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Chen Xie
Endocrinology
About me
Loudi Central Hospital, Endocrinology Department, attending physician, has been engaged in clinical work in endocrinology for many years, with rich clinical experience in the diagnosis and treatment of endocrine system diseases.
Proficient in diseases
Specialize in common diseases related to the hypothalamus, pituitary gland, thyroid gland, parathyroid glands, adrenal glands, and the reproductive axis.
Voices
Gestational diabetes: what kind of milk to drink?
The overall principle of dietary control for patients with gestational diabetes is to manage the total calorie intake and adopt a pattern of eating smaller, more frequent meals. Ideally, the day should be divided into 5 to 6 meals. This approach helps not only in controlling blood sugar levels but also in reducing the occurrence of hypoglycemia. For patients with gestational diabetes, it is recommended to drink pure milk. However, many of the milk and dairy products available on the market contain a large amount of added sugar or have a very high fat content, which can lead to excessive caloric intake and affect blood sugar control. Therefore, for patients with gestational diabetes, it is advisable to drink low-fat or non-fat pure milk, which has relatively lower calories and will not impact blood sugar levels. It is suggested to have a glass of pure milk either two hours after a meal or before bedtime to help reduce the occurrence of hypoglycemia and prevent it during the night.
Screening time for gestational diabetes
For women without high-risk factors, the general practice is to conduct a 75g glucose tolerance test between 24 to 28 weeks of pregnancy, measuring fasting blood glucose, blood glucose one hour after glucose ingestion, and blood glucose two hours after glucose ingestion. The fasting blood glucose should not exceed 5.1 mmol/L, blood glucose one hour after glucose ingestion should not exceed 10.0 mmol/L, and blood glucose two hours after glucose ingestion should not exceed 8.5 mmol/L. For women with high-risk factors, it is advisable to screen for blood glucose levels during the first prenatal visit to detect gestational diabetes early, control blood sugar levels, and reduce the occurrence of complications. Who are the women considered to be at high risk? Those who have a history of gestational diabetes, history of delivering a macrosomic infant, are obese or have polycystic ovary syndrome, have a family history of diabetes among first-degree relatives, are found to have positive fasting and ketone bodies early in pregnancy, have a history of unexplained recurrent miscarriages, have a history of fetal anomalies and stillbirths, and those who have a history of delivering newborns with respiratory distress syndrome. These women need to undergo diabetes screening after becoming aware of the pregnancy to detect any abnormality in blood sugar levels early and treat accordingly.
Risk of gestational diabetes in second pregnancy
For women with gestational diabetes, the risk of diabetes in a second pregnancy is higher. Therefore, it is recommended that mothers who have had gestational diabetes undergo fasting glycosylated hemoglobin monitoring at a hospital before becoming pregnant, to rule out the possibility of pre-pregnancy diabetes. Additionally, it is advised to maintain a reasonable diet throughout the pregnancy, exercise regularly, and avoid high-calorie, high-sugar foods, as this can help prevent and reduce the occurrence of diabetes. In fact, for mothers expecting their second child, age is also a major risk factor. As age increases, the risks of hyperglycemia during pregnancy and hypertension during pregnancy become higher, thus the risk of gestational diabetes in a second pregnancy is relatively higher compared to the first.
Standards for Blood Sugar Control in Gestational Diabetes
The control of blood sugar in gestational diabetes mainly involves monitoring fasting blood glucose, postprandial blood glucose, and ketone bodies in urine. Patients can monitor their fasting and postprandial blood glucose 4-6 times daily. The target for blood sugar control is to maintain fasting blood glucose, pre-meal, or pre-sleep blood glucose levels between 3.3 to 5.3 mmol/L, postprandial blood glucose after one hour should be less than or equal to 7.8 mmol/L, and postprandial blood glucose after two hours should be less than or equal to 6.7 mmol/L. Ketone bodies should be negative, and glycated hemoglobin should be controlled below 6%. Only by meeting these standards can the control of blood sugar in gestational diabetes be considered adequate, which can reduce risk factors for both the mother and the fetus.
What department should I go to for osteoporosis?
Osteoporosis is a metabolic bone disease characterized by reduced bone mass and destruction of bone microstructure, leading to increased bone fragility and susceptibility to fractures. It can be divided into primary and secondary types based on the cause. Secondary osteoporosis has a clear primary cause, often due to endocrine metabolic diseases such as gonadal insufficiency, hyperthyroidism, hyperparathyroidism, Cushing's syndrome, type 1 diabetes, or systemic diseases. Primary osteoporosis is commonly seen in postmenopausal osteoporosis and senile osteoporosis. Therefore, it is recommended to consult an endocrinology or orthopedics department for osteoporosis.
Can you eat sweet potatoes if you have gestational diabetes?
The overall principle of dietary control for gestational diabetes is to manage the total calorie intake by eating smaller, more frequent meals, dividing the day into five to six meals. This helps not only in controlling blood sugar levels but also reduces the occurrence of hypoglycemia. For patients with gestational diabetes, foods that quickly raise blood sugar, as well as those high in sugar content, starch, and fat, should be limited as these can easily convert into glucose, leading to an increased blood sugar level. Sweet potatoes, which are available in many varieties on the market, some with higher sugar content and some with lower, should be considered accordingly. Those with higher sugar content should ideally be avoided to prevent excessively high blood sugar levels, while those with lower sugar content can still be consumed. However, when eating sweet potatoes, they should be treated as a staple food, and the amount of other staple foods should be reduced accordingly to maintain good control of blood sugar levels.
Do you need insulin for gestational diabetes?
Gestational diabetes refers to the elevated blood glucose levels found during pregnancy. For patients diagnosed with gestational diabetes, we first need to control diet and exercise to manage blood sugar levels, maintaining fasting blood glucose between 4.0-5.3 mmol/L and postprandial (two hours after meals) blood glucose between 4.4-6.7 mmol/L. If blood sugar control can be achieved through diet and exercise, insulin treatment is not required. However, if blood sugar levels still do not meet the standards through diet and exercise, exceeding the figures mentioned earlier, insulin treatment is necessary. For patients receiving insulin treatment, it poses no harm to either the fetus or the mother. In fact, when blood sugar is well-controlled, it can actually reduce the risks associated with gestational diabetes.
Can you eat pumpkin with gestational diabetes?
The overall principle of dietary control for patients with gestational diabetes is to manage total calorie intake and to eat smaller, more frequent meals. Consuming five to six meals a day can help stabilize blood sugar levels and reduce the occurrence of hypoglycemia. Therefore, for patients with gestational diabetes, foods that can rapidly increase blood sugar levels, such as those high in sugar, starch, and fat, should be consumed less frequently, as these foods can easily be converted into glucose, leading to an increase in blood sugar levels. Pumpkin, which is high in carbohydrates, should also be eaten in moderation. However, this does not mean that pumpkin cannot be eaten at all. When consuming pumpkin, it should be treated as a staple food. After eating pumpkin, the amount of other staple foods in that meal should be reduced. This helps in maintaining good blood sugar control. Therefore, patients with gestational diabetes can still eat pumpkin, but it should not be treated as a vegetable. Instead, it should be considered like rice, and the amount of rice should be reduced when pumpkin is consumed.
What to eat with gestational diabetes
The dietary control for gestational diabetes adheres to the same overall principles as non-pregnant diabetes management, mainly focusing on controlling total caloric intake and eating smaller, more frequent meals. This approach helps manage blood sugar levels and reduces the occurrence of hypoglycemia. Additionally, it is important to consider the nutrients required for fetal growth and development. Generally, carbohydrate intake should make up 50%-60% of the diet, proteins 15%-20%, and fats should not exceed 30%. Foods that quickly increase blood sugar levels and are high in fat should be consumed minimally. Instead, it is beneficial to consume a lot of vegetables, at least 500 grams daily, to ensure adequate intake of vitamins and fiber.
The difference between thyroid enlargement and thyroid nodules
Thyroid enlargement generally refers to simple thyroid enlargement, which is typically diffuse thyroid enlargement, mainly caused by iodine deficiency, commonly seen in endemic goiter and physiological thyroid enlargement. Thyroid nodules, on the other hand, are nodular hyperplasia of the thyroid caused by certain physical and chemical factors. Thyroid nodules can manifest as benign hyperplasia or malignant hyperplasia. Therefore, the risks associated with thyroid nodules are relatively greater than those of thyroid enlargement. However, some patients with thyroid enlargement, as the disease progresses, can develop nodular hyperplasia of the thyroid. These are the differences between the two.