What Is Gestational Diabetes?
Gestational diabetes is a disorder of glucose metabolism that occurs for the first time during pregnancy and usually disappears after childbirth. Gestational diabetes is detected by a two-hour glucose stress test. About one in five expectant mothers has an increase in blood sugar levels to the extent that she is diagnosed with gestational diabetes. Gestational diabetes usually breaks out during the first pregnancy and most often recurs in subsequent pregnancies.
The number of pregnancy hormones in the blood increases during the waiting period. Likewise, the amount of body fat increases. As a result, the effectiveness of insulin begins to decline (insulin resistance) during the second trimester of pregnancy. Insulin is a blood sugar-regulating hormone produced by the pancreas. Its function is to carry sugar derived from food from the bloodstream to the tissues. In general, the pancreas can create more insulin as required, limiting dangerously high blood sugar levels. If the amount of insulin does not increase as needed, the blood sugar level will rise. This condition is called gestational diabetes.
Read this The role of insulin in diabetes
Pregnancy diabetics are exposed to:
>Overweight
>Family history of diabetes
>Over 40 years of age
>A child over 4.5 pounds in a previous birth
>Previous gestational diabetes
>Sugar in the morning urine
>Ovarian polycystic ovary syndrome (PCO).
Participate in free Well-Being to Expect online training. It is specifically designed for expectant mothers at risk for gestational diabetes.
Detection of gestational diabetes by a glucose test
Gestational diabetes is detected by a sugar stress test. Nowadays, it is recommended to take a sugar stress test for almost all pregnant women.
The glucose test is usually performed from 24 to 28. week of pregnancy. When the risk of the disease is particularly high, it is recommended that the test be performed as early as 12-16. week of pregnancy. If the result is normal at that time, the test is repeated at weeks 24-28 of pregnancy.
Sugar stress test
For 2-3 days before sugaring, it is good to eat a diet rich in high-fiber carbohydrates (whole grains, etc.).
12 hours of fasting before the experiment
The experiment is held in the laboratory in the morning from 8 to 10
Drink 75 grams of glucose (sugar) as a solution (3 dl of liquid)
Blood glucose levels are tested before and after drinking the solution at 1 and 2 hours.
A sugar stress test can cause nausea
the sugar stress test is not dangerous to the fetus
is it diabetes?
Gestational diabetes is diagnosed when one of these occurs:
Fasting blood glucose is 5.3 mmol / l or more
Blood glucose one hour after the start of the test is 10.0 mmol / l or more
Blood glucose for two hours from the start of the test is 8.6 mmol / l or more
Treatment of gestational diabetes meal
The goal of treatment for gestational diabetes is the well-being and health of the mother and child. Good care ensures the most natural possible progression of the pregnancy and the normal growth and development of the fetus and promotes the well-being of the newborn.
If gestational diabetes is diagnosed, the mother is taught self-monitoring of blood sugar with a blood glucose meter. He receives the measuring instruments from his place of care. The number and timing of measurements are agreed upon individually.
The target blood glucose values for gestational diabetics are: less than 5.5 mmol / l in the morning before breakfast less than 7.8 mmol / l one hour after a meal
The most important treatment for gestational diabetes is diet. The varied diet includes whole grains, vegetables, berries, and fruits, skimmed or low-fat dairy and meat products, and a soft-fat spread or oil.
Meals should be good to eat carbs, protein, and fat all at once.
The amount of energy - that is, the amount of food - should remain reasonable so that the weight does not increase too much and the blood sugar remains as well controlled as possible. The amount of food required is always individual.
Exercise is also an effective treatment for gestational diabetes, as it lowers blood sugar and helps with weight management. Exercise is recommended if the pregnancy is not associated with any problems other than diabetes.
The risks of gestational diabetes treated with diet and exercise in pregnancy and childbirth are similar to those in healthy mothers. However, caesareans are more common.
There is more and more detailed information on a diet suitable for gestational diabetics.
If dietary therapy does not achieve adequate glucose control, medication should be initiated. Metformin tablets, insulin injections, or both can be used as medication. The need is always assessed individually. In addition to medication, there is still a need for diet and exercise. About 15 to 20 percent of people with gestational diabetes need medication during pregnancy. Medication can almost invariably be stopped after childbirth.
Monitoring and delivery of insulin-treated gestational diabetics are usually arranged at the maternity clinic. Between 35% and 40% of insulin-treated gestational diabetics give birth by cesarean section.
Good treatment after gestational diabetes.
After birth, the newborn's blood sugar may drop abnormally low, which is why the baby's blood sugar is monitored more often in the hospital than usual.
However, maternal diabetes does not mean that the baby will develop diabetes. However, it is known that children with gestational diabetes appear to have more hypertension, overweight, or metabolic syndrome later in life than the general population.
Gestational diabetes usually resolves after the baby is born. However, after gestational diabetes, type 2 diabetes is more common than usual. Type 2 diabetes is usually asymptomatic for a long time and develops over the years. Type 1 diabetes also occurs more often than usual in people with gestational diabetes.
Although the inherited susceptibility to diabetes cannot be affected, exercise, healthy eating habits, and striving for a normal weight substantially reduce the risk of developing type 2 diabetes or delay the disease. They will also help prevent the recurrence of gestational diabetes in possible subsequent pregnancies.
Because the risk of developing diabetes is increased in people with gestational diabetes, blood glucose monitoring should also be remembered after gestational diabetes. The earlier elevated blood sugar levels are detected, the easier it is to prevent and treat diabetes.
After giving birth, you should have a regular glucose test:
• If your diabetes was treated with insulin or metformin, it is recommended that you take it 6 to 12 weeks after giving birth.
• If gestational diabetes was treated with diet, it is recommended that the test be performed one year after delivery.
• In the future, a test is recommended every 3 years or more frequently according to an individual plan.
Postpartum blood glucose limits are the same as at other times in the diagnosis of diabetes.
After fasting, a healthy person has a plasma sugar of 6 mmol / l or less. With a two-hour sugar load, the blood sugar of a healthy person remains below 7.8 mmol / l.
When the fasting blood sample measures 6.1 to 6.9 mmol / l, it is elevated fasting glucose (IFG).
Impaired glucose tolerance (IGT) is defined as a blood glucose level of 7.8 to 11 mmol / l at 2 hours or 2 hours after a meal.
Diabetes is diagnosed when:
Occasional (or measured by blood sugar) blood sugar exceeds 11 mmol / l more than once
or fasting blood glucose is 7.0 mmol / l or more (ADA 97, WHO 99)
and / or an HbA1c value of 47.5 mmol / mol (6.5%) or greater (WHO 2010).
If symptoms suggest diabetes, one abnormal measurement is sufficient. If there are no other symptoms suggestive of diabetes, there should be two or more abnormal measurements.
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