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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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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What to eat for diabetic foot

For patients with diabetic foot ulcers, first, their diet should control blood sugar. Foods with a high glycemic index like porridge, glutinous rice, and rice noodle rolls should be avoided. Additionally, sweet foods are also off-limits; it's important for meals to be regular and measured. Second, as patients with diabetic foot ulcers need nutrients for wound healing, they can eat foods high in protein such as eggs, fish, fish soup, and lean meats to promote wound healing. Third, if the patient also has high blood lipids, it's advisable to maintain a light diet and avoid greasy foods.

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Early symptoms of type 2 diabetes

The typical symptoms of type 2 diabetes are referred to as "three excesses and one deficiency." The three excesses include excessive thirst and dry mouth, increased appetite with frequent hunger, and increased urination. The one deficiency refers to weight loss; these are the more typical symptoms. Some patients might often find out about their elevated blood sugar during routine health checks at work. Others may seek medical advice due to issues like skin itchiness or wounds that heal poorly after injury. Some might mainly experience numbness in their hands and feet, or blurred vision among other symptoms.

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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
Endocrinology
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Causes of Gestational Diabetes

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.