How is gestational diabetes treated?

Written by Liang Yin
Endocrinology
Updated on September 18, 2024
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The treatment of gestational diabetes includes dietary therapy, exercise therapy, and insulin therapy. For dietary therapy, we mainly control the total calorie intake and supplement with elements such as calcium, iron, folic acid, and various vitamins; in exercise therapy, we aim to control the speed of weight gain, improve the peripheral tissues' utilization of glucose, and improve the lipid profile. For patients whose blood glucose levels do not meet the standards after two weeks of diet and exercise therapy, we initiate insulin therapy. The goal of insulin therapy is to control fasting blood glucose below 5.3 and postprandial blood glucose below 6.7. The methods of insulin therapy include twice daily injections, multiple daily injections, or the use of an insulin pump.

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Written by Chen Xie
Endocrinology
1min 42sec home-news-image

Impact of gestational diabetes on the fetus and pregnant women

The effects of gestational diabetes on the mother mainly include an increased risk of miscarriage, concurrent conditions such as gestational hypertension and preeclampsia, as well as the potential for diabetic ketoacidosis. The presence of a large fetus can lead to difficult labor, damage to the birth canal, prolonged surgical delivery, and an increased likelihood of postpartum hemorrhage. Additionally, women with gestational diabetes have an increased risk of developing the condition again in future pregnancies. In terms of long-term effects, the risk of developing type 2 diabetes significantly increases after experiencing gestational diabetes. For the fetus, the impacts of gestational diabetes primarily manifest as an increased risk of spontaneous miscarriage, congenital anomalies, and abnormal development. There is also a heightened risk of hyperinsulinemia, which can even affect the proper development and maturity of the fetal lungs, leading to delays. After birth, conditions such as hypoglycemia and neonatal respiratory distress syndrome are more likely to occur. In the long term, offspring of women with gestational diabetes are at higher risk for glucose intolerance, diabetes, obesity, and metabolic syndrome. These conditions significantly increase the risks to the cardiovascular system and can affect neuromotor development.

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Written by Luo Han Ying
Endocrinology
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Is gestational diabetes easy to treat?

Gestational diabetes nowadays is often related to excessive supplementation for pregnant women, meaning eating too much and too well. Families tend to be overprotective, and there is no need for exercise. Additionally, during pregnancy, insulin resistance and some special bodily changes occur. Therefore, between the 24th and 28th weeks, high blood sugar levels can be detected. After the diagnosis of gestational diabetes, first and foremost, it is necessary to adjust one's mindset and control the diet strictly. During pregnancy, it is sufficient to ensure adequate protein intake, and it's not about eating more or better. Secondly, for gestational diabetes, exercise can be intensified to control blood sugar levels.

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Written by Tang Zhuo
Endocrinology
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Gestational diabetes standard values

Standards for gestational diabetes, so what is gestational diabetes? It refers to diabetes that either develops during pregnancy or is first detected at this stage, presenting varying degrees of hyperglycemia, including previously unrecognized glucose intolerance or diabetes prior to pregnancy. Pregnancies in known diabetic patients are not included in this category, and may also be referred to as diabetes complicating pregnancy. So, how is gestational diabetes diagnosed? We can conduct a 75g anhydrous glucose tolerance test, where a fasting blood glucose greater than or equal to 5.1 mmol/L, and blood glucose greater than 10 mmol/L one hour after, meets the criteria to diagnose gestational diabetes.

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Written by Chen Xie
Endocrinology
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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.

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Written by Li Lang Bo
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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.