Gestational diabetes mellitus and diabetic pregnancy

Diabetes during pregnancy, mothers and infants have a high risk of complications of the merger. Sum it up in a great deal of clinical experience, so that maternal diabetes during pregnancy before and during pregnancy in a timely manner appropriate glycemic control and strict monitoring of the mother and fetus, the majority of female patients will be able to successfully give birth a healthy baby.

Diabetes in pregnancy, including both cases the main

Pre-pregnancy has been diagnosed with type 1 diabetes and type 2 diabetes patients pregnancy, medically known as gestational diabetes mellitus; the other one is found that gestational diabetes occurs or is called gestational diabetes.

In recent years, the incidence of diabetes continue to rise, diabetic patients with pregnancy are also increased, In addition, diabetes during pregnancy as a result of extensive screening, the detection rate of gestational diabetes increased. The future incidence of diabetes in pregnancy will continue to rise, the pregnancy of women with diabetes, this will attract greater attention.

Gestational diabetes, type of diabetes patients is relatively light, the majority of the performance of abnormal glucose metabolism, post-partum return to normal; However, with age, old age, after developing into the risk of type 2 diabetes has not suffered more than pregnant women with gestational diabetes mellitus high. Although gestational diabetes mellitus light condition, if not early pregnancy diagnosis, treatment, still constitutes a threat to the fetus.

The impact of diabetes on pregnancy

Diabetes have a significant effect on the pregnancy, high blood sugar in pregnant women during early pregnancy can increase the rate of fetal malformations, spontaneous abortion also increased; in late high blood sugar during pregnancy, the fetus through the placenta caused by high blood sugar, have occurred in fetal hyperinsulinemia, which in turn leads excessive fetal growth, showed a huge increase in the fetus, after birth, these children prone to neonatal hypoglycemia; third trimester fetal hypoxia increased occurrence of severe cases of intrauterine fetal death. At the same time, patients with diabetes of pregnancy itself can increase glucose metabolism disorder, timely treatment is not easy to complicated ketosis, ketoacidosis can induce severe cases, even coma.

In addition, pregnancy-related complications such as diabetes so that the incidence of hypertension increased by 4 times to 6 times, easily over-complicated by amniotic fluid; diabetic ketoacidosis occurred in pregnant women is not only a serious threat to pregnant women, the fetus will also be a greater impact. As early as ketoacidosis occurred during pregnancy, will have an impact on embryonic development, resulting in the occurrence of fetal malformations, middle and late pregnancy complicated by ketoacidosis, will add to intrauterine hypoxia, fetal death occurred in severe cases. Previous study also showed: blood glucose control during pregnancy is not ideal for pregnant women in addition to intrauterine fetal death in late pregnancy increases, the delivery of neonatal lung maturity is often delayed, at risk after birth neonatal respiratory distress syndrome (caused by a variety of factors severe acute lung injury, lung tissue caused by obstacles to gas exchange, respiratory failure, often combine multiple organ failure), high neonatal mortality rate; In addition, the mother suddenly left neonatal hyperglycemia environment, if the birth did not provide timely relief to sugar copies, neonatal hypoglycemia significantly increased the incidence of neonatal polycythemia and hypocalcemia, hypomagnesemia increased incidence. This shows that in patients with gestational diabetes is a more complex issue.

In recent years a large number of studies show that: during pregnancy if the time of diabetes diagnosis and treatment of patients, the majority of diabetic pregnant women is relatively satisfied with the outcome of pregnancy can the doctor in the medical and obstetric care of pregnancy, safe delivery of a healthy baby. These rare complications of mothers and infants.

Seriously ill patients with diabetes mellitus, diabetic patients with retinal damage, combined heart and kidney dysfunction are not pregnant. Other patients with poor blood sugar control should not be pregnant.

Ready pregnant

Pre-pregnancy diabetes must be prepared to conduct a comprehensive medical examination, consultation doctor in line with the conditions before pregnancy, during pregnancy out of oral hypoglycemic agents to use insulin, pre-pregnancy to maintain blood glucose within the normal range, to prevent high blood sugar when pregnant affect the normal development of embryos; diet during pregnancy continued to control and insulin therapy;regularly check blood glucose and body, in the event of poor blood sugar control or ketosis should be hospitalized as soon as possible; at the same time strengthen the monitoring of the fetus, if not, then the timely termination of pregnancy induced .

Once pregnant women diagnosed with gestational diabetes diet to control the first. Carbohydrate intake was stable, the daily staple food for ~ 3OO grams grams 25O;the best day of five-six meals better. Deprivation of sweets, modest eat low sugar fruits, if the above can not satisfy the appetite of pregnant women may be a small amount of snacks in between meals to food-based protein-rich, should intake of vegetables, food rich in cellulose .

Volume must be adequate. Adjustment does not mean that the more the better to eat less, inadequate carbohydrate diet, resulting in easy occurrence of ketosis in pregnant women, pregnant women and fetuses are disadvantaged, so diabetic diet pregnant women should be experienced under the guidance of doctors and nutritionists to conduct. After diet, blood sugar is still not satisfied with the adjustment, that is fasting, or fasting blood glucose 35.8mmol / L; blood glucose two hours after meal 36.7mmol / L should be a timely addition of insulin to control blood sugar.

With the changes in gestational diabetes in pregnant women have a certain degree of change in blood glucose, the normal blood sugar control, pregnancy should be regular monitoring of blood glucose, blood glucose level in accordance with the adjustment of insulin dosage. Pregnant women as a result of decreased renal glucose threshold, urine can not accurately reflect the level of blood sugar, urine sugar therefore not possible to use during pregnancy to monitor the condition of diabetes in pregnant women to manage the situation. In addition, the third trimester fetal to strengthen monitoring, in order to detect fetal hypoxia.

For blood sugar control during pregnancy is unsatisfactory, it is necessary to terminate the pregnancy. Before the termination of pregnancy, amniotic puncture should be carried out to determine the situation of fetal lung maturity.

After birth should be strengthened monitoring, care, to discuss a range of neonatal complications.

Gestational Diabetes

Many pregnant women do not have diabetes before pregnancy, and gestational diabetes have emerged, which is why?

The reasons for the occurrence of gestational diabetes

1. Pregnancy occurred after the human endocrine changes in the placenta may produce some hormones, and the role of insulin resistance;

2. To increase carbohydrate metabolism during pregnancy, insulin is also a corresponding increase in demand;

3. Placental insulin-degrading enzyme can produce damage to the body of insulin.

The existence of these factors make insulin requirements increase during pregnancy, the secretion of insulin the body must also be increased, but for those who reduce the reserve capacity of insulin for pregnant women, there will be abnormal glucose metabolism, the occurrence of gestational diabetes mellitus. Therefore, granted that there is no diabetes in pregnant women can be the first symptoms of diabetes.

Not all women are bound to happen after pregnancy diabetes, there are several cases of pregnant women should pay attention to:

① diabetes family history;

② history of abnormal delivery, such as unexplained repeated miscarriage, stillbirth, stillbirth, neonatal death, fetal malformation or a huge delivery history;


③ The large fetus suspected pregnancy or polyhydramnios;

④ and repeated fungal vaginitis;

⑤ obese pregnant women;

⑥ age greater than 3O-year-old pregnant women;

⑦ early recurrent positive urine sugar;

⑧ more drinks, more food, more than those in urine.

Pregnant women, the attention of a reasonable diet to reduce high-sugar food intake, to avoid the total daily caloric intake too much, due to increase during exercise, can reduce and prevent the occurrence of gestational diabetes at the same time, doctors deal with these pregnant women in order to strengthen the blood sugar screening, early diagnosis of diabetes mellitus.