Gestational diabetes
Gestational diabetes is a frequently diagnosed disease during pregnancy. Early diagnosis and therapy can optimize the course of pregnancy and childbirth.
What is gestational diabetes?
Gestational diabetes is a form of diabetes that is first diagnosed during pregnancy. Various pregnancy hormones lead to an increased insensitivity of the tissues to insulin (insulin resistance) and thus lead to an increase in the blood sugar level
Risk factors and precaution
There are various risk factors. If relatives of 1st Degree are suffering from diabetes mellitus, this increases the risk of developing gestational diabetes. Obesity (BMI> 30 kg/m2) also increases the risk of gestational diabetes and can be optimized before pregnancy occurs.
In addition to weight reduction, a change in diet, physical activity and the intake of supplements (vitamin D, fish oil, probiotics) have a preventive effect.
Consequences
Gestational diabetes can cause various complications during pregnancy and childbirth. The risk of vaginal and urinary tract infections is increased, and diseases such as high blood pressure and pregnancy poisoning (preeclampsia) also occur more frequently. Even if gestational diabetes is usually resolved by the end of the pregnancy, there is a risk of further consequences. 35-60% of all women who suffered from diabetes during pregnancy develop diabetes mellitus within the next 10 years. The risk of heart disease later in life also increases.
Untreated gestational diabetes results in a significantly increased production of insulin by the child. During pregnancy, this increased infant insulin level has various consequences in the tissues. This can lead to increased or too low weight gain during pregnancy and also to impaired blood sugar adjustment after the birth.
In the further course of life these children increasingly develop obesity and diabetes.
Diagnostics
To avoid these consequences, an early diagnosis is important. If there are pre-existing risk factors, the fasting blood sugar is tested at an early stage (around the 12th week of pregnancy). If this examination is normal, as is the case with patients without risk factors, a sugar test follows in the 24-28th week of pregnancy. At this point, the preprandial blood sugar (no food intake 8 hours beforehand) is tested, if this is normal, the patients are given a sugar solution to drink, then after one and two hours the blood sugar is tested to check how the sugar is broken down.
Therapy
In the event of an abnormal test result, we initiate various measures with the aim of ensuring that the blood sugar is always in the optimal range during pregnancy in order to minimize the risk of consequences.
In a nutritional consultation, the patients receive precise instructions on how they can optimize blood sugar through a healthy and balanced diet and, depending on their initial weight, achieve optimal weight gain. In the diabetes counseling, patients are shown when and how they can measure and control their blood sugar independently and regularly at home. The blood sugar level can often be kept in the optimal range with diet and exercise. If this is not the case, insulin will be administered later on.
Pregnancy checks are also carried out more frequently to regularly monitor the child’s growth and development. Towards the end of the pregnancy, the optimal delivery time is planned, taking into account the course of the pregnancy.
After delivery, the child’s blood sugar is checked in order to detect early on if the blood sugar has dropped too much due to the overproduction of insulin in the child. Depending on the situation, it may also be required that the child be given a sugar solution to drink in the first few hours after birth.
Follow-up
In most cases, women no longer need to be given insulin after giving birth, as the hormones that cause it decrease with childbirth. However, in order not to miss an ongoing diabetes, it is necessary to carry out a new sugar test as part of the postnatal follow-up. If this is inconspicuous, we recommend the repetition thereof every 1-3 years due to the increased risk.
We at gynhealth advise you on questions about pregnancy and gestational diabetes. With our wide range of experience, we can also provide you competent support in the area of complicated pregnancies.