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Gestational Diabetes Mellitus
The dangers of gestational diabetes
The harms of gestational diabetes mainly include two aspects: the effects on the child and the effects on the pregnant woman herself. For the fetus, the early impacts mainly manifest as spontaneous miscarriage, fetal abnormalities, abnormal fetal development, macrosomia, and delayed maturation of fetal lungs. At birth, this may lead to complications such as premature birth and hypoglycemia. Newborns face a higher risk of respiratory distress syndrome compared to healthy infants. The long-term effects on the child mainly include a significantly increased incidence of glucose intolerance and diabetes, increased risk of obesity, and notable rise in cardiovascular abnormalities and neuromotor developmental disorders. For the mother, the impacts mainly manifest as concurrent miscarriage, gestational hypertension and pre-eclampsia, an increased likelihood of diabetic ketoacidosis. A macrosomic fetus can lead to difficult labor, trauma to the birth canal, prolonged surgical labor, postpartum hemorrhage, and an increased risk of gestational diabetes in subsequent pregnancies, extended hospital stays, and a significantly increased incidence of Type 2 diabetes postpartum.
Gestational diabetes range
Gestational diabetes refers to abnormal blood sugar levels occurring during pregnancy. This term is used if the diagnosis is made during pregnancy, and does not include patients who were already diabetic before pregnancy, who are referred to as having diabetes concurrent with pregnancy. The criteria for diagnosing gestational diabetes are based on the results of the OGTT (Oral Glucose Tolerance Test) conducted between 24-28 weeks of pregnancy. According to the OGTT results, a fasting blood sugar level ≥ 5.1 mmol/L, a one-hour blood sugar level ≥ 10.0 mmol/L, or a two-hour blood sugar level ≥8.5 mmol/L, meeting any one of these criteria confirms a diagnosis of gestational diabetes.
Steps for Gestational Diabetes Testing
The screening steps for gestational diabetes involve, for most women, the recommendation to undergo a 75-gram glucose tolerance test at the hospital between 24 to 28 weeks of pregnancy. The method includes fasting blood draw, consuming 75 grams of glucose, and monitoring blood sugar levels one hour and two hours after glucose intake, to determine the presence of gestational diabetes. However, for pregnant women at high risk for diabetes, it is recommended to complete the 75-gram glucose tolerance test early in pregnancy to detect gestational diabetes early and initiate treatment promptly to reduce the risks to both the fetus and the mother.
Causes of Gestational Diabetes
Gestational diabetes refers to the abnormality of blood sugar levels that occurs during pregnancy, at which time it is called gestational diabetes. The reason for the occurrence of gestational diabetes is due to significant changes in the body's endocrine hormones after pregnancy. The body releases many hormones, such as estrogen and progesterone, which can increase insulin resistance. Thus, a much greater amount of insulin is needed to maintain normal blood sugar levels. If the pancreatic beta cells are not sufficient to compensate for the increased insulin secretion needed to meet the normal metabolic requirements caused by these resistance factors, then elevated blood sugar and abnormal glucose metabolism occur, ultimately leading to gestational diabetes.
Dietary Guidance for Gestational Diabetes
The dietary principles for gestational diabetes are consistent with those for non-pregnant diabetes. Firstly, the total daily caloric intake should be balanced, with carbohydrates accounting for 50%-60%, proteins for 15%-20%, and fats for 20%-30%. The overall principle is to eat smaller, more frequent meals, ideally adding two to three snacks to the three main meals per day. Common foods primarily include milk, proteins, egg whites, and fruits. Then, generally maintain the level of diet before pregnancy without overly restricting it. It is advisable to consume a significant amount of vegetables, no less than 500 grams daily, to supplement vitamins and fiber.