Increased sugar during pregnancy

Diabetes mellitus is an insidious disease that today occurs in people at any age. We recently wrote about type 1 diabetes: it increasingly appears in children from 4 to 10 years old and "disguises" as symptoms of rotavirus and appendicitis. Type 2 diabetes is also "younger": now it is diagnosed in people 35-40 years old. In addition to them, there is another, third type of diabetes, which pregnant women are susceptible to. It is called gestational diabetes, and this disease is dangerous because it threatens the health of not only the mother, but also the fetus. According to the latest data, from 15 to 20% of all expectant mothers suffer from this type of diabetes. How does it manifest itself and how is it treated? What analysis allows you to determine it? Read in our material.

Why does diabetes develop during pregnancy?

Gestational diabetes does not depend on sweetness / istockphoto.com

Gestational diabetes mellitus (GDM) is a pathological condition that manifests itself only in pregnant women. At the same time, before pregnancy, the expectant mother may not have any problems with blood sugar at all. However, in the process of carrying a child in the mother's body, the production of hCG and cortisol increases dramatically, which suppress the action of insulin. As a result, a pregnant woman needs more of it than usual to break down glucose.

The body has to produce insulin in an increased mode. And he does not always manage to cope with the task at hand. As a result, a pregnant woman develops a sustained elevated blood glucose level, which is the main symptom of gestational diabetes mellitus. The main danger of this disease is that it does not in any way affect the well-being of the expectant mother. In most cases, GDM is almost asymptomatic, and in very rare cases it manifests itself as intense thirst, fatigue, and profuse urination.

Which women are at risk?

Pregnant women with rapid weight gain at risk of GDM / istockphoto.com

Absolutely any woman can get GDM, but there are factors that increase the level of risk.

• First of all, these are the extra pounds that the expectant mother had before pregnancy. With excess weight, insulin already needs an order of magnitude more, and then there are hormones that interfere with its work. As a result, overweight pregnant women may develop GDM as early as the first trimester.
• For the same reason, expectant mothers who gain too much during pregnancy fall into the risk group. If you or the doctor notice that the kilograms are arriving faster than expected, the blood sugar level also needs to be "put on a pencil".
• Not entirely obvious, but still common risk factors are the age of the pregnant woman over 30 years old, bad habits (for example, smoking before pregnancy), and a sedentary lifestyle.
• But the presence of any form of diabetes mellitus in relatives doubles the likelihood of developing GDM. In addition, gestational diabetes tends to "come back": if a woman suffered from this disease in a previous pregnancy, then most likely the body will not cope with it again.

How to define gestational diabetes?

To test for GDM, you need to donate blood from a vein three times / istockphoto.com

To identify this disease, glucose tolerance test. It is usually prescribed between 24 and 26 weeks of gestation. However, for women from risk groups (especially those with overweight and obesity or a history of GDM), such a test is better done earlier: it can be done at the time of registration or at 14-16 weeks of pregnancy.

During the test, a pregnant woman takes blood from a vein three times. The first time on an empty stomach (it is forbidden to eat for 8 hours before blood sampling), the second time with a "load" (usually for this you need to drink a solution of 75 g of glucose) and the third time - two hours after ingestion glucose. The normal result is considered to be a fasting glucose level below 5.1 mmol / L on the first test, and below 8.6 mmol / L on the third test. On the second test, the glucose level should remain below 10 mmol / L.

If, during the first analysis (on an empty stomach), a woman has an excess of blood glucose, it is unlikely that she will be tormented by an analysis with a load. This is already a signal that you need to adjust your diet and bring your blood sugar level under regular control. If the result is too high on an empty stomach (above 7 mmol / l), this is the reason for the diagnosis of diabetes mellitus, which requires a completely different (often drug) treatment.

How can gestational diabetes be cured?

Gestational diabetes can cause premature birth / istockphoto.com

The peculiarity of this disease is that it does not stay with the woman after pregnancy. Typically, a few weeks after giving birth, your blood sugar drops on its own without any treatment. However, this does not mean at all that you can forget about the diagnosis and calmly carry the child further. Even if GDM does not yet cause you any discomfort, it can seriously affect the development of the baby in the womb and even provoke a miscarriage. Here are just a few of the complications of untreated gestational diabetes for both mother and fetus:

• death of a child during pregnancy (may be triggered by a persistently elevated mother's blood sugar)
• gestosis of pregnant women (a complication of the second half of pregnancy, which is manifested by impaired renal function and high blood pressure - up to eclampsia)
• macrosomia or large fruit (intensive weight gain by a child in the womb and the birth of a baby weighing 4 kg or more) and probable complications in childbirth
• fetal hypoxia (usually develops during a large-fetal pregnancy)
• early aging of the placenta
• polyhydramnios
• hypolycemia of the newborn (low glucose levels in the first hours of life), which then manifests itself as the child's tendency to obesity and the development of diabetes mellitus
• an increased risk of type 2 diabetes in the mother after childbirth

The good news is that most of the time, gestational diabetes can be tamed with nutrition alone. If you carefully monitor your diet and follow simple guidelines, you can keep your blood sugar levels in check until the onset of labor. In very rare cases, insulin injections are prescribed for pregnant women. You should not be afraid of this: the lack of this hormone in the body of the expectant mother is much more dangerous.

How to eat for gestational diabetes?

Diet and blood sugar control are important in GDM / istockphoto.com

It is better for a woman who has been diagnosed with GDM to immediately purchase a glucometer: before the end of pregnancy, this device will become her best friend. Sugar will have to be measured several times a day - in the morning on an empty stomach and an hour after each meal. On an empty stomach, the glucometer should show 3.5-5.1 mmol / l, and an hour after eating, the indicator should not exceed 7 mmol / l.

In food, be sure to adhere to certain rules. This is not a strict diet, but willpower may be required.

• Fractional meals with a break of more than 4 and not less than 2 hours. It is optimal to divide the entire daily diet into 3 main meals and 2-3 snacks. At the same time, it is better not to skip snacks - and yes, this applies to "that very" snack before bedtime. During pregnancy, it is very important for a woman.
• The maximum complete rejection of simple carbohydrates in the form of sugar and sugar-containing foods. The ban covers not only sweets, cakes and cookies, but even honey and jam. In addition, juices, sweet teas, and even more so, soda are not welcome.
• It is by no means impossible to completely exclude carbohydrates from the diet: if the body does not have enough glucose, it will begin to “make” it from fats. In this case, decay products are formed - ketone bodies (simply, acetone). Their concentration also negatively affects the development of the unborn child. Therefore, you need to replace simple carbohydrates with complex ones and pay attention to cereals, bread and pasta, legumes, potatoes and fruits. That being said, it is important to follow the rule of one product at a time. Do not combine several carbohydrate foods in one meal.
• Remember, fruits also contain sugar, so don't go overboard with them. You need to eat them with a break, stretching the daily portion (say, three apples) for the whole day. Do the same if you want to “beat” a large fruit (for example, a pomelo): crush it in several pieces throughout the day.
• When buying dairy products, avoid sweetened goods (fruit yoghurts, curd mass, curds). Give preference to natural kefir, fermented baked milk, unsweetened yogurt. But remember that you can consume no more than a glass (200 ml) of such products at one meal.
• The only type of food for which pregnant women with GDM practically have no restrictions is vegetables. It is advisable to eat them several times a day. Vegetables are very low in carbohydrates, but high in fiber and vitamins. Therefore, if you want to eat something really healthy, replace the apple with a tomato or nibble on a carrot.

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