Diabetes mellitus is a disease characterized by a chronic increase in blood glucose. The basis of this process is absolute or relative insulin deficiency. The disease can be diagnosed at any age. But often the first signs of pathology are detected in women during pregnancy.
Causes of diabetes during pregnancy
Gestational diabetes mellitus – a violation of carbohydrate metabolism, first detected during the period of gestation. The disease develops due to changes in the hormonal background of a pregnant woman. After birth, hormone balance returns to normal and blood glucose levels tend to stabilize.
Pregestational diabetes mellitus is diagnosed in women suffering from this disease before pregnancy.
Despite the fact that endocrine changes occur in all women who have a baby, pregnancy does not always provoke the development of diabetes. For its appearance, the presence of predisposing factors is necessary. First of all, this is the overweight of the future mother and the already existing episodes of high blood glucose diagnosed before pregnancy. An important role is played by heredity. If the parents of a pregnant woman suffer from diabetes, then the risk of developing her pathology during gestation increases several times.
The disease can also develop if the previous pregnancy ended in the birth of a child with a body weight of more than 4 kg or stillbirth.
What is the disease dangerous for the expectant mother
With diabetes, the risk of developing gestosis increases, which is dangerous for pregnant dropsy and nephropathy. With the development of more severe conditions – preeclampsia and eclampsia, immediate hospitalization is required, followed by early delivery.
High glucose often leads to a decrease in immunity in women. This increases the risk of developing infections of the reproductive system, which can lead to intrauterine infection of the fetus.
Danger to the child
Pathologies in the fetus can develop if a woman suffers from diabetes, proceeding in the stage of decompensation.
In the early stages of pregnancy, the pancreas of the fetus is not developed, and in the mother during this period due to diabetes her work is impaired. Due to impaired glucose levels, a deficiency or excess of energy necessary for proper cell division can develop. The risk of developing congenital malformations of the fetus is increased.
High blood glucose in the second half of pregnancy can lead to diabetic fetopathy. Due to the penetration of excess glucose from mother to child, it is delayed in excess. Such a pregnancy can end in the birth of a child with a large weight and a disproportionate body: a large belly and shoulder girdle, but with relatively small arms and legs.
When bandaging the umbilical cord after birth, the excess intake of glucose is disrupted and in the newborn its concentration in the blood decreases sharply. This condition can lead to further hypoglycemia and some impaired development of the child.
Signs of diabetes and its diagnosis
Symptoms of the disease develop gradually and are often taken by a woman for the usual changes that occur during the period of gestation. Pronounced weakness and fatigue come first. Constant thirst and frequent urination are noted. Low weight gain of a pregnant woman with good appetite is characteristic.
Often, the first suspicions of the presence of pathology in a pregnant woman appear when high blood glucose figures are obtained as a result of a mandatory examination. But on the basis of one analysis, the diagnosis is not made. After 2-3 days, the study is repeated. If the indicators do not improve, then appoint a consultation with the endocrinologist. The specialist can prescribe an additional examination, on the basis of which an accurate diagnosis will be made.
Treatment: insulin or diet?
Therapy is selected by the doctor depending on the stage of disease compensation. Typically, patients are prescribed short-acting insulin in combination with medium-acting insulin. The time of administration of the drug and the dose are selected only by the doctor.
Until recently, it was believed that the appointment of hypoglycemic drugs during pregnancy is contraindicated because of the risk of developing hypoglycemia in the fetus. After the studies, it turned out that with adequate therapy, it is possible to maintain a normal level of glucose in the blood without risk for the unborn child. But since not all hypoglycemic drugs are resolved during pregnancy and debates about the appropriateness of their appointment are still underway, the decision on such therapy should be made only by the doctor after a complete examination of the patient.
But treatment for gestational diabetes does not always mean insulin and medication. In the stage of compensation, there is enough compliance with a special diet.
It is better to build food according to the following principle:
- total calorie intake should be calculated from the ratio of 35-45 kcal / kg of normal body weight and should not exceed 2200 kcal / day;
- the amount of complex carbohydrates should be 40% of the total diet, and protein and fat should be approximately 30% each;
- eat better fractionally and in small portions – the day should be the main meals and a few snacks;
- the volume of fluid drunk is 1.5 liters.
More detailed dietary recommendations can be obtained from your doctor.
Prevention
It is quite difficult to completely avoid the development of the disease during the period of bearing a child with the help of a certain prevention. But at the same time, you can reduce the risk of its occurrence. Prevention should begin during pregnancy planning. For women with a large body weight, it consists in proper nutrition aimed at weight loss.
We must not forget about moderate physical activity. Simple permissible exercises should be done during the period of bearing a child.
For women with high blood sugar, the main prevention is to follow all the doctor’s recommendations and follow a diet. This helps to reduce the risk of complications.
Compliance with these simple rules will help to maintain your health and protect the future baby from possible pathologies.