Causes of Gestational Diabetes

Written by Lin Xiang Dong

Endocrinology

Updated on August 31, 2024

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Gestational diabetes refers to the abnormality of blood sugar levels that occurs during pregnancy, at which time it is called gestational diabetes. The reason for the occurrence of gestational diabetes is due to significant changes in the body's endocrine hormones after pregnancy. The body releases many hormones, such as estrogen and progesterone, which can increase insulin resistance. Thus, a much greater amount of insulin is needed to maintain normal blood sugar levels. If the pancreatic beta cells are not sufficient to compensate for the increased insulin secretion needed to meet the normal metabolic requirements caused by these resistance factors, then elevated blood sugar and abnormal glucose metabolism occur, ultimately leading to gestational diabetes.

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Written by Zhao Xin Lan

Endocrinology

1min 56sec

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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 Zhao Xin Lan

Endocrinology

1min 10sec

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How to treat diabetic foot?

Diabetic foot is one of the most severe complications of diabetes. It is caused by a combination of factors including peripheral vascular disease and diabetic peripheral neuropathy associated with diabetes. In such cases, treatment can involve internal medicine, interventional vascular treatment, and surgical treatment cooperatively managed by multiple vascular departments. Early treatment focuses on controlling blood sugar, improving circulation, and nourishing nerves. If ulcerations and skin breakdown have already occurred in the foot, further debridement and anti-infection treatments are necessary. It is essential to conduct an ultrasound of the lower limb vessels to assess for any vascular narrowing. If severe vascular occlusion occurs, vascular surgery may be needed to restore blood flow. In cases of severe diabetic foot with infection, surgical debridement or even amputation may be necessary. Thus, it is crucial to control blood sugar well in the early stages of diabetes to prevent these complications and potentially avoid the onset of diabetic foot.

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Written by Tang Zhuo

Endocrinology

1min 21sec

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Symptoms of diabetic foot

Diabetic foot is one of the severe chronic complications of diabetes, generally referred to as the abnormalities in the lower limbs caused by diabetic vascular neuropathy. Diabetic foot with gangrene of the extremity due to concurrent infection is referred to as diabetic foot with gangrene of the extremity, representing a serious stage in the progression of diabetic foot. The main symptoms of diabetic foot include: first, subcutaneous fat atrophy, thinning of the skin, common pigmentation spots on the shin, no hair on the feet and toes, and thickening of the toenails often accompanied by fungal infections; second, atrophy of the extremity muscles, malnutrition, poor muscle tone, and susceptibility to injury in joints and ligaments; third, visible sinking of the finger joints, joint bending, weakening or disappearance of foot deformities, and cool, swollen skin at the extremities; fourth, patients often experience extremity pain, numbness, sensory abnormalities, and dull or absent deep and superficial reflexes. In the initial stages of diabetic foot gangrene, blistering, blood blisters, erosion, and infection can gradually develop into ulcers, gangrene, or necrosis. Clinically, this is manifested as localized redness, swelling, increased skin temperature, pain, functional impairment, and the presence of purulent secretions, sometimes accompanied by a foul odor.

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Written by Yang Li

Endocrinology

1min 12sec

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Care for diabetic foot

The first fundamental step is monitoring blood glucose; good control of blood glucose levels is essential for the effective management of diabetic foot problems. Secondly, attention must be paid to the protection of the wound. It's crucial to keep the wound clean, perform regular cleaning and disinfection, and when necessary, debride necrotic tissue thoroughly. For instance, if there is a sinus tract or deep ulceration, it is essential to open the wound and ensure drainage, removing all necrotic tissue inside. Thirdly, footwear choice is critical for patients with diabetic foot; it is important to wear shoes that are loose fitting, moderately soft yet firm, and capable of evenly distributing pressure across the footbed. There are shoes specially designed for those with diabetic foot, and these can be custom-made. Other considerations include maintaining good blood pressure control and ensuring adequate nutrition to support wound healing, including sufficient protein intake, which plays a vital role in promoting wound repair.

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Written by Chen Xie

Endocrinology

1min 6sec

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Gestational diabetes check at how many weeks?

Screening for gestational diabetes is generally recommended between 24 to 28 weeks of pregnancy, using a 75g glucose tolerance test to measure fasting blood glucose, blood glucose one hour after consuming glucose, and blood glucose two hours after consuming glucose. However, for pregnant women with high-risk factors, it is recommended to screen for blood glucose at their first prenatal visit. High-risk factors include women with a history of gestational diabetes, a history of delivering a large baby, obesity or polycystic ovary syndrome, those with a first-degree relative with a history of diabetes, positive fasting blood glucose or urinary glucose in early pregnancy, those who have had multiple unexplained miscarriages, fetal malformation, stillbirth history, and women who have given birth to newborns with respiratory distress syndrome. These women should all be screened for blood glucose at their first prenatal visit.