Diabetes mellitus, as the name suggests, is the presence of glucose in the urine, but the underlying problem is high blood sugar. Due to the improvement of the diet, the number of diabetics in the population is increasing. Who doesn’t have one or two diabetics in their family, so it is possible that people are not too familiar with this disease.
After pregnancy, because the fetus has to get glucose from the mother as nutrition and glucose is shunted to the fetal circulation, the blood sugar of pregnant women is slightly lower than that of the general population under normal circumstances. This is why the normal values for the diagnostic criteria for gestational diabetes are lower than those for the general population.
In addition to the fact that some people have diabetes before pregnancy, why do so many pregnant women develop diabetes during pregnancy? Due to the selflessness of the mother after pregnancy, to ensure the blood sugar supply to the fetus, the placenta secretes hormones that counteract the insulin and prevent the mother from consuming blood sugar to ensure that the maternal blood sugar cannot be too low. This is a balancing mechanism created by God to ensure the nutrition of the fetus. But sometimes God makes mistakes and in some people this balance is disturbed. The insulin is fighting too strong and the maternal blood sugar is too high. After delivery, gestational diabetes returns to normal very quickly after delivery because there are no longer hormones secreted by the placenta to fight insulin.
Diabetes is a chronic disease, and except for a few people who develop ketoacidosis or hyperosmolar coma, the damage to health is caused by chronically high blood sugar. Long-term high blood sugar causes vascular sclerosis, which in turn causes complications of diabetes, such as: coronary heart disease, kidney disease, cataract, glaucoma, and diabetic foot. These complications can take at least a few years to develop. And the whole pregnancy is only 10 months, so is gestational diabetes that dangerous?
Yes, gestational diabetes usually occurs after the placenta is formed, that is, in the middle and late stages of pregnancy, and the entire course of the disease is only 2-3 months, which usually does not have long-term effects on the mother during pregnancy. So why do doctors still pay so much attention to gestational diabetes? Several times, young and delicate mothers-to-be are asked to take blood tests, even three tubes of blood a day. Those with high blood sugar also have their fingers tied frequently.
Obstetricians are concerned about gestational diabetes not only for maternal health, but also for fetal health and the health of the fetus when it reaches adulthood.
For the mother-to-be, 2-3 months, is a very short period of time, but for the fetus, which has lived in the womb for only 10 months, 2-3 months is enough to have a thank serious impact.
Effects of diabetes on the fetus
Drastic fluctuations in maternal blood glucose, too high and too low blood glucose can lead to fetal death. A few years ago we met a pregnant woman who was admitted to the hospital for induction of labor after her initial labor and delivery at 30 weeks of gestation was found to be fetal death. The inpatient examination revealed that the blood glucose reached over 40 mmol/L, and the pregnant woman herself was in a diabetic hyperosmolar coma after delivery. Of course, it is not often that such serious complications occur in gestational diabetes. High blood sugar or high ketone bodies in early pregnancy can also cause fetal malformations.
It is easy to have a huge baby. Women are experts in weight loss and know that a diet high in sugar can cause obesity, and by the same token: a high blood sugar level in a pregnant woman will result in more sugar entering the fetus, so the fetus may grow too large. Over 8 pounds we call it a huge baby. Some time ago we delivered a 10-pound baby by cesarean section here. Her mother was a gestational diabetic and her blood sugar was not well controlled. A huge baby increases the chance of difficult delivery and also increases the chance of cesarean delivery.
Fetal growth restriction. Did you just say the baby will grow too big? Why is it restricted again? Some people have early onset of diabetes or have diabetes before pregnancy, which can lead to sclerosis of the placental vessels and placental dysfunction. As a result, the fetus is malnourished and growth is limited.
Hypoglycemia in the newborn. If the placenta is functioning well, then during the fetal period, the fetus’ blood sugar is high. The fetus is stimulated to produce more insulin on its own (insulin functions to lower blood sugar) to prevent high blood sugar. After birth, there is no longer a constant supply of blood sugar from the mother, but for a while insulin cannot be lowered, and as a result, the newborn develops hypoglycemia. Hypoglycemia can be so severe that it can lead to coma or even death in the newborn.
The incidence of obesity, diabetes, coronary heart disease, and hyperlipidemia is much higher in diabetic children when they grow up than in normal newborns. Perhaps, although the mother has diabetes during pregnancy and fortunately the pregnancy is still safe, the health of the future child needs extra attention.
What are the effects of gestational diabetes on pregnant women?
In severe cases, hypertonic coma or ketoacidosis can occur due to high blood sugar. This is an emergency situation for diabetes. It is very dangerous when it occurs and may require resuscitation.
The risk of developing diabetes in the postpartum period is higher than in patients who did not have diabetes during pregnancy.
Our obstetricians check whether you have gestational diabetes, from the health perspective of pregnant women, is also a health reminder for people with gestational diabetes: after delivery, you will generally return to normal, but the high incidence of diabetes in the distant future, pay attention to diet and exercise to control blood sugar to postpone the onset of diabetes; to physical examination, timely detection of diabetes and timely treatment.
What should I do if gestational diabetes occurs?
The incidence of gestational diabetes is increasing. Due to the increasingly strict diagnostic criteria for gestational diabetes in recent years for the protection of the future health of the fetus, as well as conscious screening during maternity examinations, a diagnosis can be made for mild diabetes. What happens if you are diagnosed with diabetes?
Diet modification, increased exercise, and insulin. These are the three main principles that all obstetricians use to treat gestational diabetes.
Diet adjustment: Don’t overdo the increase in nutrition during pregnancy. When you gain too much weight, you are prone to gestational diabetes. Doctors will tell you to control your diet after diabetes occurs. However, pregnancy is a special time to ensure the nutrition of the fetus as well. So, don’t eat a diet high in sugar, and don’t go on an excessive diet, which can lead to restricted fetal growth.
Increase exercise: There are many exercises that are suitable during pregnancy and will not increase the almost of miscarriage. Exercise after meals can be effective in lowering blood sugar. The available exercises are walking, swimming, gymnastics, yoga, etc.
Insulin: If blood sugar still cannot reach the ideal level after diet adjustment and increased exercise, then insulin therapy is needed. Rest assured that insulin is safe and will not affect the fetus because insulin cannot pass through the placenta.
How to prevent gestational diabetes?
Reduce weight before pregnancy if you are obese. Do not gain excessive weight during pregnancy, 10-15 kg is more appropriate. If you do not lose your ideal weight during pregnancy, then 10 kg is sufficient. Do not eat high-energy foods during pregnancy, such as sugary drinks, fried foods, cakes, chocolates, etc. Don’t use pregnancy as an excuse to eat and drink a lot and give up exercise.
Who is at high risk for gestational diabetes? People who have parents with diabetes, obese people, people with polycystic ovary syndrome, people with prolonged menstrual cycles, and people who are hairy and prone to acne. These people should pay attention to diet, exercise and checkups.
Most gestational diabetes is asymptomatic and is diagnosed by screening. Some mothers-to-be are afraid of failing the test by dieting for a few days before the test again and then eating and drinking heavily after passing. These can interfere with the diagnosis and be detrimental to your health. Eat normally for three days before the test. If the test is normal, maintain the same diet. If your blood sugar increases, eat as ordered by your doctor.
Diabetes and gestational diabetes are chronic conditions that affect your health and that of your child. For the sake of your and your child’s future, please cooperate with the tests and treatment.
Let me tell you a story here. A patient in her 40s came to my clinic with a complaint of recurrent mycosis fungoides and asked to be examined. At first glance, this patient had a high body mass index, which means she was obese. I asked: Do you have diabetes (diabetes predisposes to mycosis fungoides)? Patient: I didn’t check. (I checked her blood sugar and diagnosed diabetes. Again: Is your period normal? No, I often don’t get my period. (Women with irregular menstruation and obesity may have polycystic ovary syndrome and are prone to diabetes). My preliminary judgment is that it is polycystic ovary syndrome. Q: Have you ever given birth (polycystic ovary syndrome is prone to infertility)? A: I have given birth. Q: Did the pregnancy go well (polycystic ovary syndrome patients are prone to gestational diabetes)? A: I was hospitalized for diabetes (really!) . Q: How many pounds was the baby born? A: More than nine pounds, born by cesarean section. Was she that fat before? Did you check your blood sugar after delivery? A: I was fat when I was a girl, but I never thought of checking my body after giving birth. I said: now start to control the diet, increase exercise to reduce weight. A: I have a bad heart now and I am afraid to exercise.
This patient has several opportunities to prevent the onset of diabetes or diagnose it earlier:.
1. health education, early weight loss and good diet control during the first visit for adolescent menstrual disorders, which may have prevented gestational diabetes from occurring and prevented the birth of such a large child, perhaps without the need for a cesarean section.
2. health education again after the occurrence of diabetes during pregnancy, weight loss after delivery to control weight and increase exercise, then she might not have diabetes so early.
3, regular medical checkups after delivery, then diabetes may be detected in time, early treatment, and medication to control blood sugar, then the complications of diabetes will not occur, which affects the heart function.
Maintain health is a lifelong business, pregnancy is an opportunity, you pay attention to perhaps the latter life will be in a good state of health, you do not pay attention, your health status may take a sharp turn.