In the past 20 years, the prevalence of diabetes in China has increased significantly, the number of patients has reached about 40 million, accounting for one-fifth of the total number of people with diabetes in the world, the prevalence rate ranks second in the world, and the corresponding incidence of gestational diabetes is also increasing rapidly, according to the 2007 national survey on the incidence of gestational diabetes, the average incidence of abnormal glucose metabolism during pregnancy in China is 6.6%, which is a This is a huge population. If you are diagnosed with gestational diabetes, how do you face it? There are two types of diabetes during pregnancy, one is gestational combined diabetes, which means that you were already a diabetic before pregnancy and now you are combined with pregnancy, and the other is called gestational diabetes, which is diabetes that occurs after pregnancy. The former is generally more severe than the latter, and the latter is more than eight times more common than the former. What are the risks of diabetes during pregnancy to the mother and child? For pregnant women, it can cause spontaneous abortion, gestational hypertension, eclampsia, decreased resistance to infection, excessive amniotic fluid, giant babies, obstructed labor, postpartum hemorrhage, and puerperal infection. To fetus: it can cause fetal malformation, premature birth, delayed fetal lung development, fetal growth restriction, etc. For newborns: it can cause hypoglycemia, respiratory distress, erythrocytosis, jaundice, etc. So, how can we prevent these complications during pregnancy and avoid these hazards? Those who already have diabetes should go to the hospital for a thorough examination, including blood pressure, electrocardiogram, fundus, kidney function, and glycosylated hemoglobin, to determine the classification of diabetes and decide whether pregnancy is possible. Diabetic patients with poor glycemic control, glycosylated hemoglobin ≥ 8, or those who have complications of severe cardiovascular disease, decreased renal function and proliferative retinopathy in the fundus should use contraception, and if they are pregnant, they should terminate as soon as possible. In diabetic nephropathy, pregnancy is possible if the 24-hour urine protein quantification is less than 1g and the renal function is normal; or if the proliferative retinopathy has been treated. For diabetic patients preparing for pregnancy, blood glucose should be adjusted to normal or near normal before pregnancy, and blood glucose should be closely tested after pregnancy. Gestational diabetes often has no spontaneous discomfort, but if it is not diagnosed in time and if no attention is paid to blood glucose control, some pregnancy complications are likely to occur, and the fetus grows and develops in a hyperglycemic environment, the chances of developing diabetes in the future will increase, so early blood glucose screening should be performed during pregnancy, and if abnormalities are found, early treatment should be provided. We recommend that all pregnant women undergo glucose screening at 20-24 weeks of pregnancy to detect gestational diabetes in a timely manner. Commonly used methods include: 50g sugar screening test: dissolve 50g of glucose powder in 200ml of water, drink it within 5 minutes, and draw blood to determine the blood glucose value exactly one hour later. When the glucose screening test blood sugar is more than 7.8mmol/L, it is necessary to do OGTT glucose tolerance test, that is, after measuring fasting blood sugar in the morning, take sugar water containing 75g of pure glucose orally, and then measure the blood sugar value once in 1 hour, 2 hours and 3 hours, one of the four times blood sugar value exceeds the normal standard is abnormal glucose tolerance, two or more times abnormal is gestational diabetes. There is a group of people who are prone to gestational diabetes, such as: age > 30 years, obesity, infertility, polycystic ovary syndrome, family history of diabetes, positive fasting urine glucose in early pregnancy, history of delivery of a huge baby, history of unexplained recurrent spontaneous abortion, history of stillbirth and neonatal death, history of fetal malformation, large fetus or excessive amniotic fluid in this pregnancy, etc. This group of people should undergo blood glucose examination early in pregnancy, i.e. once the pregnancy is diagnosed, and if necessary, add insulin levels at all hours to assess the function of the pancreas. Once diagnosed with gestational diabetes, the primary treatment is dietary control. The standard of dietary control during pregnancy should be able to meet the energy needs of the pregnant woman and the fetus while strictly limiting the intake of carbohydrates, and the weight gain throughout pregnancy should not exceed 12-13 kg, and should be lower than this figure again if the original is obese. Blood sugar should be maintained in the normal range and no starvation ketosis should occur. Total daily calories during pregnancy: 1800-2200 kcal, with a small number of meals, divided into 5-6 meals per day. A positive urinary ketone body after dietary control should lead to a readjustment of the diet to prevent the occurrence of starvation ketosis. In addition to dietary control, exercise therapy is available, with appropriate amounts of exercise. The best way is to take a walk, about 30 minutes each time, twice a day, or do some gymnastics suitable for pregnant women. It is very important to monitor the blood sugar of pregnant women with diabetes. At the early stage of diagnosis, fasting and 2-hour postprandial blood sugar should be rechecked 1~2 weeks after diet control, and if necessary, blood sugar profile test should be conducted, i.e. blood sugar should be checked half an hour before three meals, 2 hours after three meals and at bedtime. Blood sugar control standard during pregnancy: fasting: 3.3-5.6 mmol/L; 2 hours after meal and before bedtime: 4.4-6.7 mmol/. If the blood glucose control by diet alone cannot reach the standard, insulin treatment should be added. Because insulin needs to be injected and the need of each person is very different, improper application can cause hypoglycemia, so hospitalization is necessary. The dosage of insulin needs to be adjusted according to blood glucose, and after the blood glucose is adjusted smoothly, the patient can be discharged from the hospital for regular maternity checkups and monitoring of blood glucose in the outpatient clinic. During pregnancy, as the weeks of pregnancy increase, the substances that resist insulin gradually increase, and the blood sugar level and the function of the pancreas will also change. Some pregnant women have normal blood sugar in the early and middle stages of pregnancy, but their blood sugar rises in the late stages of pregnancy, so those who have risk factors for diabetes or those who are found to have excessive amniotic fluid or large fetuses during pregnancy should be checked again in the middle or late stages of pregnancy even if their blood sugar is normal in the early stages of pregnancy, in order to detect In order to detect abnormalities and take appropriate treatment to ensure the safety of the mother and the fetus. During pregnancy, the monitoring of mother and child should be strengthened, and routine ultrasound examination should be conducted from 20 to 22 weeks of pregnancy to exclude fetal abnormalities. After 28 weeks of gestation, ultrasound should be repeated every 4-6 weeks to monitor fetal development, amniotic fluid volume and fetal umbilical cord blood flow. After 36 weeks of gestation, fetal cardiac monitoring should be performed once a week. The timing of delivery and the mode of delivery should be determined on a case-by-case basis. Generally speaking, pregnancy outcome is closely related to the severity of diabetes and the degree of elevated blood glucose. Mild glucose metabolism disorder during pregnancy can achieve the same good pregnancy outcome as ordinary pregnant women after close monitoring and active treatment during pregnancy.