Gestational diabetes

Gestational diabetes is the type of diabetes where high blood glucose (sugar) levels are first diagnosed during pregnancy. Unfortunately, nowadays it affects more and more women. The reason for this may be the later age of getting pregnant and the growing problem of overweight and obesity. Also the times of the COVID epidemic, i.e. less traffic, remote work, had a significant impact on the increase in the incidence of gestational diabetes. If you want to know more about this type of diabetes, we encourage you to read this article. 

Gestational diabetes: risk factors

If you are overweight, obese and hypertensive, and have had more than two children, you are at risk of developing gestational diabetes is bigger with you. To the risk factors of development gestational diabetes there should also be a family history of diabetes. Greater risk of getting gestational diabetes it also exists in women who have had diabetes before or have had a child larger than or equal to 4 kg during pregnancy.

But gestational diabetes develops not only in women from the above-mentioned groups. About 30% of pregnant women with gestational diabetes, there are no risk factors for this disease. Therefore, it is very important that all pregnant women undergo tests that will diagnose them in time.

Take it easy if you have been diagnosed with it gestational diabetes this is not a reason to panic. This diabetes mellitus disappears in 90% of women right after childbirth. However, you need to follow certain rules to make your pregnancy with gestational diabetes it was completely safe for you and yours child.

Gestational diabetes: symptoms

Often newly diagnosed women gestational diabetes, do not believe that this disease has hit them. Sometimes they want to have a repeat test because they don't think I might have diabetes. It's perfectly normal to be gestational diabetes it did not let you know, because sugar just above the norm does not give you any symptoms. However, in some women it may appear symptoms typical of diabetes, such as: 

• high thirst and increased urination;
• somnolence;
• tiredness;
• frequent skin, bladder and vaginal infections;
• blurred vision;
• uncontrolled hunger pangs, which happen when your body is running out of insulin.

The alarm signal for a pregnant woman should also be the appearance of sugar in the urine in follow-up tests. Often, in an ultrasound examination of women with gestational diabetes, the baby is larger in relation to the gestational age, and the circumference of the baby's belly is also larger than the circumference of the head. Remember that pregnancy is a special time and you should report any disturbing changes in its course to your doctor.

Gestational diabetes: control

To properly control you need gestational diabetes follow certain rules, these include:

• measuring the level of glucose (sugar) in the blood with a glucometer;
• urine ketone measurements (Ketodiastix strips);
• a diet with a low glycemic index;
• treatment with insulin, if needed.

Gestational diabetes: the norms

Blood sugar levels you will need to measure:

• on an empty stomach, immediately after getting up, preferably until 8:30;
• 1 hour after starting the meal. The time from eating the first bite of food is counted. For example, if you start eating breakfast at 8:00 AM and finish at 8:15 AM, then you measure sugar at 9:00 AM. Do not extend the time of eating, it can also affect the level of sugar;
• in some situations, you also need to measure sugar between 2:00 a.m. and 4:00 a.m. (a diabetologist will inform you about it).

Ultimately, the frequency of measurements is decided by the diabetologist, based on the type of therapy and the results of your diabetes treatment. Well, you're starting to measure your sugars, you're following a diet… what they should be like then sugar norms in gestational diabeteswhat limits should you stay within?

According to the recommendations of the Polish Diabetes Society of 2021, sugar standards in gestational diabetes are:

• on an empty stomach and before meals: 70-90 mg / dl;
• 1 hour after starting the meal: less than 140 mg / dl.

Exceeding the norms in gestational diabetes

If your sugars exceed the above-mentioned standards, you need to contact a diabetologist as soon as possible. However, if the elevated sugar appeared once after a meal because you ate something illegal, then this is not cause for concern. This is a lesson for you in the future, not to use a given product anymore.

Worryingly, if despite following the diet, the sugars are still high and this happens day after day. This may indicate that you need additional insulin treatment. Similarly, if fasting sugar, despite dieting and adherence to the recommendations, continues to exceed the indicated values ​​for consecutive days (approximately 3 days). norms of gestational diabetes (i.e. it is above 90 mg / dl), you should also see a diabetologist to modify the treatment.

The only way to lower the sugar level is to introduce insulin through subcutaneous injections, performed with the use of special insulin pens. Insulin is supposed to help you lower your sugar. If necessary, because following the diet in gestational diabetes does not bring the expected results, it is only thanks to insulin that you are able to keep sugars within the limits Normy.. It is completely safe for your child.

Gestational diabetes and a child

Untreated gestational or incorrectly treated diabetes (in self-control for a long time, sugar exceeds the above-mentioned Normy.) can cause a number of complications for both yours child, how are you. Sugar from the female body with gestational diabetes it passes almost freely through the placenta into the body child and adversely affects its development.

The effects of improperly treated gestational diabetes for your baby include:

• macrosomia: too much birth weight of the baby. If your sugars are in gestational diabetes persist for a long time over standardthen yours child it is, overfed with "glucose donated from you." To defend itself against this, the body child secretes insulin (though it shouldn't yet), which leads to cell enlargement and enlargement of many organs (including fat, muscles and heart). Increased fetal weight also increases the risk of perinatal complications, i.e. prolonged labor, trauma and perinatal hypoxia, and consequently poor neurological development. child for a lifetime;
• premature birth;
• shoulder dystocia: stoppage of labor after the birth of the fetal head due to the impossibility of birth of the shoulders. It is mainly related to the previously discussed macrosomia;
• hypoglycemia: too low blood sugar after childbirth. For this reason, immediately after giving birth, to yours child the sugar level will be checked. If the level is too low (below 30 mg / dl) then glucose is administered intravenously, because usually in the first hours after delivery, the woman's milk supply will be negligible. In exceptional circumstances, when your child will tend to have low sugars, which may cause some adaptation disorders, it may be transferred to the neonatal unit for closer monitoring. To prevent your own hypoglycaemia child, after childbirth, start breastfeeding quickly;
• hyperbilirubinemia. Children of women with gestational diabetes, even those who are born full term, are more likely to develop neonatal jaundice, which is a consequence of elevated serum bilirubin levels. Neonatal jaundice usually wears off after a few days. However, when it is too high, your baby must stay in the ward and may need special phototherapy to help it disappear faster;
• electrolyte disturbances, hyperemia or too high number of red blood cells;
• immaturity of the lungs in relation to the gestational age;
• increased risk of developing obesity, high blood pressure, metabolic syndrome or even type 2 diabetes in your child later in life. Therefore, from the first months of a child's life, do not overfeed him and monitor his body weight.

Consequences improperly treated gestational diabetes for a woman it is:

• premature birth;
• polyhydramnios;
• body swelling, urinary tract infections (including pyelonephritis);
• perinatal injuries (e.g. damage to the genital tract and perineum);
• increased perinatal blood loss;
• surgical deliveries, e.g. with forceps, caesarean sections, induced deliveries;
• pregnancy-induced hypertension and pre-eclampsia.

Presented above-mentioned effects incorrectly treated diabetes pregnancy, They are not intended to scare you, but to make you aware of the enormous impact that you can have on the course of pregnancy and your health child. Self detection gestational diabetes it is not synonymous with the occurrence of complications in both u child, how are you. In women who follow the recommendations, these complications do not occur.

Gestational diabetes and the end of pregnancy

Once you are diagnosed with gestational diabetes, the sugars are fine, you follow the instructions, and suddenly at the end of your pregnancy, your diabetes begins to progress. Sugars are rising, you can't quite get it under control and you don't know what's going on. Then don't think to wait until delivery. Often it is just that at the end of pregnancy sugars deteriorate. However, this does not mean that it is too late to start insulin treatment.

Just before the birth, on the same floor the end of pregnancy You may also notice that your sugars drop suddenly, so if you had insulin on when you were pregnant you will need lower doses in this situation. This is perfectly normal and may herald an impending labor.

Gestational diabetes and childbirth

The mere presence of gestational diabetes does not necessarily indicate a cesarean section. However, if on childbirth the natural condition of your health (because, for example, you still suffer from other diseases) or your health child (e.g. the aforementioned macrosomia), a decision is made to terminate the pregnancy by caesarean section.

if you have gestational diabetes do childbirth you don't have to prepare yourself somehow. Just wait patiently and calmly for yours child will be ready to come into the world. However, it is best to pack the bag to the hospital even a month before the delivery (as required by the facility where you will give birth). Just don't forget to put your blood glucose meter, self-check diary and insulin pen (if you were pregnant, of course) there.

Gestational diabetes, childbirth and what's next?

After giving birth sugar levels will generally return to normal, but you will need to keep them under control, this is usually necessary for the next 7-10 days. It is worth noting that after childbirth there is a change in carbohydrate metabolism, so you should measure the sugar level then:

• on empty stomach;
• 2 hours after main meals.

Standards sugar after childbirth in a woman with a previous occurrence gestational diabetes have:

• fasting: less than 100 mg / dL
• 2 hours after a meal: less than 140 mg / dl.

If your sugar results after childbirth exceed the sugar level limits listed above, you must contact your doctor. If after 7-10 days your sugar results are normal, you can stop measuring sugar with the meter.

Despite the fact that it is the moment you come into your world child, it has become most important to you, and do not forget about yourself. A healthy mother is the greatest treasure for your child.

Postpartum check-ups

Remember about 6-12 weeks po childbirth perform an oral glucose load test (OGTT). Only in this way will you check whether the conversion of carbohydrates in your body is correct after pregnancy. It is very important to have an OGTT test performed after pregnancy, so don't forget about it and make sure you set aside time for it. This test is similar to the test performed during pregnancy. However, measuring blood sugar is checked on an empty stomach and 2 hours after drinking glucose. It's best to write down a reminder on your calendar when you should take this test.

If the test results are normal, you have nothing to worry about. Just be sure to do the next diabetes test, i.e. fasting glucose or the sugar curve (OGTT test), again after 2-3 years.

Gestational diabetes and the risk of type 2 diabetes

You must bear in mind that traveling gestational diabetes increases your risk of developing type 2 diabetes in the future. Do not only care for child, but also about myself. So do not give up on the healthy lifestyle that you followed during your pregnancy, especially your diet.

In women after gestational diabetes Introducing a diet, losing weight and increasing physical activity in the 3 years after childbirth reduces the risk of type 2 diabetes by as much as 43%. It sounds good, doesn't it?

As you can see, a lot is up to you. Also remember that gestational diabetes may come back again in the next pregnancy. Unfortunately, you have no influence on this, because you will have the risk of having another pregnancy gestational diabetes is bigger. However, this is not a contraindication to having another offspring. You are already a step ahead because next time with gestational diabetes it will be easier for you. You will know from your own experience that it is "possible to live with gestational diabetes".