A Gestational diabetes or Gestational diabetes is in most cases a temporary phenomenon. During pregnancy, the glucose metabolism in affected women is disturbed by the formation of pregnancy hormones. However, after the child is born, the sugar levels return to normal.
What is gestational diabetes?
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The Gestational diabetes is characterized by the first occurrence of a glucose tolerance disorder during pregnancy. With some certainty the so-called Gestational diabetes one of the most common pregnancy-related illnesses.
The pregnancy hormones estrogen, prolactin, progesterone and placental lactogens, which provide the female body with the necessary glucose during pregnancy, are probably responsible for the occurrence of gestational diabetes.
In some women, however, the pancreas cannot produce enough insulin to transport this glucose into the body cells (real insulin deficiency). Or the pancreas can produce more insulin, but the cells no longer react to it (relative insulin deficiency).
causes
Many pregnant women with already diagnosed Gestational diabetes wonder why it hit her of all people. This question is certainly justified, but it cannot be answered one hundred percent in all cases.
Body weight is usually a risk factor that should not be underestimated. With a body mass index of> 27, there is an increased risk of developing gestational diabetes.
Hereditary factors (type 2 diabetes mellitus in the family) and an age of over 30 are also problematic. Past pregnancies and births are also the focus of interest. If all of the following questions can be answered with a "yes", the pregnant woman should consult a gynecologist immediately:
Has a child been born with a birth weight of over 4500 g? Have there been more than three miscarriages? Did you have gestational diabetes in your last pregnancy? Nevertheless, the cause of gestational diabetes cannot always be clearly determined. Sometimes it also affects women without the risk factors mentioned.
Symptoms, ailments & signs
Gestational diabetes is not uncommon, but in many cases it goes undetected. The reason for this is that the course of the disease is usually symptom-free. As a rule, it remains completely undetected until the 24th week of pregnancy. In addition, the signs of gestational diabetes are quite unspecific if they only appear sporadically.
During pregnancy, the specific symptoms of diabetes are usually not perceived as such. Because frequent urination, constant tiredness or a feeling of weakness can also be typical side effects of pregnancy. However, there are also abnormalities in pregnancy that suggest diabetes.
These include high blood pressure, sudden rapid weight gain in the pregnant woman and / or the unborn baby due to abnormally high blood sugar levels, and rapid increases in the amount of amniotic fluid (this can be seen on an ultrasound scan).
If several of the mentioned signs of illness become noticeable, then the illness is much easier to diagnose. Increased urinary tract infections and vaginal inflammation, on the other hand, clearly indicate gestational diabetes. These infections are triggered by the high amount of sugar in the urine, because sugar promotes the development of fungi and bacteria.
Many women get along well with the symptoms of gestational diabetes, but the disease is sometimes associated with serious consequences for mother and child. If necessary medical measures are not taken, the disease may linger beyond pregnancy.
Diagnosis & course
A Gestational diabetes can only be reliably detected with a so-called "oral glucose tolerance test". The good news is that since March 3, 2012, all health insurances will cover the cost of the test.
From the 24th week of pregnancy, the doctor measures the fasting blood sugar of the patient, gives her a glucose solution to drink and waits three times for an hour until the next measurement. The blood sugar is measured every hour, with each time there is a limit value that must not be exceeded under any circumstances.
The fasting value after 8 hours of food abstinence should not exceed 95 mg / dl, after one hour 180 mg / dl must not be exceeded, 2 hours after drinking the glucose solution the value must be below 155 mg / dl and after 3 hours the Blood sugar levels have returned to below 140 mg / dl. If only one upper limit is exceeded, it can already be gestational diabetes.
Complications
With gestational diabetes, both the mother and the unborn child are at risk of complications. The risk increases if gestational diabetes is not treated. Preeclampsia is one of the greatest risks of gestational diabetes in the mother. This is too high blood pressure, which is associated with an increased protein concentration in the urine.
At the same time, the risk of a seizure (eclampsia) increases. In addition, the pregnant woman is more susceptible to inflammation of the vagina and urinary tract infections. Women with gestational diabetes also need to have more caesarean sections, in part due to complications or the size of the child.
If the mother becomes pregnant again later, the risk of further gestational diabetes is around 50 percent. Furthermore, the risk of developing type 2 diabetes mellitus increases.
Complications due to gestational diabetes also threaten the child. It is possible, for example, that the placenta may develop poorly, resulting in inadequate care for the fetus. Maturation disorders can also occur in organs such as the liver or lungs. In the worst case, intrauterine fetal death occurs.
The sequelae of diabetes also make themselves felt after the birth. It is not uncommon for affected babies to suffer from prolonged jaundice. A lack of calcium, hypoglycaemia or brain damage are also possible. In severe cases, the newborn has pauses in breathing or seizures.
When should you go to the doctor?
If you have gestational diabetes, you should definitely consult a doctor. Normal child development can only be guaranteed through proper treatment of the disease. If gestational diabetes is not treated, severe malformations can occur in the child, which must be treated after birth. The earlier the doctor is consulted in gestational diabetes, the better the further course of this disease. As a rule, a doctor should be consulted if the pregnant woman has low blood pressure and significant weight gain. The increase in weight exceeds the usual increase in pregnancy.
Furthermore, inflammation in different parts of the body can indicate gestational diabetes and should be examined by a doctor. A doctor should be consulted, especially if these symptoms occur suddenly. The urine of those affected can smell sweet and indicates gestational diabetes. If you have gestational diabetes, you can see a general practitioner or a gynecologist. Usually the disease can be treated well, so that the life expectancy of the mother and the life expectancy of the child are not reduced by the disease.
Treatment & Therapy
With a diagnosed Gestational diabetes As a rule, the referral is made to the diabetologist, who analyzes the patient's diet in detail and has suggestions for improvement. If the patient renounces the so-called "short-chain carbohydrates" such as sugar, white bread and sweets from now on, the blood sugar values can be easily adjusted in over 80% of the patients.
From now on, whole grain products, lots of vegetables and less fructose fruits like berries or apples are on the menu. Once a week, the diabetologist checks the patient's blood sugar levels, who, from the time of the first nutritional consultation, logs their levels at least three times a day:
In the morning after getting up, at noon and in the evening. If the blood sugar levels are in the range and there are few "outliers", the low-carbohydrate diet is completely sufficient to prevent excessive weight gain in the mother and developmental delays in the infant.There is then no need to administer insulin and gestational diabetes does not lead to any further complications, such as an excessive birth weight, which can lead to a problematic birth.
prevention
A Gestational diabetes cannot always be avoided. Hereditary factors, obesity and the increasing gestational age of the patients take their toll. It is not important to "eat a lot" during pregnancy, but to be healthy and varied. In this way, some gestational diabetes may not even develop and an existing gestational diabetes can be treated well.
Aftercare
In most cases, patients with gestational diabetes have only a few and only limited measures available for direct follow-up care. For this reason, the person affected should ideally consult a doctor early on in order to prevent the occurrence of other complaints or complications.
Self-healing cannot occur, so treatment by a doctor should be initiated in good time. This is the only way to prevent various malformations of the child. In most cases, the symptoms of gestational diabetes can be relieved relatively well if the diet is changed accordingly. The person affected should avoid sugar and white bread and generally pay attention to a healthy lifestyle with a healthy diet.
Regular check-ups and examinations by a doctor are very important in order to detect further symptoms at an early stage. In some cases, the disease can also be completely cured by administering insulin, so that no special follow-up measures are necessary afterwards. Gestational diabetes does not reduce the life expectancy of the patient and, as a rule, does not limit it.
You can do that yourself
Often the blood sugar level can be normalized with gestational diabetes with a change in diet and physical activity. Pregnant women with this diagnosis should definitely seek individual nutritional advice.
In gestational diabetes, the daily amount of energy should be between 1,800 and 2,400 kilocalories, depending on eating habits, the daily routine and body weight. When it comes to nutrition, pregnant women should ensure that their daily carbohydrate intake is 40 to 50 percent and mainly consists of slowly absorbable carbohydrates (e.g. whole grain products). An expectant mother with gestational diabetes should avoid white flour products, fruit juices and sweets, because the food increases blood sugar excessively quickly and strongly. To avoid this, it is still a good idea to consume around 30 grams of fiber daily in the form of whole grain products, fruits, vegetables and pulses.
Furthermore, it is advisable to consume vegetable fats and to cover the protein requirement with low-fat milk and milk products as well as low-fat meat and sausage products. To avoid blood sugar spikes after a meal, five to seven smaller meals are advisable throughout the day. For overweight pregnant women - whether with or without gestational diabetes - a diet is prohibited.
In addition to diet, regular exercise is essential. Exercising in moderation can help reduce high blood sugar levels naturally.
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