribed.

What is the difference between a diet for this disease?

Gestational diabetes mellitus in pregnancyimplies a certain diet. As it was mentioned above, right nutrition is often the key to successful treatment of ailment. Experts recommend in no case to reduce the nutritional value of food, it is better to reduce its calorie content somewhat. Below we give effective advice on diet with this diagnosis.

• Eat small meals and always at a certain time.

• It is recommended to completely eliminate from the daily diet all fried and fatty foods, as well as digestible carbohydrates (for example, cakes, sweets) and fast food.

• What can I eat with diabetes? Ration better enrich with various kinds of porridge, fresh vegetables and fruits, pasta (only whole grains). All these products contain a large amount of fiber, which is very useful in pregnancy.

• You can use lean meats and fish in the diet, it is better to limit the consumption of smoked products, sausages and sausages.

• Cooking should be steamed or baked in the oven using the minimum amount of oil.

• It is not recommended to forget about the correct drinking regime (at least two liters of still fresh water per day).

Exercise stress

Daily exercise is very usefulfor pregnant women, as they support muscle tone, improve the health and the action of insulin, prevent the appearance of excess fatty deposits. Of course, the load in this case should be moderate. Women are encouraged to attend yoga classes, take small walks every day, swim in the pool. Do not overuse active exercise (horse riding, skating and skiing), as they can lead to injuries. It is important to regulate each time the number of loads, based on the already well-being of the pregnant woman herself.

Postpartum follow-up

Immediately after delivery, gestational diabetes mellituswomen tend to go through, but in some cases it can lead to complications. As already noted above, the baby is born very large, so often you have to resort to caesarean section. The thing is that with natural childbirth, it is possible to get birth trauma.

The child is born with a low levelsugar, however, no special measures for its normalization are applied. The level of glucose independently comes to normal, if the mother feeds the baby with the breast. This indicator should be constantly monitored by specialists from the maternity hospital.

If a woman clearly follows all the prescriptions of the doctor during pregnancy, her baby will not be threatened with gestational diabetes mellitus, the birth will pass quietly.

If a woman neglects an integratedtherapy during pregnancy, this violation can lead to the fact that a newborn will have diabetic fetopathy. It is characterized by the following features:

• jaundice;

• increased blood coagulability;

• edema of tissues;

• a violation of the natural proportions of the body (for example, excessively thin limbs);

• various kinds of respiratory system disorders.

To finally overcome such a disease asGestational diabetes, the diet should continue after childbirth. To adhere to a strict diet is recommended until the blood sugar finally comes back to normal.

Experts advise all women with thisdiagnosis every year to do a test. It is believed that one in five women who had this disease, in fact, discovered undiagnosed type 2 diabetes.

Preventive measures

According to experts, to prevent the development of this disease is actually very difficult. Often, women at risk are not at all affected by diabetes.

It is important to note that the planning of pregnancyafter this diagnosis must be under the supervision of a doctor and not earlier than 2 years from the date of the previous birth. A few months before this period, it is recommended to start monitoring your own weight, to introduce physical exercises into your daily routine, to ask the doctor what to eat with diabetes.

Absolutely any medicationalways consult with a specialist. The thing is that uncontrolled use of medications, including contraceptive pills, can result in the development of a disease such as gestational diabetes mellitus.

Reviews of experts and already giving birth to women saythat in the case of a competent approach by a doctor, the probability of a positive outcome of events is very high. It is important and after the appearance of the baby to continue to monitor your body. For example, after 1.5 months you need to do a test to determine the level of glucose. Based on his results, the expert will give his recommendations for future nutrition and lifestyle in general, and will also set the date for the next control test.

Conclusion

In conclusion, it should be noted again that thisThe diagnosis at observance of all references from the attending physician practically does not carry in itself threats to health of the kid. It is very important in this case to positively adjust your thoughts, to pass all the examinations on time, to eat right. You can find interesting recipes for diabetes, they will be useful not only to the mother in childbirth, but also to her partner. Experts recommend more rest, exercise, and in the evenings to walk with your loved one. If a woman is tuned to the fact that the pregnancy will pass safely, as a result, a fully healthy baby appears to the light.