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Gestational Diabetes Mellitus
Gestational diabetes hazards
The hazards of gestational diabetes: So, what is gestational diabetes? It refers to the onset of varying degrees of hyperglycemia during pregnancy, or its first detection, including previously undetected glucose tolerance abnormalities and diabetes before pregnancy. However, pregnancies in diabetic patients are not included in this category, and should be referred to as diabetes complicating pregnancy. The main dangers of gestational diabetes are that it can jeopardize the health of both the fetus and the mother. The effects and hazards to offspring mainly manifest as an increased risk of fetal intrauterine death, congenital anomalies, and complications. There is also an increased risk of macrosomia, and an increased incidence of neonatal hypoglycemia, jaundice, polycythemia, and hypocalcemia. Additionally, the risk of obesity, glucose tolerance abnormalities, and diabetes significantly increases in offspring during adolescence or young adulthood.
Gestational diabetes blood glucose monitoring
Gestational diabetes refers to individuals who were not diabetic before pregnancy but develop high blood sugar levels due to increased insulin resistance caused by elevated hormone secretion during pregnancy. These patients also need to monitor their blood sugar, typically checking fasting blood sugar, post-meal blood sugar, and bedtime blood sugar to maintain it within a target range, such as keeping fasting levels at 5.60 and post-meal levels below 7.8 to avoid hyperglycemia or hypoglycemia and minimize the risk of low blood sugar. If the blood sugar level exceeds 10 or even higher, such patients may require medication treatment. If the increase is mild, through diet and exercise interventions, blood sugar can generally be controlled within the normal range.
How to control gestational diabetes
For diabetes during pregnancy, it is important to manage the condition in pregnant women. Initially, for blood sugar control during pregnancy, we recommend that the blood sugar levels before meals and two hours after meals be less than or equal to 5.3 mmol/L and 6.7 mmol/L, respectively, and nighttime blood sugar levels should not be lower than 3.3 mmol/L. For patients with diabetes complicated by pregnancy, the blood sugar control during pregnancy should meet the following targets: early pregnancy blood sugar control does not need to be overly strict to prevent hypoglycemia. Blood sugar levels before meals and during the night, as well as fasting blood sugar, should be controlled between 3.3 to 5.6 mmol/L, and post-meal peak blood sugar levels should be between 5.6 to 7.1 mmol/L. For both diabetes during pregnancy and diabetes complicated by pregnancy, if blood sugar levels cannot meet the above standards through diet and exercise management, insulin or oral hypoglycemic drugs should be used for further blood sugar control. Pregnancy is a special physiological period, and blood sugar control in diabetic pregnant women must not only be within the normal range but also ensure reasonable nutrient intake for the mother and fetus, reducing the occurrence of maternal and fetal complications. Most patients with gestational diabetes can control their blood sugar satisfactorily through reasonable dietary control and appropriate exercise therapy. The total daily nutrient intake should be determined based on the weight before pregnancy and the rate of weight gain during pregnancy.
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.
What to eat for breakfast with gestational diabetes
Patients with gestational diabetes are encouraged to have a balanced diet for breakfast, ensuring sufficient nutrient intake while choosing foods with a low glycemic index. For example, breakfast can include an egg, half a corn cob, a small meat bun, and a cup of milk. About two hours after breakfast, a snack can be added, selecting fruits with a low glycemic index such as strawberries, cherries, plums, apricots, apples, peaches, oranges, and grapefruits. This means that breakfast and the snack should include carbohydrates, vitamins, and proteins. Additionally, avoid eating porridge for breakfast as it has a high glycemic index, which can significantly raise blood sugar levels after the meal. Also, avoid overly greasy foods as they too can cause an increase in blood sugar.
What should people with gestational diabetes eat?
For patients with various types of diabetes, the general principle of dietary control is low salt, low fat, and a diabetes-specific diet. This means that fats and calories must be controlled. However, pregnancy is a special period that requires an adequate intake of nutrients to meet the needs of the fetus. Therefore, gestational diabetes should be managed based on one's nutritional status, and, after evaluating one's condition, sufficient high-quality protein should be supplemented. It is advisable not to consume fats, such as chicken, duck, fish, and meat, but cooking methods should be chosen carefully. Fish can be consumed steamed, and meat can be steamed or stewed, as these meats are sources of protein. However, soup should not be consumed as it is particularly high in fat. Additionally, foods like pig's feet or animal organs, which have high cholesterol levels, should be consumed in moderation. The overall principle is the same as for diabetes, but it is essential to ensure the pregnant woman's nutritional needs are met and that the fetal weight gradually increases as the pregnancy progresses. Of course, if insulin intervention is needed to some extent, insulin must be used to keep blood sugar levels within the required range.
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.
When can gestational diabetes be cured?
Gestational diabetes is a type of diabetes that is somewhat unique. People in this category usually have normal blood glucose levels before pregnancy. However, between the 24th to 28th week of pregnancy, an oral glucose tolerance test is conducted, and if high blood glucose levels are detected, a diagnosis of gestational diabetes is made. For such patients, it is generally recommended to conduct another oral glucose tolerance test 6-8 weeks postpartum. If the results are normal at this time, it indicates that the patient does not have diabetes. However, a very small proportion of individuals may still exhibit high blood glucose levels after the 6-8 week postpartum re-examination. In such cases, continued treatment for diabetes might be necessary.
Is there a difference between gestational diabetes and regular diabetes?
Gestational diabetes and common diabetes, although both types of diabetes, have significant differences between them. First, gestational diabetes is a disease specifically occurring during pregnancy and often only appears during the gestational period. After pregnancy, the majority of women will revert to a normal blood sugar state, so the main focus for gestational diabetes is on screening and intervention during pregnancy; Second, common diabetes is a chronic disease that accompanies an individual throughout their life, requiring long-term management of blood sugar through various methods. Therefore, the main difference between the two lies in the duration of the disease. Pregnant women with common diabetes, if they become pregnant, are referred to as having diabetes compounded by pregnancy, which also requires strict blood sugar management, but its mechanism of occurrence and principles of treatment differ from those of gestational diabetes.
Can pregnant women with gestational diabetes eat dragon fruit?
For patients with gestational diabetes, it is permissible to eat dragon fruit. Since dragon fruit contains relatively low sugar levels, it can be consumed. However, it should not be eaten in excess, as excessive consumption can still lead to fluctuations in blood sugar levels. In the treatment of gestational diabetes, we should not cause the pregnant woman's weight to decrease, hence a low-calorie treatment is not advocated. Generally, the total calories are calculated based on standard weight, approximately 30 to 35 kcal per kilogram of body weight per day. Sugars should make up about 50%, proteins 20%-25%, and fats 25%-30%. It is best to divide these into three main meals and three snacks, adjusting the proportion and calorie content of the diet according to body type. Therefore, patients with gestational diabetes can eat dragon fruit, and it can be consumed as a snack between main meals.