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Gestational Diabetes Mellitus
Gestational diabetes manifestations
Gestational diabetes refers to hyperglycemia that either develops or is first identified during pregnancy, including previously unrecognized glucose intolerance and diabetes prior to pregnancy. Typical symptoms of gestational diabetes include frequent urination, increased thirst, and increased hunger, or recurrent vulvovaginal candidiasis. High vigilance for gestational diabetes is warranted if the pregnant woman weighs over 90 kilograms, or if the current pregnancy is complicated by excessive amniotic fluid or a macrosomic fetus. The danger of this condition is that, in severe cases or where blood sugar control is poor, it can easily lead to miscarriage and preterm birth, as well as infections, and in severe cases, may lead to ketoacidosis. Treatment involves two aspects: one is dietary control, and for patients who cannot control their diet effectively, insulin treatment can be used. (Medication should be used under the guidance of a doctor.)
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.
What are the symptoms of gestational diabetes?
Patients with gestational diabetes have different constitutions, ages, and weights, so their clinical symptoms also vary greatly. The more typical symptoms include the obvious "three polys and one less," namely polyuria, polydipsia, polyphagia, and unintended weight loss. Pregnant women are prone to recurrent vulvar infections and itching. Some patients with gestational diabetes may not show obvious symptoms, while others may experience a series of adverse symptoms such as excessive amniotic fluid, vulvar itching, and ketoacidosis. If blood sugar is not well-controlled during pregnancy, it can cause delayed growth and development of the fetus. Gestational diabetes can pose significant risks to both the fetus and the pregnant woman. Therefore, timely diet, exercise, and appropriate insulin treatment should be administered.
What are the symptoms of gestational diabetes?
The symptoms of gestational diabetes vary depending on the severity of the disease. Most cases of gestational diabetes are symptomless and are only detected when high blood sugar levels are found during diabetes screening. Therefore, it is recommended to perform a 75g glucose screening during pregnancy, at the very least, fasting blood sugar should also be checked because most diabetic patients do not notice any symptoms on their own. If the diabetes is more severe, the patient may experience symptoms such as increased thirst, increased appetite, weight loss, and frequent urination.
Gestational diabetes symptoms
Gestational diabetes refers to the onset or first-time detection of varying degrees of hyperglycemia during pregnancy, including pre-pregnancy unrecognized glucose intolerance and diabetes. Typical clinical symptoms of gestational diabetes include polyuria, polydipsia, polyphagia, or recurrent vulvovaginal candidiasis. If the pregnant woman's weight is greater than or equal to 90 kilograms, and the current pregnancy is complicated by excessive amniotic fluid or macrosomia, there is also a high suspicion of gestational diabetes. In severe cases or those with poor blood sugar control, not only is there an increased risk of preterm labor but also miscarriage, and in severe cases, ketoacidosis may occur.
How to eat after giving birth for gestational diabetes
Patients with gestational diabetes need to be careful with their diet even after giving birth, during the period known in Chinese tradition as "sitting the month." During this time, it is customary for Chinese women to consume large amounts of animal protein, including soups that are believed to help with milk production. However, patients with gestational diabetes should still control their intake, opting for low-fat and low-salt options. Traditional dishes like pig's trotters stewed with soybeans, which are high in fat, are not recommended for patients, as their effectiveness in promoting milk production is minimal. After childbirth, patients can instead focus on consuming high-quality proteins such as lean meats and milk, which are encouraged.
What kind of milk should be consumed for gestational diabetes?
Patients with gestational diabetes can drink pure milk, which contains rich nutrients such as protein, fat, vitamins, and minerals. Milk protein contains essential amino acids for the human body, and milk fat mostly consists of short-chain and medium-chain fatty acids, which are easily absorbed by the human body. Moreover, milk is rich in calcium, making it suitable for pregnant women to supplement calcium. The daily consumption of milk can be 500mL, taken in two to three servings, choosing either pure milk or skimmed pure milk. If unsweetened yogurt is available, it is also acceptable to drink. It is important to note that one should try to avoid buying milk powder, as it often contains some additives that are not conducive to blood sugar control.
How to prevent gestational diabetes
The onset of gestational diabetes is primarily due to uncontrolled diet during pregnancy, leading to rapid weight gain, which in turn causes insulin resistance and results in high blood sugar. Gestational diabetes is characterized by increased blood sugar levels caused by this insulin resistance. In the early stages, it can be managed by controlling diet and increasing physical activity to keep blood sugar within a reasonable range. If blood sugar cannot be controlled, insulin medication intervention may be necessary. How to prevent it in the early stages? Mainly, it involves keeping weight within a reasonable range, monitoring weight gain, while ensuring normal fetal development. Additionally, in terms of diet, avoid excessive intake of foods high in oil, such as animal organs; fats and oils are high in lipids, which can also exacerbate insulin resistance, leading to the development of gestational diabetes. (Please use medication under the guidance of a doctor to avoid blind self-medication).
Are there many people with gestational diabetes?
Gestational diabetes is increasingly common now as living standards improve, and there is more attention on pregnant women from their families. Often, out of fear of malnutrition during pregnancy, there is a tendency to over-nourish and overeat, leading to significant weight gain around the 24th to 26th weeks of pregnancy. Upon examination, it is discovered that their blood sugar levels are elevated, indicating gestational diabetes. Although gestational diabetes is becoming more widespread, the blood sugar levels are usually not extremely high. Therefore, such patients can often manage their condition through diet control and encouraging appropriate exercise for pregnant women. Thus, pregnant women diagnosed with gestational diabetes should not be overly stressed psychologically.
Can gestational diabetes be inherited by the baby?
Gestational diabetes refers to hyperglycemia that starts or is first identified during pregnancy, including previously undiagnosed glucose intolerance and diabetes before pregnancy. Although most patients’ blood sugar levels may return to normal after delivery, whether or not it normalizes postpartum, it is considered gestational diabetes. The harm during pregnancy endangers the health of both the fetus and the mother. The effects on offspring mainly manifest in the following ways: First, it increases the risk of complications such as fetal intrauterine death and congenital anomalies. Second, the risk of giving birth to a large baby is increased. Third, the incidence of neonatal hypoglycemia, jaundice, polycythemia, and hypocalcemia increases. Fourth, the risk of obesity, glucose intolerance, and diabetes increases during adolescence and young adulthood. Therefore, while gestational diabetes is not inherited by the baby, it does increase the risk of obesity, glucose intolerance, and diabetes in the baby during adolescence or young adulthood.