How to Control Gestational Diabetes

Written by Zhang Lu
Obstetrics
Updated on September 17, 2024
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During pregnancy, if the pregnant woman has diabetes, it is essential to control blood sugar reasonably. Otherwise, high blood sugar can seriously affect both the fetus and the pregnant woman, and in severe cases, it can cause diabetic ketoacidosis in the pregnant woman and fetal death in utero. Diabetes in pregnant women can be intervened in the following ways: First, through dietary control, eat less sugary foods, such as sweets, pastries, and fruits. Second, it is necessary to be moderately active during pregnancy, taking a walk or maintaining 5,000 to 10,000 steps daily, which helps in the consumption of glucose in the body. Third, if the above two methods are ineffective, insulin should be used to control diabetes.

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Written by Chen Li Ping
Endocrinology
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incidence of gestational diabetes

Gestational diabetes refers to diabetes that appears or is diagnosed during pregnancy, or any degree of glucose tolerance abnormality, which is classified as an independent type of diabetes. Diabetes combined with pregnancy or gestational diabetes can pose serious risks to the health of both mother and child. Before national screening of blood sugar levels during pregnancy was initiated, the detection rate of gestational diabetes was not very high, only 0.24%. However, with the widespread implementation of blood sugar screening during pregnancy, the current incidence rate of gestational diabetes is approximately 1% to 5%.

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Written by Zhang Lu
Obstetrics
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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.

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Written by Zhao Dan
Orthopedics
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Gestational diabetes standards

Before addressing this question, let's first clarify another concept: if diabetes is diagnosed before pregnancy, this is referred to as pre-existing diabetes in pregnancy, which is different from gestational diabetes. Gestational diabetes refers to cases where there is no pre-existing diabetes diagnosis before pregnancy, but abnormal blood glucose levels are detected after becoming pregnant. Generally, a glucose screening test is conducted between the 24th and 28th weeks of pregnancy. Currently in China, there are two approaches: the one-step and the two-step methods. The one-step method involves a direct 75-gram oral glucose tolerance test. However, most of China uses the two-step method, which starts with a 50-gram glucose challenge test. If the blood glucose level one hour after eating is greater than or equal to 7.8 mmol/L, a 75-gram oral glucose tolerance test is recommended. For the 75-gram glucose test, the fasting blood glucose level should generally be less than or equal to 5.6 mmol/L, one hour post-glucose intake should be 10.3 mmol/L, two hours post-glucose should be 8.6 mmol/L, and three hours post-glucose should be 6.7 mmol/L. If two or more of these values exceed the diagnostic criteria, gestational diabetes can be diagnosed. If only one value is abnormal, impaired glucose tolerance can be diagnosed. It is recommended that anyone who experiences abnormal blood glucose levels during pregnancy undergo another 75-gram oral glucose tolerance test six months post-pregnancy to determine if blood glucose levels are still abnormal and whether treatment should continue.

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Written by Zhao Xin Lan
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Key Points of Diabetic Foot Care

First, a daily foot examination is necessary, including the top, bottom, and toes. Carefully observe the skin's color, temperature, and moisture level, check for edema, skin lesions, and assess sensory and motor reflexes. Second, maintain a daily routine of soaking the feet in warm water. The water temperature should not exceed 40°C, with the soaking time ideally between 10 to 20 minutes. Third, regularly trim your toenails. Long toenails can easily break and damage the surrounding tissue, thus it is important for diabetic foot patients to regularly trim their nails. Fourth, the breathability of shoes and socks is important. It is advised not to wear sandals or slippers that expose the skin of the feet since exposed skin is more susceptible to injuries. Fifth, never walk barefoot. Sixth, avoid using electric blankets, hot water bottles, heating by the fire, and cupping therapy, to prevent burns on your feet. Seventh, maintain proper skin moisture. For patients with sweaty feet prone to excessive sweating, fungal infections may occur. It is recommended to wipe the spaces between toes with medical alcohol during foot baths, and to add a small amount of vinegar to the footbath water, as a bifunctional environment discourages fungal growth. Eighth, actively control blood sugar levels in diabetes. Ninth, maintain moderate exercise. Frequently elevate the affected limb to facilitate blood return and improve circulation in the lower limbs.

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Written by Lin Xiang Dong
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How to reduce sugar in a diabetic diet?

Dietary control is the most important method of treatment for diabetes. If dietary control is improper, all hypoglycemic drugs, including insulin, will not be very effective, and the focus of dietary management in diabetes is to control the intake of carbohydrates. Our Chinese diet is primarily based on carbohydrates like rice. Mainly, we control the amount of rice consumed, with each meal (lunch and dinner) consisting of about 100 to 200 grams of rice. This is complemented by plenty of vegetables and a certain amount of lean meat to enhance satiety. By controlling the intake of carbohydrates in our daily lives, blood sugar levels can drop significantly.