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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Does gestational diabetes cause itching in the vulva?

During gestational diabetes, white blood cells have various functional defects, reduced chemotaxis, phagocytic action, and bactericidal activity. This can easily lead to infections during pregnancy or childbirth, and even develop into sepsis, often caused by bacteria or fungi. Therefore, when blood sugar is not controlled in gestational diabetes, there may be symptoms like vulvar itching, or even infections of the urinary or reproductive systems. If the infection is not further treated, it may cause preterm birth, or even septic shock. Therefore, in gestational diabetes, it is crucial to actively control blood sugar and prevent infections.

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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.

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Symptoms of Gestational Diabetes

Gestational diabetes refers to the onset of different levels of hyperglycemia during pregnancy, or first diagnosed during pregnancy, including previously unrecognized glucose intolerance and diabetes before pregnancy. Typical clinical manifestations of gestational diabetes include symptoms such as polyuria, polydipsia, and polyphagia, or recurrent Candida infections of the vulva and vagina. If a pregnant woman weighs more than 90 kilograms, presents with polyhydramnios, or has a macrosomic fetus during this pregnancy, there should be a high degree of vigilance for the possibility of gestational diabetes. Its dangers lie in severe cases or poorly controlled blood sugar in gestational diabetes, which not only tends to lead to miscarriage and preterm birth but also can cause infections, and in severe cases, may lead to ketoacidosis. Therefore, dietary control and medication are very important for managing gestational diabetes.

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Can you drink yogurt if you have gestational diabetes?

Regarding yogurt, there are two scenarios. Currently, you can make yogurt at home with a yogurt maker. If it's homemade yogurt and you haven't added sugar, it is okay to eat because it contains probiotics and nutritious ingredients, which are actually beneficial for pregnant women. However, the yogurt sold in stores contains very high sugar levels because anyone who has made yogurt would know that unsweetened yogurt is very sour. The kind sold in stores tastes that way because a large amount of sugar is added, not to mention various additives. This is very unfavorable for blood sugar control in patients with gestational diabetes. Therefore, we recommend that pregnant women should drink less or even avoid commercial yogurt. In fact, we can obtain these nutrients by drinking regular milk, like pure milk.

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Gestational diabetes standard values

The screening for gestational diabetes should be conducted between the 24th and 28th weeks of pregnancy. This includes a 75g glucose test, where 75 grams of anhydrous glucose is dissolved in water and consumed within five minutes on an empty stomach. This test monitors fasting blood sugar, blood sugar one hour after the meal, and blood sugar two hours after the meal. A diagnosis of gestational diabetes is made if any of the following criteria are met or exceeded: fasting blood sugar is greater than or equal to 5.1 mmol/L, blood sugar one hour after the meal is greater than or equal to 10 mmol/L, and blood sugar two hours after the meal is greater than or equal to 8.5 mmol/L.