As we all know, diabetes and diabetes-related coronary heart disease and hypertension are the major killers of human health today. The main cause of type 2 diabetes is that the body is insensitive to insulin, which regulates blood glucose, in other words, the effect of insulin is greatly reduced, which is called “insulin resistance” in technical terms, and the function of pancreatic B-cells to secrete insulin is reduced and cannot meet the needs of the body. The process of development of diabetes is long. The development of most diabetes is a long process, from “insulin resistance” to actual diabetes often takes years, decades or even decades, which is why the majority of people with type 2 diabetes are middle-aged and elderly. So, can people anticipate the possibility of developing diabetes in the future and prevent it before it happens? The answer is yes! Pregnancy is a serious “test” for the function of the pancreas, or an opportunity to “check” for diabetes in the future, so I hope you won’t miss it!
During pregnancy, in order to protect the growth and development of the fetus and provide more nutrients and sufficient blood sugar supply to the fetus, a large amount of anti-insulin substances (including various hormones) will be produced, and physiological “insulin resistance” will occur. In order to maintain the balance of blood sugar, the pancreas has to increase its workload and secrete more insulin to meet the body’s needs. Of course, after delivery, most patients’ blood sugar will return to normal, but these people are very likely to develop type 2 diabetes in the future! We are a nation with a high prevalence of diabetes, and the incidence of gestational diabetes in China is increasing year by year. According to the 2007 national survey on the incidence of gestational diabetes, the average incidence of abnormal glucose metabolism during pregnancy was 6.6%, which is a serious reality we must face. On the other hand, this also gives us a good way to identify the problem early and solve it. As long as we pay attention to it and treat it with a rigorous scientific attitude, we can still prevent or greatly postpone the onset of type 2 diabetes.
How can we prevent or delay the onset of type 2 diabetes? As mentioned earlier, diabetes is caused by “insulin resistance” and a decrease in the function of insulin secretion by pancreatic islet B cells. “This phenomenon is called “glucose toxicity”. Therefore, the best way to prevent type 2 diabetes is to detect “insulin resistance” at an early stage and increase insulin sensitivity and reduce the degree of insulin resistance through lifestyle changes such as controlling diet, increasing exercise and reducing weight.
The “physiological” insulin resistance during pregnancy can actually reveal whether a person has “pathological” insulin resistance or not. If a person has abnormal glucose tolerance or gestational diabetes during pregnancy, it indicates the presence of pathological insulin resistance, which must be taken seriously and treated actively to strictly control blood sugar, reduce the degree of insulin resistance, ease the burden on pancreatic B cells, and prevent the continued decline of B cell function. However, pregnant women with abnormal glucose tolerance during pregnancy or less severe gestational diabetes often have no special discomfort and are difficult to detect without vigilance, which is why some people have multiple unexplained miscarriages, premature births or fetal malformations without knowing that diabetes is the real culprit of these adverse pregnancy outcomes! Screening for gestational diabetes is now available in most areas of the country, allowing for early detection and monitoring of gestational diabetes and a dramatic improvement in pregnancy outcomes. However, some regions have not yet carried out gestational diabetes screening, or some pregnant women are not sufficiently aware of the seriousness of gestational diabetes and are unwilling to undergo diabetes screening or glucose tolerance test, resulting in the underdiagnosis of gestational diabetes. This not only increases the risk of pregnancy and the fetus, but in the long run, uncontrolled blood glucose during pregnancy increases the burden on pancreatic B cells, impairs their function, and plays a catalytic role in the development of type 2 diabetes.
In addition, studies have shown that an increase in the number of births can accelerate the progression of abnormal glucose tolerance to diabetes, and that a second pregnancy with a history of gestational diabetes increases the chance of developing type 2 diabetes by a factor of three.
Although most pregnant women with gestational diabetes can have their blood glucose reduced to normal levels after delivery, the likelihood of developing type 2 diabetes in the future is greatly increased, so it is important to have regular postpartum checkups. In places or hospitals where it is possible, it is better to conduct glucose tolerance test and insulin release test at the same time, so as to understand the degree of insulin resistance and the secretion function of pancreatic B cells. After normalization of blood glucose after delivery, it is still necessary to review blood glucose regularly, once every six months to one year. In order to detect elevated blood glucose and control it in time. Pregnant women with a history of gestational diabetes, even if their blood glucose has returned to normal after delivery, still need to maintain a good lifestyle, low-fat and low-sugar diet, adhere to physical exercise, control weight gain, maintain a good mood, prevent obesity, and quit smoking and drinking. The occurrence of various complications caused by diabetes will make your life more meaningful and your life more qualitative.