Gestational diabetes – symptoms, tests, treatment. What should the sugar level be in pregnancy?

Hormonal disorders, exercise and stress cause spikes in glucose levels. Why? Glucose is broken down in the body with the help of insulin. During pregnancy, the effect of insulin may be weaker due to higher levels of hormones such as progesterone, prolactin, estrogens, and cortisol. And the pancreas may not be able to keep up with the production of insulin (with increased needs – it is also about the needs of the baby), your body cells are now more resistant to it, and insulin can also be broken down by enzymes in the placenta. When insulin levels are low, glucose cannot be absorbed into the tissues and properly used by the body. It begins to draw energy from fats and proteins, and a by-product of this process is ketones that disrupt the functioning of internal organs.

Gestational diabetes usually manifests itself in the second trimester of pregnancy and resolves spontaneously after delivery. Its symptoms are dizziness, increased thirst, loss of consciousness. Often, however, the disease proceeds without any symptoms, and the accompanying fatigue is attributed to a different condition. Therefore, it is necessary to check the blood sugar level regularly, especially if a woman is over 35 years old, is overweight (BMI over 27), suffers from hypertension or kidney disease, is in another pregnancy, and there have been cases of diabetes in her family.

Untreated diabetes mellitus can have serious consequences for a woman: it can lead to metabolic acidosis and diabetic coma. In 30 percent of patients, the disease develops into type II diabetes. A complication of diabetes may include high blood pressure, urinary tract infections, and above all miscarriage, premature or difficult childbirth. Its development is dangerous for the fetus. It causes insufficient development of many organs, including defects of the heart and respiratory system. Macrosomia also happens – the baby is born very large (over 4.2 kg or over 90 percentile) with a disproportionate body. During childbirth, paresis of the upper limbs may develop due to difficulties in giving birth to the shoulders. Children after diabetic pregnancy need to be connected to a ventilator due to underdeveloped lungs, and they are less likely to cope with perinatal jaundice. In the future, they may suffer from obesity and glucose intolerance.

The first step is to change your eating habits and introduce a proper diet. What matters most is the regularity of meals (5 a day) and not too long intervals between them, which will prevent spikes in glucose levels. The diet should be balanced and contain the right amount of carbohydrates, protein and fat. Avoid sugar and sugary foods. The pregnant diet is determined individually with a diabetologist, who will also take into account other diseases, lifestyle and weight. It is likely to include dark bread, oatmeal, coarse grains, vegetables and fresh fruit (not fruit juices), skim milk, buttermilk, poultry, game, baked fish (not fried), vegetable soups, rapeseed oil, olive oil with olives. After introducing the new diet, the blood sugar level is monitored regularly with a glucose meter (it can be borrowed from the diabetes clinic). When it turns out that it is still too high, treatment with insulin preparations will be necessary.

During pregnancy, tests to detect diabetes are performed several times. The first test in the second month of pregnancy is simply an fasting blood test. The second is performed in the sixth month of pregnancy. The glucose load test consists in drawing blood twice: before and an hour after drinking a solution of water with glucose (50 g), The sugar level up to 125-140 mg / dl is normal – you can sleep well. Above 180-200 mg / dL is evidence of diabetes mellitus and requires immediate treatment. When the result is between these values, an additional test must be done. It looks similar to the previous study, except that the glucose content in the water is greater (75g) and the interval between blood sampling is longer. When the next examination confirms diabetes, you need to prepare for an appointment with a diabetologist and that in addition to the obstetrician, a neonatologist will be present in the delivery room.

In addition to diet and medications, moderate exercise is important to stabilize the metabolism. Diabetes during pregnancy requires not only visits to a diabetologist but also more frequent meetings with the attending physician (even weekly in the last month of pregnancy). In this way, the doctor can better control the condition of the fetus and find any abnormalities (e.g. too much weight). Diabetic pregnancy cannot be transferred. It is often resolved by caesarean section. Prompt diagnosis and regular self-care allow the woman to give birth to a healthy baby despite diabetes.