In the ideas of every woman, the period of waiting for a child seems to be something iridescent, airy and serene, but it happens that this idyll is disturbed by serious health problems.
Gestational diabetes mellitus during pregnancy, why is it dangerous, what are the indicators and signs in pregnant women, diet and menu, consequences for the child, analysis for latent blood sugar - the topic of this article.
The material will be useful to any woman of fertile age who has risk factors and heredity for the disease with sweet ailment.

Gestational diabetes in pregnant women: what it is

Gestational or gestational diabetes is a disease of increased blood sugar levels that occurs during pregnancy at any time. Many people confuse the name and call it remote. Before pregnancy, the woman was completely healthy and did not show signs of illness. This disease is also called “pregnancy diabetes”.


As a rule, this type of diabetes occurs in the second half of gestation, when a woman is at a decent time. After delivery, gestational diabetes may disappear or develop into overt type 1 or 2 diabetes.
However, there are studies that show a strong link between diabetes during pregnancy and type 2 diabetes later in life. In other words, if a woman had gestational diabetes at a young age, then in adulthood she has a greater risk of type 2 diabetes if there are risk factors in the form of obesity, poor nutrition, and others.

The incidence of this type of diabetes is about 2.5 - 3.0%. Certain risk factors contribute to this, which I list below:

• overweight and obesity
• age over 30
• diabetes inheritance
• large baby after a previous pregnancy
• detection of glucose in urine in a past pregnancy
• past gestational diabetes
• polycystic ovary syndrome (PCOS)

Diabetes in pregnant women: what is dangerous and the consequences for the child

Diabetes is always a pathology and it cannot but affect the course of pregnancy and fetal health. But with good compensation, it is possible to safely endure and give birth healthy baby... I will tell you what you need for good compensation below, and now I will list what the expectant mother can expect.

• high risk of fetal death in utero or in the first week of life after childbirth
• the birth of a child with developmental disabilities
• a high risk of various diseases in the born child in the first month of life (for example, infection)
• the birth of a large fetus and the risk of complications associated with this (trauma to the skull and limbs of the child, ruptures of the mother during childbirth, etc.)
• the risk of developing diabetes in a child in the future
• late pregnancy complications (eclampsia and preeclampsia, arterial hypertension, edema syndrome)
• polyhydramnios
• intrauterine infection

What are the signs of diabetes during pregnancy

Quite often, an increase in glucose levels is asymptomatic, and if there are any signs, it is usually attributed to the pregnancy itself. The symptoms of gestational diabetes are no different from those of any other type of diabetes. The severity of these symptoms depends on the blood sugar level.

Symptoms of diabetes during pregnancy

• dry mouth
• frequent urination
• itching and itching of the perineum
• thrush
• rapid weight gain
• general weakness and drowsiness

As you can see, the manifestations are often a manifestation of the pregnancy itself and therefore every woman regularly takes blood and urine tests, for early diagnosis carbohydrate disorder.

Blood sugar readings in gestational diabetes

As I mentioned in the article, in order to diagnose "Gestational diabetes", you need to conduct a special analysis - an oral glucose tolerance test. Based on the results of this test, you can accurately diagnose and choose the correct management tactics.


In the same place I said that during pregnancy, not only gestational diabetes can occur, which is caused directly by the state of pregnancy, but also manifest diabetes mellitus, which is caused by other reasons, and pregnancy only provoked its development.
The difference between these types is that the gestational course is more sluggish and passes after childbirth, and with manifest diabetes, the glycemic indicators are higher, pronounced clinic and it remains forever and does not disappear with childbirth.
Below is a table that displays diagnostic indicators for gestational diabetes. Anything that exceeds these indicators speaks of overt type 1 or 2 diabetes mellitus. Click to enlarge.


So, you can see that the diagnosis "Gestational diabetes mellitus (GDM)" is made when fasting sugar is higher than 5.1 mmol / L, but less than 7.0 mmol / L.
After a glucose test, after 1 hour, blood glucose should not exceed 10.0 mmol / l, and after 2 hours - no more than 8.5 mmol / l.
What are the normal indicators for a pregnant woman, I said in the article. I recommend reading.

How to take an analysis (test) for latent pregnancy diabetes

The test is performed at 24-26 weeks of gestation. First of all, you need to wait a 10-12 hour period of hunger and get a good sleep the night before. No smoking. For the procedure, you will need 75 grams of glucose powder and 200 ml of warm water.

1. First, blood sugar is given on an empty stomach.
2. After that, dissolve the glucose powder in the brought water and drink.
3. We sit down in an armchair or on a couch in the laboratory's waiting room, we don't go anywhere.
4. After 1 and 2 hours, we donate blood from the vein again.
5. After the third fence, you can be free.

Treatment and diet for gestational diabetes in pregnant women

In some cases, nutrition and diet are already powerful tools in the management of gestational diabetes. During pregnancy, all pill medicines are contraindicated, so insulin injections are the only means to lower blood sugar, in addition to diet.


But in most cases it is possible to do without it, only by properly adjusting the nutrition, making a rational menu, and also increasing feasible physical activity in the form of walking, for example.

Only a few are prescribed insulin and only in two cases:

• failure to achieve target glycemic values ​​within 1-2 weeks only with the help of a diet
• the presence of signs of fetal suffering according to ultrasound data

What is the diet and nutrition of a woman with diabetes

If to normalize blood sugar in a non-pregnant woman effective method If there is a low-carb diet, then this method is not suitable for a pregnant woman.


Such a woman should not completely deprive herself of carbohydrates, since this will lead to education ketone bodies that can negatively affect the development of the fetus. But there are still some limitations. These restrictions are imposed on carbohydrates with a high glycemic index, namely any sweets, bread and flour, potatoes, cereals, sweet fruits (banana, persimmon, grapes).

What you can eat with gestational diabetes during pregnancy

All types of meat and fish are allowed, any vegetables except potatoes, whole grains, seasonal local fruits and berries, nuts, mushrooms, herbs. Observe the following protein / fat / carbohydrate ratio. It is important to get high-quality proteins and healthy fats, both vegetable and animal, in equal proportions.

• proteins 30 - 25%
• fats 30%
• carbohydrates 40 - 45%

Various cooking sites offer a variety of recipes and menus, so I won't go overboard. In addition, it is not always possible to satisfy the tastes of a multi-thousand audience of blog readers.

What should be the sugar in a pregnant woman (normal)

How do you know that you are doing everything right? Frequent monitoring of your blood glucose will help you with this. Be sure to watch blood sugar before every meal, and also 1 hour after a meal, after 2 hours you can not look. If necessary, you will have to watch sugar at night at 2-3 hours.

• fasting sugar should be less than 5.1 mmol / l
• 1 hour after eating should not exceed the level of 7.0 mmol / l
• before going to bed and at night, sugar should be no more than 5.1 mmol / l
• the level of glycated hemoglobin should not be more than 6.0%

Management of women after childbirth

If a woman received insulin therapy, then immediately after childbirth, this insulin is canceled. During the first three days, blood glucose is monitored to detect a violation of carbohydrate metabolism. If the sugar is normal, then you can be calm.
All women who have undergone GDM should be monitored because they are at increased risk of recurrent GDM or the development of type 2 diabetes in the future.

• after 6-12 weeks, a repeated test with glucose is carried out, only in its classic version (sugar is viewed only on an empty stomach and 2 hours after loading)
• it is recommended to stick to a low-carbohydrate diet (but not ketosis) in order to reduce weight, if any
• increased physical activity
• planning subsequent pregnancies

That's all for me. Good sugars and easy delivery. Click on the social buttons. networks if you liked the article and found it useful. , so as not to miss the release of new articles. Until next time!

With warmth and care, endocrinologist Lebedeva Dilyara Ilgizovna

- a type of diabetes that occurs exclusively in women during pregnancy. After giving birth, after a while, it usually goes away. However, if such a violation is not treated, started, then the problem can turn into a serious disease - type 2 diabetes (and this is a mass of difficulties and unpleasant consequences).

Every woman with the onset of pregnancy becomes registered in antenatal clinic at the place of residence. Due to this, throughout the entire period of bearing a child, the health of a woman and her fetus is monitored by specialists, and periodic blood and urine tests are mandatory for monitoring.

If suddenly an increase in glucose levels is found in the urine or blood, then a single such case should not cause panic or any fears, because for pregnant women this is considered a physiological norm. If the test results showed more than two such cases, and glucosuria (sugar in the urine) or hyperglycemia (blood sugar) are found not after eating (which is considered normal), but taken on an empty stomach in tests, then we can already talk about gestational diabetes mellitus of a pregnant woman.

Causes of Gestational Diabetes, Its Risk and Symptoms

According to statistics, approximately 10% of women suffer from complications during pregnancy, and among them there is a certain risk group who may develop gestational diabetes. These include women:

• with a genetic predisposition,
• overweight or obese
• with ovarian disease (for example),
• with pregnancy and childbirth after the age of 30,
• with previous births accompanied by gestational diabetes mellitus.

There can be several reasons for the occurrence of GDM, but this is mainly due to a violation of loyalty to (as in type 2 diabetes). This is due to the increased load in pregnant women on the pancreas, which may not be able to cope with the production of insulin, namely, it controls the normal level of sugar in the body. The "culprit" of this situation is the placenta, which secretes hormones that resist insulin, while increasing the level of glucose (insulin resistance).

The "opposition" of the placental hormones to insulin usually occurs at 28-36 weeks of pregnancy and, as a rule, this occurs due to a decrease in physical activity, which is also explained by the natural weight gain during gestation.

Symptoms of gestational diabetes during pregnancy are the same as in type 2 diabetes:

• increased feeling of thirst,
• lack of appetite or constant feeling of hunger,
• the occurrence of discomfort from frequent urination,
• possibly an increase in blood pressure,
• blurred vision.

If at least one of the above symptoms is present, or you are at risk, then be sure to inform your gynecologist so that he examines you for GDM. The final diagnosis is made not only in the presence of one or more symptoms, but also on the basis of tests that must be passed correctly, and for this you need to eat foods that are included in your daily menu (do not change them before taking the test!) And keep familiar image life.

The following indicators are the norm for pregnant women:

• 4-5.19 mmol / liter- on an empty stomach,
• no more than 7 mmol / liter- 2 hours after eating.

If the results are questionable (i.e., an insignificant increase), a glucose load test is performed (5 minutes after the test on an empty stomach, the patient drinks a glass of water in which 75 g of dry glucose is dissolved) - to accurately determine the possible diagnosis of GDM.

Why is gestational diabetes mellitus (GDM) dangerous for a child?

For the preservation of the fetus in the placenta, hormones such as cortisol, estrogen and lactogen are needed. However, these hormones are forced to resist insulin, which disrupts the normal functioning of the pancreas, and because of this, not only mommy suffers, but also her baby.

The formation of the fetus occurs in the first trimester of pregnancy, and therefore the manifested GDM after 16-20 weeks cannot lead to any abnormalities in the development of organs. Moreover, timely diagnosis is quite capable of helping to avoid complications, but there remains the danger of diabetic fetopathy (DF) - "feeding" the fetus, the symptoms of which are associated with impaired development.

The most common symptom of DF deviation in GDM disease is macrosomia - an increase in the size of the fetus in weight and height. This is due to the large amount of glucose supplied for the development of the fetus. The child's pancreas, which is not yet fully developed at this moment, is already producing its own insulin in excess, which converts the excess sugar into fat. As a result, with normal head and limb sizes, there is an increase in the shoulder girdle, heart, liver, abdomen, and a fat layer is expressed. And as the consequences of this:

• due to the difficult passage of the birth canal of the child's shoulder girdle - difficult labor;
• for the same reason - damage internal organs mothers and possible injuries to the child;
• due to an increase in the fetus (which may not yet fully develop), the cause of premature birth.

Another symptom of DF is impaired breathing of the newborn after delivery. This happens due to a decrease in surfactant - a substance in the lungs (this is due to the GDM of a pregnant woman), and therefore, after the birth of a child, they can be placed in a special incubator (incubator) under constant control, and, if necessary, they can even carry out artificial respiration using a lung ventilation apparatus.

Treatment and prevention of gestational diabetes mellitus

As we have already said, the main cause of GDM is an increase in sugar, and therefore treatment, as well as prevention of the disease, is based on controlling this indicator in the body.

The task of a pregnant woman is to regularly pass tests and strictly follow the recommendations of the attending gynecologist. In addition, you should control (or even change) your diet and lifestyle.

As the practice of doctors and statistics show, the main key to the health of a mother and her child is proper nutrition, which is needed not to lose weight (lose weight), but to normalize glucose levels. And here it is important to eat less high-calorie, but at the same time nutritious food. This means:

• exclude baked goods and confectionery from the diet, but do not exclude carbohydrates from the diet in general (this is a source of energy);
• limit or exclude certain types of fruits that contain easily digestible carbohydrates;
• refuse to use semi-finished products and instant products (noodles, soups, cereals, mashed potatoes, sausages);
• give up the use of smoked meats, margarine, mayonnaise, butter, pork;
• do not forget about protein food: it is very important for the body;
• when preparing food, boiling, stewing, baking or steaming food is preferred;
• meals should be in small portions, but every 3 hours.

Besides, expectant mother will be useful:

• special classes,
• outdoor walks away from the roadway.

Physical activity contributes to the effective neutralization of sugars (less glucose accumulates in the blood, and its level decreases), a good metabolism and has a beneficial effect on overall well-being.

During pregnancy, chronic diseases may worsen or signs of previously unknown problems may appear. Gestational diabetes can become such a problem.

According to the classification The World Organization health care, "gestational diabetes" is diabetes mellitus detected during pregnancy, as well as impaired glucose tolerance (the perception of glucose by the body), also identified during this period. It is caused by decreased sensitivity of cells to their own insulin (insulin resistance), which is associated with high levels of pregnancy hormones in the blood. After childbirth, blood sugar levels most often return to normal. However, the likelihood of developing type 1 and type 2 diabetes during pregnancy cannot be ruled out. Diagnosis of these diseases is carried out after childbirth.

When analyzing data from multiple studies, doctors concluded that more than 50% of pregnant women with gestational diabetes develop true diabetes later in life.

Why is gestational diabetes dangerous?

Gestational diabetes in most clinical situations develops in the interval before. Disorders of carbohydrate metabolism, identified earlier, as a rule, indicate previously unnoticed pregestational ("pre-pregnant") diabetes.

Of course, it is better to learn about chronic diseases before pregnancy, and then it will be possible to compensate them as much as possible. It is for this reason that doctors strongly recommend planning a pregnancy. In terms of preparation for pregnancy, a woman will undergo all basic examinations, including those to identify diabetes mellitus. If violations of carbohydrate metabolism are identified, the doctor will prescribe treatment, give recommendations, and future pregnancy will proceed well, and the baby will be born healthy.

The main condition for the management of pregnancy complicated by diabetes (both gestational and its other forms) is the maintenance of blood glucose levels within the normal range (3.5-5.5 mmol / l). Otherwise, mom and baby find themselves in very difficult conditions.

What threatens mom? Possible premature birth and stillbirth. There is a high risk of developing (with diabetes mellitus it develops more often and earlier - up to 30 weeks), hydramnios, and, consequently, fetal malnutrition. Perhaps the development of diabetic ketoacidosis (a condition in which there is a sharp increase in the level of glucose and the concentration of ketone bodies in the blood), infections of the genital tract, which are recorded 2 times more often and cause infection of the fetus, etc. Progression of microangiopathies with an outcome in visual impairment, renal function, impaired blood flow through the vessels of the placenta and others is also possible. A woman may develop weakness in labor, which, in combination with a clinically narrow pelvis and large fruit make delivery inevitable by caesarean section... In women with diabetes, infectious complications are more common in the postpartum period.

In the previous article, we wrote about how important it is not to miss the first signs of gestational diabetes in pregnant women. So, glucose tolerance test allows you to accurately establish the diagnosis, but, unfortunately, sometimes the test procedure itself is carried out incorrectly, as a result, the results are incorrect. It is worth talking about common mistakes and misconceptions when screening for gestational diabetes mellitus in our country.

Only a vein and nothing but a vein

The first phase of screening for gestational diabetes begins imperceptibly. When registering, all pregnant women take blood tests, among which the determination of glucose levels is hidden. In order for the data to be reliable, the analysis is carried out after an overnight fast for a period of at least 8 and no more than 14 hours. In accordance with the current consensus, glucose levels should be determined exclusively in venous plasma. It is completely unacceptable to use portable devices (glucometers) for analysis.

"Wrong" rate

We, doctors, often come across indignant comments: “Doctors do not know the norms!”, “I have normal rate, and I am already diagnosed with diabetes! ". As a result, the woman does not trust doctors and refuses to be treated.

It is important to understand that normal blood glucose levels during pregnancy are different. Already at a level of 5.1 mmol / l in venous plasma on an empty stomach, we are obliged to diagnose gestational diabetes mellitus and send the patient to an endocrinologist.

But the cases when the doctor manages to miss a small increase, because outside of pregnancy such glycemic indicators are completely normal, are just depressing.

And one more important test

Even if a woman passed the analysis according to all the rules and received a normal result, this does not mean that everything is ok and you can relax. Sometimes problems start a little later.

All women who have not been found to have a carbohydrate metabolism disorder early dates pregnancy, between 24 and 28 weeks, a glucose tolerance test with 75 g of glucose in powder is mandatory. The optimal test time is 24-26 weeks.

The stress test takes two hours to complete. The first blood sampling from a vein is done on an empty stomach. If it is technically possible to quickly determine the level of glucose in the venous plasma (but not with the help of a glucometer), then you should wait for the result. At the level of 5.1 mmol / l and more, it is not worth continuing - the diagnosis of "gestational diabetes mellitus" or "suspicion of manifest diabetes mellitus" can already be made.

If this is not possible (this is a common situation, there is nothing wrong with that), the load is carried out. The powder, consisting of 75 g of dry glucose, is dissolved in 250-300 ml of warm (37-40 ° C) still drinking water. This solution should be drunk within 5 minutes. As soon as the patient took the first sip, the test began. Exactly after 60 minutes and after 120 minutes, blood sampling from the vein is repeated.

Glucose level 5.1 mmol / L and higher, but less than 7.0 mmol / L on an empty stomach, or 10.0 mmol / L one hour after exercise, or 8.5 mmol / L 2 hours after exercise - this is gestational diabetes mellitus ...

No additional research is needed anymore. The situation must be accepted, go for a consultation with an endocrinologist, buy a glucometer and begin to follow dietary recommendations. In most cases, the situation can be controlled without the need for insulin administration.

What if you are late?

Everything needs to be done on time. If for some reason the deadline was missed, the decision on the advisability of holding it in more late dates taken individually. If the patient belongs to a risk group for the development of gestational diabetes (overweight or obesity, a woman's age of 30 years and older, diabetes mellitus in relatives, gestational diabetes in previous pregnancies, the birth of a child weighing more than 4500 kg or a history of stillbirth, a rapid increase weight during this pregnancy) or ultrasound results in suspected diabetic fetal damage, glucose tolerance test can be performed up to 32 weeks of pregnancy.

How do I prepare for the test?

Of course, everyone wants the test result to be “good”. That is why some especially shy pregnant women go on a diet with a strict restriction of carbohydrates, hoping to "slip through". Unfortunately, you can get a completely opposite result - the body, missing carbohydrates, mobilizes and gives an "increased" indicator.

Test errors

• Limiting carbohydrates. A common misconception is to limit carbs before testing. I don’t know where this recommendation came from. In the hope of getting a "better" result, you can get the opposite effect. For 3 days before the test, you should maintain your usual eating habits, getting at least 150 g of carbohydrates per day.
• Not eating enough break. Immediately before the test, the fasting period should be 8-14 hours. The last dinner on the eve of the test must necessarily contain 30-50 g of carbohydrates.
• Excessive activity. During the test (120 minutes), the patient must sit. You can, of course, walk once along the corridor, but running into the nearest shop is a bad idea.
• Smoking and medications. Smoking is prohibited until the test is completed. If the patient is taking medications that affect the blood glucose level (multivitamins and iron supplements containing carbohydrates, glucocorticoids, β-blockers, β-adrenomimetics), the next pill can be taken only after the end of the test.

It is strictly forbidden to replace the load with glucose with any "test breakfasts", sweet tea and other nonsense. In order for the test results to be reliable, you must strictly follow the instructions.

The glucose tolerance test is not performed:

• at early toxicosis pregnancy (vomiting, nausea);
• if it is necessary to comply with strict bed rest (the test is not carried out until the expansion of the motor regimen);
• against the background of an acute inflammatory or infectious disease; with exacerbation of chronic pancreatitis or in the presence of dumping syndrome (resected stomach syndrome);
• if the diagnosis of gestational diabetes mellitus has already been established.

Endocrinologists treat gestational diabetes. The basis of therapy is the correct diet. Contrary to popular belief, a lot is allowed (even dark chocolate 25–30 g per day). And the reward for timely treatment will be your health and the health of your baby.

Oksana Bogdashevskaya

Photo istockphoto.com

Gestational diabetes mellitus- one of the variants of diabetes that occurs or is first diagnosed during pregnancy. At the heart of the disease is a violation of the metabolism of carbohydrates of varying degrees, namely, a decrease in glucose tolerance in the body of a pregnant woman. It is also called diabetes pregnant.

The results of epidemiological studies conducted in the United States have shown that gestational diabetes mellitus develops in 4% of all pregnant women. European researchers have voiced data according to which prevalence of gestational diabetes mellitus fluctuates in the range of 1-14% of the total number of pregnancies. About 10% of women after childbirth remain with signs of the disease, which subsequently transforms into type 2 diabetes mellitus. According to statistics, half of women who underwent gestational diabetes mellitus during pregnancy develop type 2 diabetes mellitus over the next 10-15 years.

Such high prevalence rates of this pathology and possible complications indicate a low awareness of women about possible risks development of gestational diabetes mellitus and its consequences, and, as a result, late referral for diagnosis and qualified assistance... For the timely detection of the disease in reproductive family planning centers and antenatal clinics, active educational work is currently being carried out, which allows maintaining the health of women and contributing to the birth of healthy offspring.

What is the threat of diabetes during pregnancy?

First of all, in a negative impact on the growth and development of the fetus. With the occurrence of gestational diabetes mellitus in the early stages of pregnancy, there was a significant increase in the risk of spontaneous abortion and the appearance of congenital malformations of the heart and brain structures of the fetus. If diabetes mellitus begins later in pregnancy (2-3rd trimester), it leads to excessive fetal growth (macrosomia) and hyperinsulinemia, and after birth it can be complicated by diabetic fetopathy. Signs of diabetic fetopathy of a newborn are overweight (over 4 kg), body imbalance, excess subcutaneous fat, respiratory distress, hypoglycemia, increased blood viscosity with a risk of thrombus formation.

How is gestational diabetes during pregnancy different from other types of diabetes?

Diabetes mellitus is a disease characterized by a gross violation of carbohydrate metabolism due to a deficiency of the pancreatic hormone - insulin - in the blood, which can be absolute or relative. Diabetes mellitus is almost always accompanied by an increased blood glucose - hyperglycemia and the detection of sugar in the urine - glucosuria. According to the WHO, there are several types of diabetes mellitus.

Type 1 diabetes mellitus occurs in childhood and adolescence as a result of autoimmune decay of specific cells of the pancreas that produce insulin, which leads to a decrease or complete cessation of its production. Type 1 diabetes mellitus occurs in 15% of all diabetics. The disease is detected when a high starting level of glucose is detected in the blood at a young age, while antibodies to β-cells and insulin can also be detected in the blood. The level of insulin in the blood of these patients is reduced. For the treatment of patients with type 1 diabetes mellitus, insulin injections are used - unfortunately, there are no other ways.

Type 2 diabetes mellitus often develops in overweight people in the second half of life against the background of genetic defects, previous infectious diseases, acute and chronic pancreatitis, taking certain medications and chemicals. The disease is characterized by a hereditary predisposition. In laboratory diagnostics, an increase in glucose levels (> 5.5 mmol / l) is noted in the blood of patients. Treatment of such patients consists of the appointment of a special diet, physical activity and drugs that lower blood glucose levels.

Causes of Gestational Diabetes Mellitus

Gestational diabetes mellitus during pregnancy develops as a result of a decrease in the sensitivity of cells and tissues of the body to its own insulin, that is, insulin resistance develops, which is associated with an increase in the blood level of hormones produced by the body during pregnancy. In addition, in pregnant women, glucose levels decrease more rapidly due to the needs of the fetus and placenta, which also affects homeostasis. The consequence of the above factors is a compensatory increase in the production of insulin by the pancreas. That is why insulin levels in the blood of pregnant women are most often increased. If the pancreas cannot produce insulin in the amount required by the pregnant body, gestational diabetes mellitus develops. The deterioration in the function of β-cells of the pancreas in gestational diabetes mellitus can be judged by the increased concentration of proinsulin.

Often, immediately after delivery, the woman's blood sugar level returns to normal. But it is not necessary to completely exclude the likelihood of developing diabetes mellitus in this case.

Who is most susceptible to developing diabetes during pregnancy?

Gestational diabetes mellitus during pregnancy develops in the case of a genetic predisposition, realized under the influence of a number of risk factors, such as:

Overweight, obesity with signs of metabolic syndrome;

Other disorders of carbohydrate metabolism;

Increased sugar levels in the urine;

Diabetes mellitus of the second type in direct relatives;

The woman's age is over 30;

Arterial hypertension and other diseases of the cardiovascular system;

History of severe toxicosis and gestosis;

Hydramnios, birth of a previous overweight child (over 4.0 kg), stillbirth in previous pregnancies;

Congenital malformations of the cardiovascular and nervous systems in previous children;

Chronic miscarriage of previous pregnancies, characterized by spontaneous abortion in the first two trimesters;

Gestational diabetes mellitus in previous pregnancies.

Diabetes mellitus during pregnancy: symptoms and signs

There are no specific manifestations in gestational diabetes mellitus, so the only criterion for making a diagnosis is laboratory screening of pregnant women. Women at risk, at the first visit to the antenatal clinic, should be tested for fasting blood sugar levels against the background of a normal diet and physical activity. If your finger stick blood sugar is 4.8-6.0 mmol / L, a special glucose load test is recommended.

To detect gestational diabetes mellitus, an oral glucose tolerance test is performed for all pregnant women between the sixth and seventh months, which shows the quality of glucose uptake by the body. If the level of glucose in blood plasma taken on an empty stomach exceeds 5.1 mmol / L, an hour after a meal - more than 10.0 mmol / L, and after a couple of hours - more than 8.5 mmol / L, then the doctor has a reason to diagnose GDM. The test can be repeated multiple times if necessary.

With timely diagnosis of the disease and subsequent observation and implementation of all the doctor's recommendations, the risk of having a sick child is reduced to 1-2%.

Diabetes mellitus treatment during pregnancy

The course of pregnancy in diabetes mellitus is complicated by the fact that a woman will have to constantly monitor blood glucose levels (at least 4 times a day). In addition, to correct gestational diabetes mellitus, it is necessary to adhere to a diet that includes three main meals and two or three snacks, while limiting the daily amount of calories consumed to 25-30 per kilogram of body weight. It is very important to control that the diet is as balanced as possible in terms of the content of basic nutrients (proteins, fats and carbohydrates), vitamins and microelements, since the full growth and development of the fetus directly depends on this.

Reception medicines, lowering the level of glucose in the blood, is contraindicated during pregnancy. If the diet prescribed by the doctor, along with moderate physical activity, does not give the expected results, you will have to resort to insulin therapy.

Diet of patients with gestational diabetes mellitus

Diabetes mellitus during pregnancy requires mandatory diet therapy, since it is proper nutrition that can be the key to successful treatment of this disease. When developing a diet, it is important to remember that the emphasis must be on reducing the calorie content of food, without lowering its nutritional value. Doctors recommend following a number of simple but effective dietary guidelines for GDM:

Eat in small portions at the same hours;

Exclude from the diet fried, fatty foods saturated with easily digestible carbohydrates (cakes, pastries, bananas, figs), as well as fast food and fast food;

Enrich the diet with cereals from various cereals (rice, buckwheat, pearl barley), vegetable and fruit salads, bread and whole grain pasta, i.e. foods rich in fiber;

Eat lean meat, poultry, fish, exclude sausages, wieners, smoked sausages, which contain a lot of fat

Prepare food using a small amount of vegetable oil;

Drink a sufficient amount of liquid (at least one and a half liters per day).

Exercise for gestational diabetes during pregnancy

Exercise is very beneficial for pregnant women, as, in addition to maintaining muscle tone and maintaining vigor, it improves the action of insulin and prevents the accumulation of excess weight. Naturally, physical activity for pregnant women should be moderate and consist of walking, gymnastics, water exercises. You should not abuse active physical activity, such as cycling or skating, horse riding, as this is fraught with injuries. It is important to regulate the number of loads based on the actual this moment time of well-being.

Preventive measures to prevent the development of diabetes mellitus during pregnancy

Preventing the development of gestational diabetes mellitus is most likely difficult. Often, women at risk do not develop diabetes mellitus during pregnancy, and pregnant women who do not have any prerequisites may develop the disease. However, planning a pregnancy with gestational diabetes mellitus already suffered once should be responsible and possibly no earlier than 2 years after the previous birth. To reduce the risk of re-developing gestational diabetes mellitus a few months before the expected pregnancy, you should start monitoring your weight, include it in your daily routine physical exercises and monitor blood glucose levels.

Taking any medications must be agreed with the attending physician, since the uncontrolled use of certain medications ( birth control pills, glucocorticosteroids, etc.) can also provoke the subsequent development of gestational diabetes mellitus.

1.5-2 months after childbirth, women who have had gestational diabetes need to be tested to determine the level of glucose in the blood and to conduct a glucose tolerance test. Based on the results of these studies, the doctor will recommend a specific diet and exercise regimen, as well as determine the timing for control tests.