Diabetes mellitus is a disease characterized by a constantly elevated level of glucose in the blood. Gestational diabetes mellitus (HSD) is isolated as a separate type of diabetes mellitus , since it first appears during pregnancy. In this case, this pathology can occur only during pregnancy and disappear after childbirth, and may be a harbinger of Type I diabetes mellitus. Consider the causes, clinical symptoms, laboratory diagnosis and treatment of gestational diabetes maternal.
Gestational diabetes mellitus (HSD) in pregnancy - causes and risk factors
The main cause of gestational diabetes is a decrease in the sensitivity of cells to their own insulin (insulin resistance) under the influence of a large amount of progesterone and estrogens. Of course, high blood sugar during pregnancy is not found in all women, but only in those who have a predisposition (about 4-12%). Consider risk factors for gestational diabetes mellitus (HSD):
- overweight or obesity;
- presence of diabetes mellitus in close relatives;
- Gestational diabetes mellitus diagnosed during previous pregnancies;
- birth of children weighing more than 4 kg from previous pregnancies;
- frequent spontaneous abortions in the anamnesis;
- the birth of dead children in the anamnesis.
Characteristics of carbohydrate metabolism in gestational diabetes mellitus
Normally, during pregnancy, the pancreas synthesizes more insulin than ordinary people. This is due to the fact that pregnancy hormones (estrogen, progesterone) have a counterinsul function, i.e. they are able to compete with the insulin molecule for communication with cellular receptors. Especially bright clinical symptoms become on the 20-24th week, when another hormone-producing organ is formed - the placenta , and then the level of pregnancy hormones becomes even higher. Thus, they disrupt the penetration of glucose molecules into the cell, which remains in the blood. In this case, cells that have not received glucose, remain hungry, and this causes the removal of glycogen from the liver, which, in turn, leads to an even higher rise in blood sugar.
Gestational diabetes mellitus - symptoms
The clinic of gestational diabetes is similar to diabetes mellitus in non-pregnant women. Patients complain of constant dry mouth, thirst, polyuria (increased and frequent urination). Such pregnant people are concerned about weakness, drowsiness, and lack of appetite.
In a laboratory study, an increased level of glucose in the blood and urine, as well as the appearance of ketone bodies in the urine. Analysis for sugar during pregnancy is carried out twice: the first time at a time from 8 to 12 weeks, and the second time - at 30 weeks. If the first study shows an increase in blood glucose, then the analysis is recommended to be repeated. Another study of blood glucose is called a glucose tolerance test (TSH). In this study, the fasting glucose level is measured and 2 hours after eating. The limits of the norm in pregnant women are:
- 4-5,2 mmol / l - when testing on an empty stomach;
- no more than 6.7 mmol / l - when tested 2 hours after a meal.
Diet in gestational diabetes mellitus (HSD)
The primary method of treatment of gestational diabetes is diet therapy and moderate exercise. From the diet should exclude all easily digestible carbohydrates (sweets, flour products). They should be replaced with complex carbohydrates and protein products. Of course, the best diet for such a woman will develop a dietician.
In conclusion, one can not help saying that dangerous gestational diabetes mellitus is dangerous if it is not treated. HSD can lead to the development of late gestosis, infection of the mother and fetus, as well as the emergence of typical complications of diabetes mellitus (kidney and eye diseases).