How is gestational diabetes treated?

Written by Liang Yin
Endocrinology
Updated on September 18, 2024
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The treatment of gestational diabetes includes dietary therapy, exercise therapy, and insulin therapy. For dietary therapy, we mainly control the total calorie intake and supplement with elements such as calcium, iron, folic acid, and various vitamins; in exercise therapy, we aim to control the speed of weight gain, improve the peripheral tissues' utilization of glucose, and improve the lipid profile. For patients whose blood glucose levels do not meet the standards after two weeks of diet and exercise therapy, we initiate insulin therapy. The goal of insulin therapy is to control fasting blood glucose below 5.3 and postprandial blood glucose below 6.7. The methods of insulin therapy include twice daily injections, multiple daily injections, or the use of an insulin pump.

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Written by Liu Wen Li
Obstetrics
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How to treat gestational diabetes?

The treatment principle for gestational diabetes is to control blood sugar and then ensure the normal development of the child. There are many methods to control blood sugar. First, it involves diet management guided by a doctor, adjusting the diet's structure and quantity, followed by post-meal exercise. If after a week of adjusted diet and post-meal exercise, blood sugar levels still do not meet the standards, insulin injections can be used to keep the pregnant woman's blood sugar within the prescribed range. This can help reduce the impact of diabetes on the fetus and the pregnant woman.

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Written by Chen Xie
Endocrinology
1min 42sec home-news-image

Impact of gestational diabetes on the fetus and pregnant women

The effects of gestational diabetes on the mother mainly include an increased risk of miscarriage, concurrent conditions such as gestational hypertension and preeclampsia, as well as the potential for diabetic ketoacidosis. The presence of a large fetus can lead to difficult labor, damage to the birth canal, prolonged surgical delivery, and an increased likelihood of postpartum hemorrhage. Additionally, women with gestational diabetes have an increased risk of developing the condition again in future pregnancies. In terms of long-term effects, the risk of developing type 2 diabetes significantly increases after experiencing gestational diabetes. For the fetus, the impacts of gestational diabetes primarily manifest as an increased risk of spontaneous miscarriage, congenital anomalies, and abnormal development. There is also a heightened risk of hyperinsulinemia, which can even affect the proper development and maturity of the fetal lungs, leading to delays. After birth, conditions such as hypoglycemia and neonatal respiratory distress syndrome are more likely to occur. In the long term, offspring of women with gestational diabetes are at higher risk for glucose intolerance, diabetes, obesity, and metabolic syndrome. These conditions significantly increase the risks to the cardiovascular system and can affect neuromotor development.

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Written by Chen Xie
Endocrinology
1min 12sec home-news-image

Gestational diabetes blood sugar standards

The diagnostic criteria for gestational diabetes involve a pregnant woman undergoing a 75-gram glucose test at any time during pregnancy to measure fasting blood glucose, blood glucose one hour after consuming glucose, and blood glucose two hours after consuming glucose. The thresholds are: fasting blood glucose equal to or greater than 5.1 mmol/L, blood glucose one hour after glucose intake equal to or greater than 10.0 mmol/L, and blood glucose two hours after glucose intake equal to or greater than 8.5 mmol/L. Diagnosis of gestational diabetes can be made if blood glucose levels exceed these standards at any of the three time points. In China, pregnant women typically undergo the 75-gram glucose test between the 24th to 28th week of pregnancy. Women at high risk for gestational diabetes are advised to undergo the 75-gram glucose test early.

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Written by Chen Xie
Endocrinology
1min 32sec home-news-image

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.

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Written by Chen Xie
Endocrinology
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How to reduce blood sugar in gestational diabetes

Gestational diabetes cannot be treated with oral medications, as they can affect the fetus. Currently, the main treatment for gestational diabetes in China is insulin, with options for short-acting or rapid-acting insulin. If fasting blood glucose is high, long-acting insulin can be used to control fasting blood glucose levels. If post-meal blood glucose is high, short-acting or rapid-acting insulin can be used to control post-meal blood glucose levels. The blood glucose control standards for gestational diabetes are fasting blood glucose between 4.0 and 5.3, and two hours post-meal blood glucose between 4.4 and 6.7.