As mentioned above, gestational diabetes only begins to develop during pregnancy. It occurs in a woman suddenly and just as suddenly disappears after childbirth. The development of this disease is caused by increased production of hormones in the female body, necessary to maintain pregnancy. They act not only on the organs of the reproductive system, but also on the whole organism.
Especially from the excessive production of hormones of pregnancy, the pancreas suffers, as it is subjected to severe stress. But this does not stop her from producing insulin and coping with her main tasks, so after the birth, further progression of diabetes, as a rule, does not occur.
During pregnancy, it is very important to constantly monitor blood sugar levels, since all women over the age of 25 years are at risk of developing GDM
With gestational diabetes, a woman only occasionally has an increased blood sugar and most often this happens during certain periods (in the second trimester). The main provoking factors in the development of this disease are:
- hereditary predisposition;
- polycystic ovary (pregnancy in this case occurs extremely rarely and is almost always accompanied by complications);
- the presence of gestational diabetes in the history of previous pregnancies.
You can suspect the presence of this disease in a pregnant woman by the following symptoms:
- constant thirst and a feeling of dry mouth (observed with a sharp increase in blood sugar);
- hunger, even after eating;
- frequent dizziness;
- decreased visual acuity;
- frequent urination and increased urine output per day.
With this form of diabetes, a woman can give birth to a healthy baby. However, for this, she needs to constantly monitor her nutrition and follow all the doctor’s recommendations. If this is not done, then the risks of complications increase significantly.
As a rule, women suffering from gestational diabetes have children who are overweight. This is due to the fact that in the presence of high blood sugar levels, not only the pancreas of the mother, but also her baby in the womb is exposed to a strong load. As a result of this, the fetus is disturbed in carbohydrate and fat metabolism, which becomes the reason for the appearance of excess body weight.
The consequences of gestational diabetes
Moreover, at the birth of large children, complications often arise during childbirth in the form of severe ruptures and bleeding. Therefore, a woman needs to be very careful about her diet during pregnancy and constantly monitor her blood sugar. If it does not decrease with the help of special diets, you should start taking sugar-lowering drugs. But you can drink them only as directed by a doctor.
Important! With the development of gestational diabetes in a pregnant woman, the risks of diabetes in born children are very low. The likelihood of this disease in a child increases if a woman has a hereditary predisposition to this disease or her husband has been diagnosed with type 1 or type 2 diabetes.
According to the classification of Dedov from 2006, pregestational diabetes in pregnant women can exist in the following forms and manifestations.
A mild form of pathology is type 2 diabetes, which is corrected by the diet and is not accompanied by vascular disorders.
The average form is a disease of any type, requiring the use of sugar-lowering drugs, without complications or accompanied by their initial stages:
- retinopathy in the proliferative stage (retinal trophism disorders of the visual analyzer);
- nephropathy in the form of microalbuminuria (pathology of the vessels of the kidneys with a small amount of protein in the urine);
- neuropathy (damage to nerve nodes and cells).
Severe form with frequent drops in sugar and the appearance of ketoacidosis.
1 or 2 type of disease with severe complications:
- retinal trophic pathology;
- impaired renal vascular function, manifested by renal failure;
- diabetic foot;
- sclerosis of the coronary arteries;
- cerebrovascular accident;
- occlusion of the arteries of the legs.
Depending on how compensatory mechanisms of the body cope with the task of lowering blood sugar levels, there are several stages of pre-gestational diabetes mellitus. Each of them has its own laboratory indicators indicated in the table (in mmol / l).
|Indicator Time||Stage of compensation||Subcompensation Stage||Decompensation stage|
|Before food enters the body||5,0 – 5,9||6,0 – 6,5||6,6 and above|
|Hours after eating||7,5 – 7,9||8,0 – 8,9||9,0 and above|
|In the evening before bedtime||6,0 – 6,9||7,0 – 7,5||7,6 and above|
Diabetes mellitus, which occurred during the period of gestation, also has a separation. Depending on the way in which it is possible to keep the quantitative indicators of glucose in the blood within normal limits, a disease can be distinguished that is compensated by diet and that is corrected by diet therapy and the use of insulin.
According to the level of work of compensatory mechanisms, there is a stage of compensation and decompensation.
Throughout life, a woman may not be disturbed by disorders of carbohydrate metabolism, indicators in the analyzes may be within normal limits, but when passing tests in a antenatal clinic, a disease such as gestational diabetes mellitus can be detected – a condition in which an increase in blood glucose is detected for the first time during pregnancy and passing after childbirth.
The causes of gestational diabetes can be:
- the presence of diabetes in relatives;
- viral infections that affect and impair pancreatic function;
- women with polycystic ovary;
- women suffering from hypertension;
- women over the age of 45;
- smoking women;
- women who abuse alcohol;
- women who have a history of gestational diabetes;
- large fruit. All these factors are at risk of developing this pathology.
Insulin resistance results from factors such as:
- increased formation in the adrenal cortex of the contra-hormonal hormone cortisol;
- synthesis of placental steroid hormones: estrogens, placental lactogen, prolactin;
- activation of the placental enzyme that breaks down insulin – insulinase.
The symptomatology of this disease is nonspecific: until the 20th week, and this is exactly the period from which diagnosis of gestational diabetes mellitus is possible, the woman is not worried. After the 20th week, the main symptom is an increase in blood glucose, which was not previously observed. It can be determined using a special test that detects glucose tolerance. First, blood is taken from the vein on an empty stomach, then the woman takes 75 g of glucose diluted in water and blood is taken from the vein again.
A diagnosis of gestational diabetes is established if the first indicators are not less than 7 mmol / l, and the second not less than 7,8 mmol / l. In addition to hyperglycemia, symptoms such as feeling of thirst, increased urination, fatigue, and uneven weight gain may join.
- Manifest Diabetes
- If a man has diabetes, can he have children?
- The mechanism of development of diabetes in pregnant women
- Diabetes Prevention During Pregnancy
- Symptoms of pathology
- Natural birth or cesarean section?
- Conclusions from the article
- Blood sugar during planning and gestation
- Management and treatment of diabetes during pregnancy
- Insulin therapy
Another type of diabetes mellitus, which, unlike gestational diabetes, occurs mainly in the first trimester of pregnancy and corresponds to the standard course and mechanism of development of diabetes mellitus of the first and second type.
An important difference between manifest and gestational diabetes mellitus is the indicator of glycosylated hemoglobin, which reflects the amount of hemoglobin associated with glucose – with manifest diabetes this indicator exceeds 6,5%, and with gestational numbers of this hemoglobin below 6,5%.
If a man has diabetes, can he have children?
Men with decompensated diabetes can suffer from complications such as nephropathy. Such a pathology leads to problems in the functioning of the kidneys and urination system.
The development of the disease contributes to the formation of narrowing of the urethra, which leads to difficulties in the release of sperm during ejaculation. Instead of being expelled from the body, the seed is pushed into the bladder.
This phenomenon is called reverse ejaculation and is one of the causes of male infertility.
In addition, the appearance and progression of diabetic neuropathy can be dangerous for reproductive function.
The first signs of a complication are:
- tingling in the upper and lower extremities;
- the appearance of a burning sensation in the legs;
- frequent occurrence of cramps in the calves;
- the occurrence of pain in the lower extremities.
Sensory impairment is especially dangerous. This is due to the fact that the patient does not experience pain when receiving superficial injuries. Minor injuries over time can transform into non-healing ulcers that provoke the destruction of soft tissues and bones over time. Most often, this situation is recorded on the feet, the patient develops a diabetic foot.
The appearance of autonomic neuropathy of the nervous system threatens the male body with impaired potency. Very often there is the occurrence of problems with potency, which is associated with insufficient blood flow into the cavernous bodies of the penis.
Is it possible to give birth if the husband has diabetes, many women ask such a question when visiting a antenatal clinic. Joint studies of endocrinologists and gynecologists have proved that with diabetes in a man, a woman is able to give birth to a healthy child. But at the same time, in case of conception, it is important to understand the full degree of responsibility and plan pregnancy properly.
The birth of a healthy or sick child depends on the level of sugar in the mother’s blood during the formation of the fetus; in the presence of serious deviations from the norm, complications can occur both in the mother’s body and in the unborn baby.
Men with diabetes can have children, but it should be borne in mind that in the presence of this disease, the quality of seminal fluid sharply decreases. One can see the dependence – the higher the severity of the disease, the less likely the occurrence of fertilization and conception of the child.
The answer to the question of whether it is possible to have children with diabetes in a man is positive only if the woman is absolutely healthy and she has no abnormalities in carbohydrate metabolism.
A contraindication to pregnancy is the presence of diabetes in both parents, which is associated with the presence of overestimated risks of transmission of the disease from parents to the child.
Babies in mothers of patients with diabetes mellitus adapt to conditions of extrauterine existence slowly, therefore they need intensive observation. A feature of the management of newborns is the introduction of 10% glucose into the umbilical cord vein immediately after birth. Further glucose administration is carried out on the basis of the daily fluid requirement, depending on the level of glucose in the blood, which is checked 2, 3, 6 hours after delivery, then according to indications.
And, despite the fact that diabetes is considered a hereditary disease, there is no congenital diabetes.
The development of diabetes in a child is affected by the way he eats. The best protection is breastfeeding. Studies have shown that children who are breastfed have diabetes more often than those who are naturally fed.
In the future, try to exclude sweets and carbonated drinks from the children’s diet up to five years. Make sure that the child does not gain too much weight in the first five to seven years of life.
In young children, the instincts of a healthy diet are not yet spoiled. They can regulate the amount of food themselves. Do not season the baby’s food with sugar and salt – let him learn to feel the natural taste of healthy food. The nutrition of the child should be full and varied.
Instill a child’s taste for an active life. Diabetes mellitus often develops in sedentary people. It is necessary that calm exercises alternate with sports exercises. Therefore, as soon as possible, put the child in the sports section or in the pool.
If the diagnosis is nevertheless confirmed, then the question immediately arises – how will it affect the child? Unfortunately, this pathology has a huge negative effect on the fetus, since diabetes in the mother leads to disruption of microcirculation in small vessels, which leads to photoplacental insufficiency and chronic fetal hypoxia. This in turn leads to dire consequences, impaired growth and development of the child.
Maternal hyperglycemia leads to early depletion of the cells of the aforementioned islets of Langerhans, which leads to severe disorders of carbohydrate metabolism. A child may develop pathologies such as macrosomia (an increase in the size and body weight of the fetus), a violation of the functions of the cardiovascular, digestive, respiratory, nervous, and other body systems.
But, unfortunately, complications can arise not only in the fetus, but also in the mother herself. Gestational diabetes mellitus can cause the development of late gestosis, which can manifest itself in the form of syndromes such as preeclampsia and eclampsia (increased blood pressure, impaired renal function, convulsive syndrome, impaired vision, etc.), pregnant nephropathy, dropsy of pregnant women, diabetic retinopathy.
This type of diabetes can “disappear” after childbirth, but leave diabetes mellitus of the second type. Therefore, glycemia control is necessary, which is carried out once every 1 years at normal glucose levels, once a year when glucose tolerance disorders are detected.
Pregnancy with diabetes of a pre-gestational type gives a huge number of complications from the mother and the child, and the insulin-dependent form of the disease is accompanied by such conditions many times more often than other forms of the disease. The following pathological consequences may develop:
- the need for caesarean section;
- large fruit that does not meet development standards;
- weight at birth more than 4,5-5 kg;
- Erb paralysis – a violation of the innervation of the shoulders;
- the development of preeclampsia of varying severity;
- defects and congenital malformations in a child;
- preterm delivery;
- fetal distress syndrome;
- pregnancy fading;
- fetal death during fetal life or in the first month after birth.
High risk groups include patients who have diabetes for more than 10-12 years, have perinatal death earlier, as well as those who have one or more serious complications, and patients with urinary tract infection.
Depending on in which period the development of diabetes occurred and how long the effect of high sugar on the baby’s body has become, there are three main pathologies, the development of which is characteristic of a child.
The development of deformities, congenital malformations and abnormalities is characteristic of babies whose mothers have a pre-gestational form of diabetes. Manifestations and signs of pathology are practically no different from those that can appear in children from mothers without a “sweet disease”:
the absence of one or both k >
The absence of one kidney is a variant of the pathology of the child’s body against the background of pregestive diabetes of the mother
In women suffering from a pre-gestational form of diabetes, the possibility of spontaneous abortion is several times higher. This is not associated with genetic abnormalities of the fetus, against which miscarriages occur in healthy mothers, but with placental insufficiency and the development of congenital malformations of the child, incompatible with life.
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This is a pathological condition, which is accompanied by an excessive increase in the weight of the child at the time of birth (above 4,5-5 kg). The development of macrosomia is accompanied by the need for caesarean section due to the high risk of trauma to the child and the birth canal of the mother.
Important! The intake of a significant amount of glucose in the fetus leads to the fact that most of the nutrients are deposited in fat cells. Macrosomia usually occurs against gestational diabetes.
A gynecologist-endocrinologist examines the physique of a pregnant woman, measures the circumference of the abdomen, the height of the uterine fundus, the height and weight of the woman, and the size of the pelvis. Patient weight assessment is an important diagnostic indicator. Based on the results that the pregnant woman shows at the first examination, they make a schedule of allowable weight gain by months and weeks.
Laboratory diagnostics consists of the following tests:
- general clinical tests (blood, urine, biochemistry);
- blood lipids and cholesterol;
- coagulation indicators;
- urine culture;
- urine according to Zimnitsky, according to Nechiporenko;
- determination of the level of female hormones;
- determination of acetone in the urine;
- daily urine for albuminuria.
Important! Blood pressure indicators are monitored, ultrasound diagnostics of the fetus with Doppler ultrasonography.
One of the specific methods that allows to determine the presence of pathology in pregnant women is considered an oral glucose tolerance test. It consists in fasting blood, drinking a concentrated hyperosmolar glucose solution and further blood sampling (after 1, 2 hours). The result shows the sensitivity of cells and body tissues.
Test for glucose tolerance – one of the stages of a mandatory examination of a pregnant woman
The mechanism of development of diabetes in pregnant women
“Sweet disease” type 1 develops against the background of destructive changes in the cells of the pancreas, responsible for the synthesis of insulin. This form arises as a result of the negative effects of exogenous factors against a background of hereditary predisposition.
Hyperglycemia is the basis of any form of diabetes, including gestational
Type 2 disease, which is accompanied by a violation of the sensitivity of cells and body tissues to insulin, develops due to malnutrition, a sedentary lifestyle. The gestational diabetes of pregnant women is more similar to the second variant of the pathology in its developmental mechanism.
The placenta, which is necessary for the implementation of a constant relationship between mother and child during the gestation period, produces a significant amount of hormones. The fact that the adrenal glands of women begin to synthesize large amounts of cortisol and the accelerated excretion of insulin from the body with urine (activation of insulinase is provoked) leads to the fact that the cells and tissues of the body become less sensitive to insulin.
Julia, 27 years old: I have 28 weeks of pregnancy, injected Protafan and Novorapid. Against the background of pregnancy, Protofan began to give hypoglycemia at night. My doctor transferred me to Levemir. Now grief I do not know. The drug does not give a sharp decrease in sugar. I feel great.
Svetlana, 31 years old: Hello everyone! I have type 1 diabetes. Pregnancy 12 weeks. They did not want to register for a long time, because they needed a certificate that I could bear a child. The morning dawn tormented, sugar jumped to 9. The doctor explained how to make the morning “joke”. Now the condition has improved, registered.
Irina, 24 years old: She became ill with diabetes, became pregnant 4 years after being diagnosed. Endured up to 34 weeks. The glucose level rose sharply, did a cesarean section. The girl was weak, breathing badly. She is now 5 years old, no different from her peers.
General nurse. Over 40 years of work experience. Retired copywriter.
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Last Updated: September 21, 2019
Diabetes Prevention During Pregnancy
In order to reduce the risk of developing gestational diabetes mellitus, sufficient physical activity is necessary – doing yoga or going to the pool is an excellent solution for women at risk. Particular attention should be paid to diet. From the diet, it is necessary to exclude fried, fatty and flour products, which are “fast” carbohydrates – these products are rapidly absorbed and contribute to a sharp and significant increase in blood glucose, having a small supply of nutrients and a large number of calories that badly affect the body.
Salty foods should be excluded from your diet, as salt retains fluid, which can lead to edema and high blood pressure. Fiber-rich foods are an essential component of the diet for diabetics, and especially women with gestational diabetes. The fact is that fiber, in addition to possessing a large supply of vitamins and minerals, stimulates the gastrointestinal tract and slows down the absorption of carbohydrates and lipids into the blood.
Include fruits, vegetables, dairy products, eggs in your diet. You need to eat in small portions, a properly balanced diet plays one of the main roles in the prevention of diabetes. Also, do not forget about the glucometer. This is a great tool for daily measurement and monitoring of blood glucose levels.
Symptoms of pathology
The clinic of diabetes in a pregnant woman depends on the following factors:
- form of the disease;
- stage of compensation;
- how long the failure already exists;
- development of complications;
- history of therapy used.
Signs of gestational diabetes are similar to the clinical picture of a gestational form
In most cases, the gestational form has no manifestations (latent diabetes) or they are quite scarce. Hyperglycemia-specific symptoms sometimes appear:
- constant thirst;
- increased urine output;
- high appetite amid sufficient intake of food into the body;
- itching of the skin;
- rashes like furunculosis.
Important! Pregnant women can develop significant swelling. From the 28th week, it is necessary to clarify the presence of polyhydramnios, placental insufficiency.
Natural birth or cesarean section?
This problem almost always confronts doctors when they face a pregnant woman with diabetes. The management of labor depends on many factors: the expected weight of the fetus, the parameters of the pelvis of the mother, the degree of compensation of the disease. Gestational diabetes mellitus itself is not an indication for cesarean section or natural delivery until 38 weeks. After 38 weeks, the likelihood of developing complications is not only on the part of the mother, but also the fetus.
Self-delivery. If the birth occurs naturally, then blood glucose control is necessary every 2 hours with intravenous administration of insulin, a short action, if during pregnancy there was a need for it.
Cesarean section. Detection by ultrasound of significant fetal macrosomia in the diagnosis of a clinically narrow pelvis in the mother, decompensation of gestational diabetes mellitus are indications for cesarean section. It is also necessary to take into account the degree of compensation for diabetes mellitus, the maturity of the cervix, the condition and size of the fetus.
Emergency indications for cesarean section in patients with diabetes mellitus are distinguished:
- severe visual impairment in the form of an increase in diabetic retinopathy with possible retinal detachment;
- increase in symptoms of diabetic nephropathy;
- bleeding that may be caused by placental abruption;
- severe danger to the fetus.
If delivery occurs for a period of less than 38 weeks, it is necessary to assess the state of the respiratory system of the fetus, namely the degree of maturity of the lungs, since at this time the pulmonary system is not yet fully formed, and if the fetus is not removed properly, it is possible to provoke newborn distress syndrome in him.
With diabetes, the late maturation of the functional system of the fetus is possible, therefore, timely delivery is of great importance for the health of the child. The term of delivery in pregnant women with diabetes is determined individually, taking into account the severity of the disease, the degree of compensation, the functional state of the fetus and the presence of obstetric complications.
The optimal method of delivery for mothers with diabetes, consider childbirth through the natural birth canal. They are carried out under constant monitoring of blood glucose levels (every hour), thorough anesthesia, monitoring and correction of blood pressure and adequate insulin therapy.
Indications for planned caesarean section, with the exception of the generally accepted ones, in addition for diabetes are the following: severe or progressive complications of diabetes and pregnancy; pelvic presentation of the fetus; the presence of a large fetus; progressive fetal hypoxia in the absence of conditions for urgent delivery through the natural birth canal and with a gestational age of at least 36 weeks.
After the birth of a child, in most mothers, blood sugar levels return to normal, even if insulin was administered during pregnancy. Only in some women after childbirth, changes in sugar absorption are observed. This will show the analyzes. It must be remembered that diabetes during pregnancy nevertheless increases the risk of its development in the future. But this can be avoided by strictly monitoring your weight.
Conclusions from the article
Thus, diabetes, in any form, is not a “taboo” for a woman. Compliance with the diet, active physical activity for pregnant women, taking specialized drugs will reduce the risk of complications, improve your well-being and reduce the likelihood of developing fetal pathologies.
With the right approach, careful planning, joint efforts of obstetrician-gynecologists, endocrinologists, diabetologists, ophthalmologists and other specialists, pregnancy will proceed in a safe manner for both the expectant mother and the baby.
Blood sugar during planning and gestation
It is important for a woman with diabetes to check her blood sugar regularly, even before she becomes pregnant. Doctors say that it is necessary to control blood sugar, plus it is recommended to achieve a certain level of glycated hemoglobin A1C before planning a pregnancy. You need to make sure that the blood sugar level is close to normal, so that it was at the time of conception, when the child is most vulnerable to the influence of negative factors.
During pregnancy, the optimal blood sugar level is from 3,3 to 5,0 mmol / L, when a woman wakes up, has not eaten, below 6,0 mmol / L before lunch and dinner, or below 7,8 mmol / L through two hours after eating. Frequent checks of blood sugar levels may be inconvenient, but they are important both for your own health and for the health of the unborn child.
Women with a diagnosis of diabetes before the conception of a baby should know about how important it is to plan a pregnancy in this condition and be constantly monitored by a qualified specialist.
Planning includes an examination and a medical history, including the following points:
- the presence of complications of the disease;
- refinement of the form of diabetes;
- self-monitoring data recorded in a personal diary;
- the presence of concomitant diseases;
- family history;
- the presence of hereditary pathologies.
The following examinations are also carried out:
- blood pressure measurement, consultation with a cardiologist;
- examination by an ophthalmologist, treatment of the initial stages of retinopathy;
- screening for coronary heart disease (ECG, echocardiography);
- biochemistry of blood;
- specification of indicators of thyro >
Blood is a biological fluid used for a number of diagnostic measures against diabetes
In addition, it is necessary to abandon bad habits if they exist, a thorough analysis of those drugs that are taken by a woman in order to avoid a negative impact on the future baby.
There are conditions that are absolute or relative contraindications to bearing a child. The absolute ones include:
- severe kidney damage;
- Ischemic heart disease;
- progressive pathology of the visual analyzer.
Diabetes mellitus and pregnancy – this combination is undesirable (considered individually) in the following cases:
- woman’s age over 40 years;
- the presence of diabetes in both spouses;
- diabetes mellitus and Rhesus sensitization;
- diabetes mellitus and active tuberculosis;
- the birth of children with a history of malformations on the background of the disease;
- ketoacidosis in the first trimester of pregnancy;
- chronic kidney disease;
- asocial living conditions.
Type 1 diabetes mellitus, although it is not a contraindication to pregnancy, but it is often accompanied by other diseases in which it is not recommended to become pregnant. These include:
- k >
Before planning to become a mother with diabetes, it is necessary to undergo a preliminary examination to identify other diseases that may adversely affect the course of pregnancy
In the presence of such diseases, a woman in labor can have serious problems. First, a kidney failure or a heart attack can occur during childbirth. And secondly, if Rh factors are incompatible under the influence of T1DM, a miscarriage or premature opening of labor can occur.
Management and treatment of diabetes during pregnancy
A prerequisite is the ability of a woman to conduct self-monitoring of blood sugar levels with subsequent recording of data in a personal diary. During the period of gestation, the clinical recommendations indicate the need to monitor indicators up to 7 times a day. There are also test strips to measure the level of ketone bodies in the urine. This can be done at home.
Correction of the diet and revision of the personal menu allow you to keep sugar levels within acceptable limits, prevent the development of ketoacidosis and excessive weight gain by a woman. Experts recommend limiting the amount of carbohydrates consumed to 35% of the total daily diet. About 25% should be consumed in protein foods, the remaining 40% should be unsaturated fats.
Pregnant nutrition is as follows:
- breakfast – 10% of the daily amount of calories;
- lunch – up to 30%;
- dinner – up to 30%;
- snacks between main meals – up to 30%.
Important! Recipes can be found on specialized sites dedicated to diabetes.
If we talk about the pre-gestational form of the disease, the first half of pregnancy with type 1 and type 2 diabetes is similar in the required amount of insulin, but after the 24th week the need increases with an insulin-independent form of the disease. During the period of gestation, preference is given to Actrapid, Humulin R, Novorapid, Humalog.
Insulin therapy and the ability to correct the diet – the ability to protect the baby and mother from serious disorders of the organs and systems of the body
The greatest need for insulin therapy is characteristic for the period from the 24th to the 30th week, after the 35th it is significantly reduced. Some experts talk about the possibility of using a pump system for administering drugs. This is effective for those women who used pumps before the conception of the baby.
The non-insulin-dependent type of diabetes is quite sensitive to exercise. There are cases when the adequate activity of the pregnant woman allowed replacing the administration of insulin. Type 1 disease is not so sensitive to stress, and excessive activity, on the contrary, can cause hypoglycemia attacks.
In the presence of a pre-gestational form of diabetes, a pregnant woman is hospitalized in a hospital three times:
- At 8-10 weeks – to determine the work of compensatory mechanisms, clarify the presence of complications, train a woman, conduct dietary correction and treatment.
- At 18-20 weeks – the determination of pathologies from the baby and mother, prevention of complications, correction of metabolic processes.
- At 35-36 weeks – for delivery or preparation for childbirth.
The most suitable period for the birth of a baby with any form of the disease is 37 weeks. From the 36th week, the following indicators are monitored every day:
- stirring a child;
- listening to the heartbeat;
- blood flow test.
A woman can give birth on her own in case of head presentation of the fetus, with normal sizes of the pelvis, if there are no complications of diabetes. Early birth is necessary in the following conditions:
- deterioration in the well-being of the baby;
- deterioration of laboratory indicators of the mother;
- development of renal failure;
- sharp decrease in visual acuity.
Throughout all births, glucose indicators should be monitored. Immediately after delivery, the need for insulin decreases sharply, is restored to its previous levels by the tenth day.
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