What is gestational diabetes like?

Written by Chen Li Ping
Endocrinology
Updated on December 19, 2024
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Gestational diabetes refers to diabetes that appears during pregnancy, or is detected during pregnancy, or is an abnormal glucose tolerance of any degree. Gestational diabetes affects both the pregnant mother and the fetus. Although the mortality rate of pregnant women with gestational diabetes has significantly decreased, complications are still quite common. It may increase the rate of spontaneous miscarriages and preterm births for fetuses. Secondly, it can cause fetal or neonatal death, and intrauterine growth retardation. Thirdly, it leads to excessive amniotic fluid and macrosomia, and may result in neonatal polycythemia, fetal malformations, neonatal respiratory distress syndrome, neonatal hypoglycemia, as well as neonatal hypocalcemia and hypomagnesemia. For the mother, it can lead to pregnancy-induced hypertension syndrome, infections during pregnancy or childbirth, and in severe cases, diabetic ketoacidosis.

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Endocrinology
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Gestational diabetes symptoms

During pregnancy, there are two scenarios concerning diabetes: one is where diabetes is diagnosed before pregnancy, referred to as pregestational diabetes combined with pregnancy. The other scenario is where the sugar metabolism is normal before pregnancy, or there is an underlying reduced glucose tolerance, and diabetes appears or is diagnosed during pregnancy, also known as gestational diabetes. Over 80% of diabetic pregnant women have gestational diabetes. Typically, gestational diabetes doesn't show clear symptoms of the classic "three polys and one less" - excessive drinking, eating, urination, and weight loss. Some women with gestational diabetes may experience itching of the vulva, caused by repeated infections with Candida albicans. Additionally, gestational diabetes may lead to conditions like fetal macrosomia and polyhydramnios during pregnancy, and pregnant women with gestational diabetes are more prone to infections.

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Written by Zhou Yan
Geriatrics
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Symptoms of diabetes in the elderly

Elderly diabetes often begins inconspicuously, lacking the typical symptoms of excessive thirst, urination, hunger, and weight loss. It can present with various complications such as diarrhea, constipation, urinary retention, limb numbness, skin itching, and shoulder joint pain. Elderly diabetics often have concurrent infections, particularly in the respiratory and urinary systems, as well as cholecystitis and skin infections. They may also suffer from ketoacidosis, hyperosmolar hyperglycemia syndrome, and coexist with multiple chronic diseases of old age such as heart failure, coronary heart disease, hypertension, and hyperlipidemia. They require different types of medications and are susceptible to hypoglycemia, making timely diagnosis and treatment challenging. These are the symptoms of diabetes in the elderly.

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How to control diet for diabetes

The diet for diabetes mainly involves setting reasonable blood sugar reduction targets. Before achieving these targets, strict dietary control is necessary. All fruits, nuts, fried foods, and barbecued foods must be avoided. Meals should be regular and quantified without any extra meals or snacks. The amount of rice for lunch and dinner should be controlled, approximately a couple of ounces per meal, while intake of sufficient vegetables is encouraged to satiate hunger. However, vegetables like pumpkin should not be eaten. A certain amount of lean meat can be included, but fatty meats are to be avoided. Additionally, dry foods are recommended for diabetics, while liquid diets, like soups and porridges, should be avoided. For breakfast, if blood sugar control is poor, one should temporarily avoid noodles and rice noodles. Instead, consuming some pure milk and an egg, along with buns or dumplings such as steamed dumplings or wontons, is acceptable.

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Written by Li Hui Zhi
Endocrinology
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Causes of diabetic foot

The main causes of diabetic foot are as follows: The first one is poor blood sugar control in patients. Some patients have long neglected their blood sugar levels, leading to consistently high levels. The second cause is vascular disease in the lower limbs of the patient, including arteriosclerosis, with severe cases leading to occlusion and subsequent ulceration of the feet. The third reason is the presence of diabetic peripheral neuropathy in patients, which results in abnormal sensations or numbness in the feet. Many patients wearing new shoes or stepping on sharp objects inadvertently can lead to diabetic foot. The fourth cause is infection induced by patients who initially neglect minor foot injuries, or who improperly manage such injuries at home, leading to the development of diabetic foot. Therefore, we advise diabetics to maintain good control of their blood sugar and take timely measures to prevent diabetic foot.

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Where to massage for diabetic foot

For diabetic patients, we do not recommend foot therapy. Why is that? First, the foot therapy institutions outside are not very professional; many individuals start working without proper training. The massage might lack strength, and the hygiene standards are often not met, which can lead to local injuries and infections. Second, diabetic patients have a specific bodily constitution due to high blood sugar levels, making their tissues particularly susceptible to damage. Once damaged, these tissues do not heal easily. If the hygiene is substandard, the feet of diabetic patients are especially prone to infection. Diabetic foot patients, because of poor blood supply, are also more susceptible to fungal infections. Therefore, given these factors, it is advised that diabetic patients avoid foot therapy.