Gestational diabetes during pregnancy impact on the fetus. Possible consequences of gestational diabetes mellitus during pregnancy and effects on the fetus. Deviations from the norm

If the course of pregnancy is complicated by diabetes mellitus, the woman is at risk, since the disease is quite dangerous and can adversely affect both the development of the fetus and health future mother, and for childbirth. Therefore, qualified management of pregnancy in diabetes mellitus is so important. the best specialists in the most proven and well-known perinatal centers. Much will depend on the form of the disease, since diabetes and diabetes in such an interesting position are different.

There are several types of diabetes mellitus, each of which poses a threat to the course of pregnancy:

1. insulin-dependent diabetes mellitus (type I);
2. non-insulin-dependent diabetes mellitus (type II);
3. gestational diabetes (type III), which appears only after the 28th week of pregnancy.

All these varieties represent a danger to the health of mother and baby. If women who previously suffered from this disease carefully approach, then the acquired disease is taken by surprise. Therefore, it is so important to know where gestational diabetes mellitus comes from during pregnancy, in which carbohydrate metabolism in cells is disrupted, causing fetal pathologies and worsening the general condition of the expectant mother.

Why does diabetes occur during pregnancy?

Hormonal changes in the body of a pregnant woman partially block the action of insulin, a substance that helps glucose nourish cells. Without receiving such an important product for their life, the cells begin to “starve”, and gestational diabetes develops. However, most organisms cope with this difficulty, and the likelihood of this disease increases in the following cases:

• uncontrolled weight gain above the norm;
• age over 25 years;
• heredity;
• ethnic group (Spanish, African, Asian women are most susceptible to diabetes during pregnancy);
• large previous child;
• smoking;
• infectious diseases of the pancreas;
• gestational diabetes during a previous pregnancy;
• a large number of spontaneous abortions;
• stillborn child;
• polyhydramnios;
• previous children with developmental disabilities.

The best option would be to process these data even during pregnancy planning, so that the endocrinologist gives the necessary advice. If conception has already occurred, and the woman has two or more of the above symptoms, it is necessary to inform the doctor as soon as possible.

Symptoms of diabetes during pregnancy

Sometimes perfectly healthy women are also susceptible to the disease. The most important thing in such cases is to see the important symptoms of diabetes in time, so as not to be late with treatment. If it is type I or type II diabetes, you should expect an increase in blood sugar levels. In the case of gestational disease, in addition to this symptom, there are also:

• uncontrolled weight gain;
• strong feeling of thirst;
• increase in the volume of urine;
• blurred vision up to blindness;
• a sharp decrease in activity;
• loss of appetite.

If there are signs of diabetes during pregnancy, you need to urgently take blood tests for the presence of sugar in it so that it does not exceed the permissible limits. Only timely treatment can somehow alleviate the course of the disease and reduce the risk of a threat to the baby being born.

The impact of the disease on pregnancy

The negative and even negative impact of diabetes on pregnancy can seriously harm the child and undermine the health of the expectant mother. An elevated blood sugar level in a pregnant woman leads to various complications in the formation and intrauterine development of the fetus. These complications are called diabetic fetopathy:

• (birth weight more than 4 kg), which complicates childbirth;
• many organs of the newborn are structurally underdeveloped - accordingly, they cannot perform some of their functions;
• this leads to the fact that the baby may experience neurological, respiratory and cardiovascular disorders after birth, as well as hypoglycemia, characterized by low blood sugar;
• late toxicosis of pregnant women, edema, impaired kidney function, problems with cerebral circulation, high blood pressure;
• urinary tract infections;
• premature birth.

Pathologies can be quite serious, and yet even diabetic women give birth to healthy babies with minimal losses. How do they do it? For those who have suffered from diabetes for a long time, pregnancy planning for diabetes mellitus becomes an important point, and for the rest - timely prescribed treatment.

Insulin drugs and special diets will be required to treat diabetes

Prevention of diabetic fetopathy is the constant control of the blood sugar level of a pregnant woman as early as possible. To maintain normal sugar levels, the doctor will prescribe diabetes treatment and an appropriate diet. Women themselves must take various measures to alleviate their condition in such a difficult, but solvable condition.

First, insulin treatment will be prescribed, which will not harm the child.

Secondly, nutrition in diabetes should be special:

• frequent (6 times) meals;
• easily digestible carbohydrates (sweets and pastries) are excluded;
• limited in the consumption of fats (fatty meat, cream, butter).
• fiber-rich foods (greens, vegetables, fruits, except bananas, grapes and melons) increase in the diet.

Diabetes mellitus greatly complicates the situation and condition of a pregnant woman. Therefore, the issue of its treatment, and best of all - prevention, should be approached very responsibly and only in the closest tandem with a doctor. Constant examinations, monitoring by specialists, tests and the exact fulfillment of all medical requirements will reduce the risk of complications and allow a healthy and strong baby to be born.

Good afternoon my dears! Glad to see you again. Remember when we talked about diabetes? So, now let's talk about this far from sweet disease from the point of view of pregnancy. Have you ever heard that having a baby can cause blood sugar spikes? And such cases happen. They are quite rare, but they need to be talked about.

I do not want to scare, but none of us is immune from such unpleasant surprises. Gestational diabetes during pregnancy is detected in about 4% of cases. So female body sometimes reacts to a hormonal surge. Glucose tolerance is impaired, it is not broken down properly and enters the bloodstream.

Even if otherwise the health of a woman does not fail, diabetes sometimes turns the bearing of a baby from pleasure into real torture! Doctors immediately warn the expectant mother that the impact on the fetus of such a serious diagnosis can be unpredictable. What threatens high blood sugar to a child and his mother, we will find out today.

The Hormonal Explosion Affects Sugar

If sugar jumped above the norm for another early term, then the baby can be lost! The risk of miscarriage and the development of serious fetal pathologies in the first trimester is very high. If diabetes appears in the 2nd and 3rd trimesters, the child is threatened with hyperinsulemia. In the mother's womb, he receives too much glucose, and when he is born, its amount will drop sharply, which means that the baby's blood sugar will noticeably decrease.

Very often, with elevated glucose levels in the mother, the baby quickly gains weight. At birth, he will weigh more than 4 kg. At the same time, his arms and legs will be thin. These are external manifestations of diabetic fetopathy, which also manifests itself as jaundice, hypoglycemia and a low content of calcium and magnesium in the baby's blood.

Most often, gestational diabetes appears in the third period of pregnancy. It is during this period that the body of the expectant mother actively produces insulin (three times more than in the pre-pregnancy state!). This reduces the effect of raging hormones on sugar levels. And here a failure may occur: the pancreas will refuse to produce insulin, and sugar levels will rise sharply.

How to recognize

I already feel how many of you are now worried, especially future mothers. I assure you, most likely, everything will go fine for you, you will give birth to a healthy, strong baby, because diabetes in pregnant women is an infrequent phenomenon. If you are interested in how to identify your predisposition to the disease, I suggest that you familiarize yourself with the “risk” list of factors. I warn you in advance: even if you find all these signs in yourself at once, this does not mean that you can make a serious diagnosis for yourself! Therefore, inhale, exhale and read:

• sugar in the urine;
• The level of glucose in the blood is higher than normal (pre-diabetic state);
• Heredity;
• Gestational diabetes was during a previous pregnancy;
• polyhydramnios;
• Stillborn child.
• Overweight before pregnancy;
• Belonging to a certain nationality (Negroes, Asians, Native Americans suffer from gestational diabetes much more often);

If you are still worried that you have a high risk of getting sick, tell your gynecologist about it. You will be given a detailed examination. Although all pregnant women are already waiting for mandatory glucose tolerance tests at 24-28 weeks. The expectant mother is given sweetened water to drink, and after 20 minutes, blood is taken from a vein to find out how well glucose has been absorbed. The norm is 7.7 mmol / l, everything that is higher is already an indicator of diabetes.

diet for diabetes

This diagnosis and life ordinary person can turn into an endless race for insulin. Imagine how difficult it is for pregnant women to endure diabetes. Here and so preeclampsia, toxicosis, edema and other troubles, but also a lot of restrictions due to high glucose and treatment. To alleviate the symptoms of the disease and reduce the risk of its complications and effects on the fetus, the following measures will help:

• Regular monitoring of glucose levels with a glucometer. Do not forget to take measurements 4 times a day, twice on an empty stomach and two more times - a couple of hours after eating.
• Special diet (I'll tell you more about the menu later)
• Urinalysis (should not show ketone bodies)
• Taking insulin (it is allowed for pregnant women)
• Weight control and light exercise.
• Measurement of blood pressure.

As you know, to stimulate the production of insulin, it is recommended to reduce weight. But a strict diet is contraindicated for pregnant women. Carrying a baby, a woman is obliged to eat fully. Only for some, this usefulness is expressed in the obligatory presence of pies and sweet buns in the menu, and for others - in a proper balanced diet with the necessary calorie content. This is what you need to follow with gestational diabetes.

Here are a few rules that will suit absolutely healthy expectant mothers:

• Fractional nutrition with three full meals and a couple of snacks in between. For breakfast, you need to eat about 45% of the daily carbohydrate intake, so that about 10-15% is left for dinner.
• Do not abuse "light" carbohydrates, which are rich in confectionery and some fruits (figs, cherries, bananas). They provoke a sharp jump in blood sugar levels. Eat less fatty and fried, as well as salty foods.
• Forget fast food! It's not just about shawarma and hot dogs, but also about noodles fast food and other quick meals.
• Keep dry crackers or crackers on the dressing table by the bed. Eat a few before you get out of bed in the morning. This will prevent nausea and dizziness.
• Drink more than 1.5 liters of water per day
• Eat fiber. It is found in rice, buckwheat, vegetables and some types of bread. Such food improves bowel function and fat and sugar are less absorbed into the blood.
• Watch out for saturated fats. Sausages, smoked meats, bacon during pregnancy should leave your refrigerator. Replace them with lean meats and fish. With caution, you need to eat butter, mayonnaise, sour cream and store-bought sauces, seeds and nuts.
• And now about your main "friends" during gestational diabetes. Cucumbers, zucchini, tomatoes, celery, beans, cabbage should always be "available" and be present on the menu in all forms: boiled, stewed or in a salad. You can eat these vegetables without restrictions. They contain a meager amount of calories and carbohydrates - what you need to lower blood sugar.

Thank you charging

By the way, its optimal level is maintained not only by nutrition, but also by physical exercises. Of course, we are not talking about visiting the gym and running with obstacles. But feasible loads are very useful: running, walking, aqua fitness. Dr. Komarovsky is sure that it is necessary to engage in physical education even in the "position" every day, at least 30 minutes! Movement is life! In the case of gestational diabetes, the life of two at once, mother and baby.

Do not forget to always monitor your condition! We don't want rebound effects, do we? Remember: during active calorie burning, blood sugar also decreases actively, and this already threatens with hypoglycemia (dangerously low glucose levels). After a workout, be sure to eat an apple or a cheese sandwich to normalize the condition.

Natural childbirth is cancelled.

The closer the birth, the more questions a pregnant woman has: how everything will go, whether there will be complications and whether diabetes will persist after pregnancy. First, let me reassure you: usually, in most cases, blood sugar levels after the birth of the baby are normal.

And now I’ll worry a little: get ready for a difficult birth, the fetus fed “on glucose” will be large, which means it will be long and difficult to pass through the birth canal. Usually, in order to make the woman's task easier, the doctor decides in advance to do a caesarean section. After giving birth, the baby is immediately applied to the mother's breast so that the milk increases the reduced sugar in his blood to the desired level.

Glucose in a woman in labor returns to normal almost immediately after the placenta is delivered. It was she who provoked the production of hormones and contributed to the development of diabetes. A few months after childbirth, it is necessary to control the level of sugar with a glucometer, as well as monitor nutrition and continue to exercise. More often get out for walks together with the baby, gain strength, eat more vegetables and fruits, and then diabetes is unlikely to come back to you.

If in the near future you are not planning the next pregnancy, then it's time to consult with a gynecologist about the choice of contraceptives. Some of them increase the risk of an increase in glucose. Try to treat the purchase of any drugs as carefully as possible now. Take care of yourself!

Please leave your stories, feedback on today's article in the comments. The livelier our forum, the more real life examples you bring, the more interesting our communication will be. Bye, my dears. Suggest new topics, ask questions, I will be happy to respond and write to you!

Experts are rather optimistic about the possibilities of young people with diabetes to have a family, healthy children, to enjoy everything that love and sex bring into a person's life. Diabetes and pregnancy mutually adversely affect each other. Any pregnancy places increased demands on her body. The body of a woman with diabetes does not always cope with this, because she already has metabolic and hormonal disorders. Often, a woman develops complications of diabetes during pregnancy, which can even lead to disability. Therefore, it is very important to learn and responsibly control blood sugar levels before and during position. This is necessary for the birth of a healthy baby and avoiding complications in the mother.

As for diabetes, which first appears or becomes noticeable for the first time during pregnancy, referred to as. It develops due to a certain hormonal background and metabolic features of pregnancy. In 95% of cases, this diabetes disappears after childbirth. However, in some women, about 5 percent of it remains. If a woman had diabetes during pregnancy, she is at an increased risk of developing another form of diabetes, which is usually type 2.

According to statistics, the gestational type develops in about 3% of pregnant women, moreover, it is more common in women over 25 years old. Therefore, if you have such risk factors as: heredity or overweight, planning a pregnancy before the age of 25 reduces the risk of developing this disease.

The symptoms and signs of gestational diabetes are usually mild and do not threaten a woman's life. However, this condition can create problems for the infant, including hypoglycemia (low blood sugar) and respiratory depression. Also, women with diabetes are more likely to suffer from toxicosis, which is life-threatening for both the mother and the child.

To control blood glucose levels, some women have to take insulin during the critical period, but most are helped to cope with diabetes.

Additional examinations

Ultrasound examinations allow you to check how the fetus develops and estimate its size and weight. This information makes it possible to decide whether to have a baby in the usual way or a caesarean section may be required.

It is worth doing an electrocardiogram to check the condition of the heart, tests that control the functioning of the kidneys, the presence of ketones in the urine. Have regular eye exams to prevent the development of diabetic retinopathy. Women who already have it should be checked at least once a month, since pregnancy often accelerates the development of this disease.

Special ones can also be prescribed, such as alpha-fetoprotein levels, to identify possible spinal defects.

In general, women with usual or gestational diabetes need increased medical attention, especially for blood sugar control and pregnancy-related complications.

Possible pregnancy complications in people with diabetes

In diabetes mellitus, more often than in people who do not have this disease, a pathological course of pregnancy is observed:

• late toxicosis;
• prematurity;
• polyhydramnios.

In various stages of diabetes mellitus, including the stage of prediabetes, there is a frequent death of the fetus. In some clinics, it ranges from 7.4 to 23.1%. However, when assessing the outcome of pregnancy in patients with diabetes mellitus, it is necessary to take into account the state of compensation for metabolic disorders during pregnancy. With compensation achieved before 28 weeks of pregnancy, fetal death was 4.67%. The frequency of fetal death increased sharply if compensation was achieved later than 28 weeks of gestation, and amounted to 24.6%. In the group of pregnant women admitted with decompensated diabetes mellitus directly to the maternity ward, fetal death was in 31.6%. With compensation achieved in the first trimester of pregnancy and steadfastly maintained in its subsequent periods, fetal death decreased to 3.12%. The death of fetuses in pregnant women with diabetes decompensated during pregnancy reached an average of 12.5%.

One of the main reasons for more frequent fetal death in women with diabetes mellitus is the developing functional and morphological changes in the placenta, which usually correlate with pathological changes in the mother's body. In patients with diabetes mellitus, an increase in the weight of the placenta is often noted in parallel with the development of large fetuses; there is evidence of an increase in the level of placental lactogen in the blood.

Electron microscopy studies can detect a thickening of the basement membrane of capillaries in the placenta. It develops dystrophic and degenerative changes that threaten the life of the child. A prognostically unfavorable sign in relation to the vital activity of the fetus is a drop in the level of placental lactogen in the blood and a decrease in urinary excretion of estriol.

diabetic fetopathy

Diabetic fetopathy is when blood glucose passes through the placental barrier and enters the fetus. The total amount of fluid in the body is reduced, but after birth, as a result of increased breakdown of glycogen, fluid moves from the vascular bed to the interstitial space, which explains the swelling of the subcutaneous tissue. In response to this, the fetus begins hyperplasia of the pancreas. But since insulin has an anabolic effect, children are usually born large, due to hyperinsulinemia, hormonal imbalance develops, they are disproportionate:

• with large shoulder girdle;
• small brain part of the head;
• puffy.

They do not correspond to their gestational age, that is, they are 2-3 weeks behind in development.

Children from diabetic mothers have more pronounced metabolic acidosis at birth than healthy children, and the process of metabolic adaptation takes them longer. Severe acidosis is usually associated with hypoglycemia in excess of physiologic neonatal hypoglycemia. With severe hypoglycemia, various neurological symptoms can be observed:

• anxiety;
• tremor;
• convulsions.

These disturbances usually disappear after administration of glucose. To prevent hypoglycemic conditions in newborns whose mothers have diabetes, it is advisable to inject them through the mouth every 2 hours with a glucose solution. The most common disorders in children born to diabetic women are respiratory disorders. Hyaline membranes of the lungs often develop, which can lead to neonatal death. Mortality in the first days of life in these children is 4-10%. It can be significantly reduced by correcting metabolic disorders in the newborn and carefully compensating for diabetes in the mother during pregnancy to 1%.

Newborns from diabetic mothers are significantly different from healthy children. They may have malformations, an enlarged liver, uneven maturation of various organs. Their adaptation is reduced, the lung tissue is underdeveloped, insulin is produced more than necessary, and hypoglycemia occurs. They are discharged somewhere on the 10th day, and some are transferred for further nursing to other hospitals.

insulin during pregnancy

During the first three months, most pregnant women do not feel any need to change the amount of insulin prescribed to them, however, some women experience during this period, and the amount of insulin prescribed to them should be reduced.

Under the influence of hormonal changes during the subsequent months of pregnancy, it can be observed, and, therefore, its amount must be increased to maintain blood sugar levels from 4 to 6 mmol / l. By the end of pregnancy, the amount of insulin taken can in some cases increase by 2-3 times compared to the amount before pregnancy. After all, it is well known that blood sugar levels can also change in pregnant women who do not have diabetes.

Due to hormonal changes, pregnancy is a frequent provocateur of glucose in women. Causing resistance to insulin, it leads to the development of (GDM) in 12% of women.

Developing after 16 weeks, gestational diabetes, whose impact on the fetus and mother's health can be very dangerous, causes severe consequences and death.

Why is gestational diabetes dangerous for a child during pregnancy?

An imbalance in the compensatory mechanism of carbohydrate metabolism leads to the development of GDM. This pathology begins during pregnancy and is initially asymptomatic, manifesting itself in most cases already in the third trimester.

Almost half of the pregnant GDM subsequently develops into the present. Depending on the degree of GDM compensation, the consequences manifest themselves in different ways.

It poses the greatest threat. She expresses herself:

• the development of malformations in the fetus caused by glucose deficiency. The imbalance of carbohydrate metabolism in the mother at an early stage of pregnancy, when the pancreas has not yet formed in the fetus, causes an energy deficiency of cells, leading to the formation of defects and low weight. Polyhydramnios - feature insufficient intake of glucose, which makes it possible to suspect this pathology;
• - a pathology that develops as a result of the action of diabetes on the fetus and is characterized by metabolic and endocrine anomalies, polysystemic lesions;
• deficiency of surfactant production, which causes functional disorders respiratory system;
• the development of postpartum, provoking neurological and.

Fetal diabetic fetopathy

A pathology called diabetic fetopathy (DF) develops as a result of the influence of maternal diabetes on fetal development.

It is characterized by dysfunction of the internal organs of the child - the respiratory system, causing neonatal hypoxia, hypoglycemia, acute heart failure, the development of type II diabetes and other severe complications in the baby, up to death.

Macrosomia

Intrauterine hypertrophy (macrosomia) is the most common manifestation of DF. Macrosomia develops as a result of an excess of glucose from the mother through the placenta to the fetus.

Excess sugar, under the action of insulin produced by the pancreas of the fetus, is converted into fat, causing its deposition on the organs and too rapid growth of the child's body weight - more than 4 kg.

Body disproportion is an external hallmark of children with macrosomia. They have a disproportionately large body in relation to the head and limbs, a large belly and shoulders, blue-red, covered with a petechial rash, cheese-like grease, hair in the ears.

When diagnosing macrosomia, vaginal delivery is not recommended due to high level trauma. In addition, its presence increases the risk of encephalopathy, leading to the development of mental retardation or death.

Jaundice

To characteristic symptoms DF in newborns also includes jaundice, manifested by yellowing of the skin, eye sclera,.

In contrast to the physiological jaundice of newborns, which has similar symptoms and is able to resolve on its own after a week, the appearance of jaundice in babies with diabetic fetopathy requires complex therapy, since it indicates the development of liver pathologies.

In the treatment of jaundice, newborns with DF are usually treated with UV irradiation sessions.

hypoglycemia

Termination of glucose supply from mother to child after his birth against the background of increased secretion of insulin by his pancreas leads to the development of another symptom of DF.

Hypoglycemia exacerbates the development of neurological abnormalities in babies, affects their mental development.

To avoid hypoglycemia and its consequences - convulsions, coma, brain damage - from the moment of birth in newborns, the state of sugar levels is taken under control, in case of its fall, glucose is injected into the baby.

Low levels of calcium and magnesium in the blood

Chronically causes an imbalance of mineral metabolism, causing hypocalcemia and hypomagnesemia in the newborn.

The peak of a decrease in the level of calcium in the blood to 1.7 mmol / l or less in a baby is observed 2-3 days after birth.

This state is manifested by hyperexcitability - the newborn twitches his limbs, screams piercingly, he develops tachycardia and tonic convulsions. Such symptoms occur in the newborn and with hypomagnesemia. It develops when the magnesium concentration reaches a level below 0.6 mmol/L.

The presence of such a condition is diagnosed using an ECG and a blood test. In 1/5 of newborns who have had seizures due to neonatal hypomagnesemia or hypocalcemia, neurological disorders are observed. For their relief, babies are prescribed intramuscular, intravenous administration of magnesium-calcium solutions.

Respiratory disorders

Children with DF are more likely than others to suffer from chronic intrauterine hypoxia.

Due to insufficient synthesis of pulmonary surfactant, which ensures the expansion of the lungs in newborns at the first breath, they may develop respiratory disorders.

It implies the appearance of shortness of breath, respiratory arrest.

To avoid perinatal asphyxia, a surfactant may be additionally administered to newborns.

premature delivery

GSD is one of common causes frozen fetus, spontaneous abortion or premature birth.

A large fetus that has developed as a result of macrosomia - more than 4 kg, in 24% of cases causes premature birth, which often leads to the development of respiratory distress syndrome in newborns against the background of delayed maturation of the surfactant system in the lungs.

What threatens pregnancy with diabetes?

Uncompensated GDM causes severe toxicosis in pregnant women in the third trimester. The most dangerous complications for a woman are preeclampsia and eclampsia. With their threat, the pregnant woman is hospitalized for the purpose of resuscitation and premature delivery.

Severe preeclampsia

Changes that occur in the vessels due to a violation of carbohydrate metabolism are the cause of the development of preeclampsia.

Prevention of complications of GDM involves:

• timely detection of diabetes and hospitalization, allowing for examination and correction of treatment;
• early detection of DF using ultrasound;
• careful monitoring and correction of glucose from the first day of detection of diabetes;
• compliance with the schedule of visits to the gynecologist.

Related videos

Risk factors and dangers of gestational diabetes in the video:

Early detection of GDM and competent conduct of compensatory treatment during the entire period of pregnancy will be the key to minimal complications and consequences for both the mother herself and her baby.

During pregnancy, a woman has to take a lot of tests - this is necessary in order to exclude various pathologies and protect the mother and child. At hormonal changes in the body of a woman, old ailments are exacerbated, immunity is depleted and carbohydrate metabolism may be disturbed. This condition entails diabetes in pregnant women, the consequences for the child and the woman in labor can be the most deplorable.

Diabetes is considered a pathology of the endocrine system, when there is a lack of insulin in the body. With hyperglycemia, that is, an increase in glucose levels, carbohydrate, protein, fat and water-salt metabolism fails. Subsequently, the disease affects all human organs, gradually destroying them.

Diabetes happens:

1. . Diagnosed mainly in children, it is insulin-dependent and is characterized by a lack of insulin in the body when the cells of the pancreas do not produce this hormone.
2. . It is diagnosed in adults over 21 years of age, while the pancreas produces insulin, but due to damage to tissue receptors, it does not absorb it.

Gestational diabetes is characteristic only of pregnant women and often all symptoms gradually disappear after childbirth. If this does not happen, then the disease passes into the second form of diabetes, that is, at the initial stage, the disease is type 2 prediabetes. The main reason is a violation of carbohydrate metabolism, which increases blood sugar.

Causes

On average, the disease is diagnosed in 4-6% of women. Persons with a pronounced predisposition to the disease need to approach this issue with special attention. Women at risk include:

1. With a hereditary predisposition (there are blood relatives with a similar diagnosis).
2. Overweight.
3. FROM severe course pregnancy, which in the past ended in miscarriage, fading or fetal pathology.
4. Already having large children and born babies weighing more than 4 kg.
5. In late pregnancy, after 30 years.
6. With impaired glucose tolerance.
7. Having polyhydramnios during the current pregnancy.
8. With diseases of the genitourinary system.
9. With intensive fetal growth and the release of an excessive amount of progesterone (progesterone reduces insulin production, which causes the pancreas to work at an increased load and gradually deplete. At the moment when insulin production is blocked, the cells become insensitive to the hormone and the quantitative indicator of blood glucose increases).

Signs of the disease

You can suspect the presence of the disease in the expectant mother by the following symptoms:

• increased thirst and urination;
• lack of appetite or vice versa constant hunger;
• high blood pressure;
• clouding in the eyes;
• overwork;
• insomnia;
• skin itching.

Diagnostics

In the absence of complications, the analysis is done in the period from 24 to 28 weeks of pregnancy. For this, an oral glucose tolerance test is performed. Pregnant women on an empty stomach need to drink a sweet liquid. After 20 minutes, venous blood is taken.

Normally, the results should be in the range of 5-6 mmol / l. 7.5 mmol / l is already an excess of glucose, which is a signal for re-analysis. In this case, blood is taken on an empty stomach (2 hours after eating). With a similar indicator of the secondary test, the pregnant woman is diagnosed with gestational diabetes. Blood sugar levels are normal if:

• the analysis is taken from a finger, and the result varies from 4.8 to 6.1 mmol / l .;
• the analysis is taken from a vein, with a result ranging from 5.1 to 7.0 mmol / l.

Effect on the fetus

The disease can proceed both in a latent form and bring a lot of inconvenience. Decompensation of diabetes during pregnancy causes a number of complications for the fetus:

1. Respiratory distress syndrome (excess insulin leads to delayed intrauterine development respiratory organs of the child, the lungs do not open on their own on the first breaths of the baby after birth).
2. Premature birth and death of the fetus during the first day after birth.
3. Malformation of an infant.
4. The appearance of type 1 diabetes in a child after childbirth.
5. Macrosomia (excess glucose is converted into subcutaneous fat, which leads to accelerated intrauterine growth of the child and disproportion of body parts).

Fetopathy of the fetus - pathological changes in all organs and systems of the child's body, along with increased body weight (4-6 kg). There may be swelling, lethargy, hemorrhage, cyanosis of the extremities, a swollen abdomen. Usually, the pathology is diagnosed by ultrasound. After birth, the baby experiences glucose hunger, so the baby's blood sugar level begins to drop sharply. After feeding, the balance is gradually restored.

Important! With gestational diabetes in the mother, the child is at risk of developing jaundice, which is difficult to tolerate and takes a long time to heal.

childbirth

A cesarean section may be recommended for a woman when the fetus reaches a large size before childbirth. The condition can be dangerous for both the mother and the baby, with contractions and attempts, the child is difficult to move through the birth canal, there is a risk of injuring the shoulders, and the woman in labor may experience an internal rupture.

If occur natural childbirth, then the glucose indicator is measured every 2-3 hours. When rising to high rates, insulin is administered, with hypoglycemia - glucose. great attention is given at this moment to the heartbeat and the rhythm of the fetal breathing.

After childbirth, the blood sugar in a woman in labor returns to normal. But for prevention, blood for analysis must be taken every three months.

The baby often has a low blood glucose level, then the child is either fed with a specially adapted mixture, or a glucose solution is injected intravenously.

Treatment

In gestational diabetes, therapy is prescribed by an endocrinologist. All activities imply compliance with certain rules of self-control, diet, gymnastic exercises. The main rules of self-control include:

1. Measurement of blood sugar at least 4 times a day, on an empty stomach and 2 hours after each meal.
2. Control of urine analysis for the presence of ketone bodies, which can be carried out at home using special strips.
3. Compliance with dietary nutrition.
4. Measurement and control of body weight throughout pregnancy.
5. Measurement of blood pressure in order to be able to normalize the condition in a timely manner during sudden jumps.
6. Administration of insulin as needed.

Important! If you do not contact a specialist in a timely manner, then the pathology can turn into type 2 diabetes on an ongoing basis.

Helps lower blood sugar levels physical exercise, it can be both yoga, fitness, swimming, and walking, light jogging.

Phytotherapy

In the treatment of gestational diabetes, you can use various decoctions and infusions from medicinal herbs. The most popular are:

1. Decoction of blueberry leaves
   60 g of the plant is poured with one liter of boiling water and infused for about 20 minutes. Strain, take 100 ml 5 times a day.
2. Freshly squeezed cabbage or carrot juice
   This tool provides favorable influence on the whole body, including the work of the pancreas, as it contains secretin. It is better to drink it on an empty stomach, half an hour before meals.
3. Decoction of blueberries
   Helps relieve inflammation, starts the process of tissue regeneration, reduces elevated level blood sugar and restores vision, which often suffers from diabetes.

Diet

To prevent sudden spikes in sugar, you need to control your diet. If there is excessive weight gain, then you should reduce the calorie content of your menu. It is very important to eat 5-6 times a day in small portions, of which there must be 3 main meals.

During pregnancy, you should abandon fast foods, fried, fatty and salty foods. Gestational diabetes involves eliminating:

• baking;
• confectionery;
• bananas;
• persimmon;
• sweet cherry;
• grape;
• potato;
• pasta;
• margarine;
• smoked products (fish, meat, sausage);
• semolina;
• sauces;
• rice, except for brown.

Preference should be given to boiled or steamed food. Vegetable oil is best added to an already prepared dish. Some nuts, seeds, sour cream are allowed.

From meat products are useful: chicken, turkey, rabbit, lean beef. You can eat baked or boiled fish of low-fat varieties. When choosing cheese, less fatty varieties with a low salt content are preferred.

Important! It is necessary to observe the drinking regimen. Daily rate- 1.5-2 liters of water (in its pure form).

Low-calorie and low-carbohydrate foods include:

• tomatoes;
• cucumbers;
• zucchini;
• radish;
• celery;
• lettuce leaves;
• cabbage;
• string beans.

You can use the above products in unlimited quantities. AT percentage the daily menu includes 50% protein foods, 40% complex carbohydrates and about 15% vegetable fats.

Prevention

To reduce the risk of developing diabetes, a pregnant woman must follow a number of rules:

1. Eat a balanced diet, eliminating harmful and heavy meals.
2. Monitor your sugar readings if you had gestational diabetes during your first pregnancy.
3. Walk outdoors daily.
4. Control weight, refuse products that provoke weight gain, follow the norms for the months of pregnancy.
5. Refuse to take nicotinic acid.
6. Get rid of bad habits
7. Avoid hard physical labor.

Gestational diabetes complicates the process of bearing a baby and harms the health of the mother. Helps prevent disease healthy lifestyle life, proper nutrition, sports activities (swimming, yoga).

If the disease was diagnosed at an early stage, you need to follow the doctor's recommendations and only under these conditions can you count on a safe birth, protecting yourself and your unborn child.