What is Gestational Diabetes Mellitus?

 

The rise in blood sugar above normal for the first time during pregnancy is called 
Gestational diabetes mellitus GDM

The norm of blood sugar in pregnant women in the morning on an empty stomach (before meals) is not more than 5.0 mmol / l, 1 hour after meals not more than 7.0 mmol / l.

After filling with glucose during the glucose tolerance test in 24-28 weeks of pregnancy: 1 hour in the morning before meals 3.3-5.0 mmol / l, 1 hour after meals less than 7.0 mmol / l.

Each sugar value should be recorded in a self-monitoring diary with the date, time, and detailed description of the food intake, after which you measured the sugar.

You should take this diary with you every time you see an obstetrician-gynecologist and endocrinologist.

GDM treatment during pregnancy:

1. Diet is the most important thing in the treatment of GDM
2. Easily digestible carbohydrates are completely excluded from food: sugar, jam, honey, all juices, ice cream, cake, pastries, bakery products made of white high-quality flour; rich pastries (pastries, pastries, pies),
3. Any sweeteners, such as fructose products (sold in stores under the "diabetic" brand), are prohibited for pregnant and breastfeeding women.
4. If you are overweight, then in the diet you must limit all fats and completely eliminate: sausages, sausages, sausages, bacon, margarine, mayonnaise,
5. Never starve! Food should be evenly distributed over 4 to 6 meals throughout the day; breaks between meals should not exceed 3-4 hours.

2. Physical activity. If there are no contraindications, moderate physical activity of at least 30 minutes a day, for example, walking, or swimming in the pool, is very useful.

Avoid exercises that cause high blood pressure and cause uterine hypertension.

3. Self-control diary in which you write:

• Blood sugar in the morning before meals, 1 hour after each meal during the day, and at bedtime - daily,
• All meals (in detail) - daily,
• Ketonuria (ketones or acetone in urine) in the morning on an empty stomach (there are special test strips for determining ketone bodies in urine - for example, "Uriket", "Ketofan") - daily,
• Blood pressure (blood pressure should be less than 130/80 mm RT. art.) - daily,
• Fetal movements - daily,
• Bodyweight - weekly.

Attention: if you do not keep a diary or do not keep it honestly, you are deceiving yourself (not the doctor) and risking yourself and your child!

• If the blood sugar exceeds the recommended values despite the measures taken, then it is necessary to start insulin treatment (for this you will be referred to an endocrinologist).
• Don't be afraid to prescribe insulin. You should know that insulin dependence does not develop, and in the vast majority of cases, insulin is canceled after childbirth.
• Insulin in appropriate doses does not harm the mother, it is prescribed to maintain her complete health, and the child will remain healthy and will not learn about the use of insulin from the mother - the latter does not pass through the placenta.

BIRTH and GDM:

The date and manner of delivery are determined individually for each pregnant woman, and no later than 38 weeks of pregnancy, the gynecologist-obstetrician conducts a final examination of the mother and child and discusses the prospects of childbirth with the patient.

 Prolonging pregnancy for more than 40 weeks with GDM is dangerous, the placenta has few reserves and may not be able to bear the burden of childbirth, so earlier births are desirable. Gestational diabetes alone is NOT an indication for a cesarean section.

GDM after childbirth:

1. Diet 1.5 months after birth,
2. Insulin therapy is canceled (if any),
3. Control of blood sugar in the first three days (blood sugar rate after childbirth: on an empty stomach 3.3 - 5.5 mmol / l, 2 hours after meals up to 7.8 mmol / l),
4. 6-12 weeks after birth - consulting an endocrinologist for diagnostic tests to clarify the state of carbohydrate metabolism,
5. Women who have undergone GDM are included in a high-risk group for the development of GDM in the following pregnancies and type 2 diabetes in the future, so a woman who undergoes GDM must:
6. - Follow a diet aimed at losing weight with its excess,
7. - Expand physical activity,
8. - Plan subsequent pregnancies,

children of mothers with GDM have an increased risk of developing obesity and type 2 diabetes throughout their lives, so they are recommended a balanced diet appropriate physical activity, and observation by an endocrinologist.

If GDM is detected, patients should completely discontinue use:

• All sweet foods (this includes sugar and honey, ice cream, sweet drinks, etc.);
• White bread, pastries, and flour products (including pasta);
• Semolina;
• Semi-finished products;
• Smoked meat;
• Fast food products;
• Fast food;
• High-calorie fruits;
• Soft drinks, juices in bags;
• Fatty meat, aspic, fat;
• Canned food, regardless of their type;
• Alcohol
• Cocoa;
• Cereals, diet bread;
• All legumes;
• Sweet yogurt.
• You will also need to significantly limit your use:
• potatoes;
• butter;
• chicken eggs;
• baking dough.

Prohibited products should be completely excluded from the diet. Even a small consumption of them can lead to negative consequences. Very limited quantities of potatoes, butter, eggs, and pastries are allowed

What can pregnant women eat with gestational diabetes? The above products can be replaced:

• Hard cheeses;
• Sour-milk curds;
• Natural yogurts;
• Greasy cream;
• Fish;
• Green vegetables (carrots, pumpkins, beets, unlike cucumbers, onions, and cabbage must be consumed in limited quantities);

• Mushroom;
• Soybeans and products thereof (in small quantities);
• Tomato juice;
• Tea.

Several dietary options can be followed in gestational diabetes, but a low-carbohydrate diet is excluded.

This is because when there is not enough carbohydrate intake from food, the body will start burning fat energy reserves.

The diet must contain the following products:

• Whole-wheat bread;
• Any vegetables;
• Legumes;
• Mushroom;
• Cereals - preferably millet, pearl barley, oats, buckwheat;
• Lean meat;
• Fish;
• Chicken eggs - 2-3 pcs./week .;
• Dairy Products;
• Sour fruits and berries;
• Vegetable oils.

In most cases, doctors prescribe to their patients a diet that contains a large number of carbohydrates and a moderate amount of protein. Preference is given to unsaturated fats, the use of which must also be limited. Saturated fats are completely excluded from the diet.

I am diabetic

All about diabetes

What postprandial blood sugar levels are considered normal in pregnant women?

During pregnancy, a woman's body experiences severe stress and endures changes. Therefore, it is necessary to constantly monitor the state of health, including blood sugar levels.

 Its increase can negatively affect the condition of the mother and the development of the future baby. To properly control the control, it is necessary to remember the blood sugar level after a meal.

What is the normal sugar level for pregnant women?

The concentration of glucose in the blood of pregnant women can vary throughout the day. Her jumps can be seen even after eating. If the expectant mother is healthy, then the indicators should be at the following intervals:

1. If the analysis is performed in the morning on an empty stomach, then the norm is an interval of 3.9 to 5.1 mmol.
2. Sometimes before a meal: 4 - 6.1 mmol.
3. An hour after a meal, the norm is an indicator of up to 7.0 mmol.
4. If two hours have passed since the meal, the sugar level should not exceed 6.7 mmol.
5. The measurement should be done one hour before bedtime. Glucose should be kept between 6.0 and 7.1 mmol at this time.
6. If you wake up at night, you can perform a control measurement. In this period, the norm is 4 - 5.1 mmol.

For a complete assessment of women's health, it is necessary to perform two measurements a day: on an empty stomach and an hour after a meal. 

This is especially important for pregnant women with a predisposition to diabetes. It is worth remembering that this disease is often inherited and can occur just while expecting a child. Diabetes can serve as a reaction to changes in the hormonal system.