Prevention of Gestational Diabetes

Written by Lin Xiang Dong
Endocrinology
Updated on September 28, 2024
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The prevention of gestational diabetes mainly focuses on diet and exercise. First, weigh yourself every morning to monitor weight changes during pregnancy, as excessive weight gain can increase the risk of gestational diabetes. Second, maintain a healthy and balanced diet that is low in fat and calories, and high in fiber and protein, avoiding excessive consumption of high-sugar foods. Third, regularly engage in exercises suitable for pregnancy. Fourth, keep a regular routine. Finally, closely monitor the fetus.

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Diabetic foot ulcer precursor

Diabetic foot, as we discuss in medical terms, refers to patients with a history of diabetes who, due to poor blood sugar control, experience various complications such as the narrowing of arteries in the lower limbs, insufficient blood and oxygen supply, and neuropathy, which results in insensitivity to temperature and pain, making them prone to burns or other injuries. Additionally, diabetic patients have compromised immune systems, making them susceptible to infections. When these three factors combine, it easily leads to diabetic foot, which is also the precursor to what is colloquially known as "rotten foot" in diabetes.

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Symptoms of diabetic foot

Diabetic foot is one of the severe chronic complications of diabetes, generally referred to as the abnormalities in the lower limbs caused by diabetic vascular neuropathy. Diabetic foot with gangrene of the extremity due to concurrent infection is referred to as diabetic foot with gangrene of the extremity, representing a serious stage in the progression of diabetic foot. The main symptoms of diabetic foot include: first, subcutaneous fat atrophy, thinning of the skin, common pigmentation spots on the shin, no hair on the feet and toes, and thickening of the toenails often accompanied by fungal infections; second, atrophy of the extremity muscles, malnutrition, poor muscle tone, and susceptibility to injury in joints and ligaments; third, visible sinking of the finger joints, joint bending, weakening or disappearance of foot deformities, and cool, swollen skin at the extremities; fourth, patients often experience extremity pain, numbness, sensory abnormalities, and dull or absent deep and superficial reflexes. In the initial stages of diabetic foot gangrene, blistering, blood blisters, erosion, and infection can gradually develop into ulcers, gangrene, or necrosis. Clinically, this is manifested as localized redness, swelling, increased skin temperature, pain, functional impairment, and the presence of purulent secretions, sometimes accompanied by a foul odor.

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Written by Lin Xiang Dong
Endocrinology
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How to control diet for diabetes

The diet for diabetes mainly involves setting reasonable blood sugar reduction targets. Before achieving these targets, strict dietary control is necessary. All fruits, nuts, fried foods, and barbecued foods must be avoided. Meals should be regular and quantified without any extra meals or snacks. The amount of rice for lunch and dinner should be controlled, approximately a couple of ounces per meal, while intake of sufficient vegetables is encouraged to satiate hunger. However, vegetables like pumpkin should not be eaten. A certain amount of lean meat can be included, but fatty meats are to be avoided. Additionally, dry foods are recommended for diabetics, while liquid diets, like soups and porridges, should be avoided. For breakfast, if blood sugar control is poor, one should temporarily avoid noodles and rice noodles. Instead, consuming some pure milk and an egg, along with buns or dumplings such as steamed dumplings or wontons, is acceptable.

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Written by Tang Zhuo
Endocrinology
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Gestational diabetes symptoms

During pregnancy, there are two scenarios concerning diabetes: one is where diabetes is diagnosed before pregnancy, referred to as pregestational diabetes combined with pregnancy. The other scenario is where the sugar metabolism is normal before pregnancy, or there is an underlying reduced glucose tolerance, and diabetes appears or is diagnosed during pregnancy, also known as gestational diabetes. Over 80% of diabetic pregnant women have gestational diabetes. Typically, gestational diabetes doesn't show clear symptoms of the classic "three polys and one less" - excessive drinking, eating, urination, and weight loss. Some women with gestational diabetes may experience itching of the vulva, caused by repeated infections with Candida albicans. Additionally, gestational diabetes may lead to conditions like fetal macrosomia and polyhydramnios during pregnancy, and pregnant women with gestational diabetes are more prone to infections.

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Written by Yang Li
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Care for diabetic foot

The first fundamental step is monitoring blood glucose; good control of blood glucose levels is essential for the effective management of diabetic foot problems. Secondly, attention must be paid to the protection of the wound. It's crucial to keep the wound clean, perform regular cleaning and disinfection, and when necessary, debride necrotic tissue thoroughly. For instance, if there is a sinus tract or deep ulceration, it is essential to open the wound and ensure drainage, removing all necrotic tissue inside. Thirdly, footwear choice is critical for patients with diabetic foot; it is important to wear shoes that are loose fitting, moderately soft yet firm, and capable of evenly distributing pressure across the footbed. There are shoes specially designed for those with diabetic foot, and these can be custom-made. Other considerations include maintaining good blood pressure control and ensuring adequate nutrition to support wound healing, including sufficient protein intake, which plays a vital role in promoting wound repair.