Currently, there are many female diabetic patients in the world, 2/5 of female diabetic patients are of childbearing age, and 1/7 of childbirths are affected by diabetes. In this article we will know that how danger is hyperglycemia during pregnancy.
So how does diabetes affect pregnancy and how is gestational diabetes managed?
1. What is gestational diabetes?
Gestational diabetes includes diabetes before pregnancy (type 1 or type 2 diabetes combined with pregnancy) and gestational diabetes. Gestational diabetes (GDM) is an independent type of diabetes, different from the commonly recognized type 1 or type 2 diabetes. It refers to diabetes or any degree of glucose intolerance that appears or is first discovered during pregnancy.
2. What impact does gestational diabetes have on pregnant women?
(1) Miscarriage: High blood sugar can cause abnormal embryo development or even death, and the miscarriage rate reaches 15%-30%.
(2) Hypertensive disease during pregnancy: the incidence rate is 2-4 times higher than that of non-diabetic pregnant women.
(3) Infection: Pregnant women who cannot control their blood sugar well are prone to it. Infection can also aggravate diabetic metabolic disorders and even induce acute complications such as ketoacidosis.
(4) Polyhydramnios: The incidence is 10 times higher than that of non-diabetic pregnant women.
(5) As the incidence of macrosomia increases significantly, the chances of dystocia, birth canal injury, and surgical delivery increase.
(6) Diabetic ketoacidosis is prone to occur.
(7) When pregnant women with gestational diabetes become pregnant again, the recurrence rate is as high as 33%-69%; the risk of developing diabetes in the long term increases, and up to 70% of women with gestational diabetes develop diabetes within 22-28 years after pregnancy (mainly type 2) .
3. What impact will it have on the fetus?
(1) Congenital malformations: The incidence rate is 7-10 times that of normal pregnancy.
(2) Macrosomia: the incidence rate is as high as 25%-42%.
(3) Miscarriage and premature birth: the incidence rate is 10%-25%.
(4) Intrauterine growth restriction: the incidence rate reaches 21%.
In addition, fetuses exposed to maternal diabetes are at increased risk for childhood and adult diabetes and obesity .
4. What impact will it have on newborns?
(1) The incidence of neonatal respiratory distress syndrome increases.
(2) Neonatal hypoglycemia: After the newborn is separated from the maternal hyperglycemic environment, hyperinsulinemia still exists. If sugar is not supplemented in time, hypoglycemia is prone to occur, and in severe cases, the newborn’s life is endangered.
5. What are the high-risk factors for gestational diabetes?
On the basis of being overweight or obese [Asian or Asian body mass index (BMI) ≥23 kg/m2], having one or more of the following additional risk factors will greatly increase the risk of gestational diabetes.
6. What clinical manifestations should alert you to the possibility of pregnancy complicated by diabetes?
(1) Three symptoms (polyuria, polyphagia, polydipsia).
(2) Recurrent vulvovaginal Candida infection.
(3) Pregnant woman weighs >90kg.
(4) Complicated by polyhydramnios or macrosomia.
7. How to detect gestational diabetes early?
The American Diabetes Association recommends:
(1) Pregnant women with high-risk factors should be comprehensively screened for type 2 diabetes during their first prenatal check-up.
(2) Pregnant women who are not diagnosed with diabetes during the first prenatal check-up should be screened for gestational diabetes at 24-28 weeks of pregnancy.
(3) Pregnant women with gestational diabetes should undergo an oral glucose tolerance test to screen for diabetes at 6-12 weeks postpartum.
(4) Women with a history of gestational diabetes should undergo diabetes screening at least every 3 years and maintain it throughout their lives.
(5) Women with a history of gestational diabetes need lifestyle intervention or drug intervention if they have developed into a pre-diabetic state.
8. What to do about gestational diabetes?
(1) Diet control : It is necessary to ensure the energy needs of pregnant women and fetuses, maintain blood sugar within the normal range, and avoid starvation ketosis. Try to choose sugar-water compounds with low glycemic index, and eat small and frequent meals, 5-6 times a day. meal.
(2) Exercise therapy : The best way for pregnant women to exercise during pregnancy is aerobic exercise, such as walking, yoga, Tai Chi, etc. No strenuous exercise, such as running, playing ball, etc., at least once a day, usually 0.5-1 hour after a meal. It takes place every hour and lasts 20-30 minutes.
(3) Monitor blood sugar : Monitor fasting, pre-meal blood sugar and 1-2h post-meal blood sugar, 4-6 times a day if conditions permit.
(4) Glucose control treatment : Avoid the use of oral hypoglycemic drugs. If blood sugar cannot be controlled through dietary treatment, follow the doctor’s instructions and use insulin treatment.
(5) Control blood pressure : Control blood pressure below 130/80mmHg.
(6) Complication monitoring : Renal function, fundus and blood lipid testing should be performed every 3 months.
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