Diabetes, a disease characterized by impaired glucose metabolism, is the enemy of the health of pregnant mothers and babies. If the mother is diabetic and the disease is not well treated, in fact, there can be important consequences for the baby, who is at greater risk of hypoglycemia, jaundice, low or high birth weight, cardiac malformations, respiratory disorders. They also increase the risks of preeclampsia (a serious disease typical of pregnancy) for the mother and the chances of undergoing a caesarean section.
And the negative consequences of maternal diabetes are also felt in the long term, increasing the risk that children, as adults, in turn develop diabetes, obesity, hypertension.
In some cases, the mother has already been diabetic before pregnancy.
In others, however, diabetes is linked to pregnancy itself: we speak then of gestational diabetes, a condition that affects about 10% -15% of pregnancies and often resolves after delivery. Women who have had gestational diabetes are more at risk of developing diabetes later in life.
1. When diabetes occurs in pregnancy
"During pregnancy, some hormones produced by the placenta hinder the action ofinsulin, a substance synthesized by the pancreas which has the task of regulating the concentration of glucose in the blood. For this reason, the pancreas has to produce more of it. If this does not happen, due to particular genetic characteristics, the blood glucose values (the concentration of glucose in the blood) are higher than normal and you have gestational diabetes »explains Gabriele Rossi.
2. How the diagnosis is made
The key exam is the blood glucose measurement, to be performed with a simple blood sample in the first trimester (it is one of the tests passed free of charge by the National Health Service). We talk about gestational diabetes if the glycaemia is equal to or greater than 92 mg / dl twice (if it is greater than twice the 126 mg / dl twice it means that the woman already had diabetes before pregnancy). If blood glucose is normal in the first trimester, but there are particular risk factors, the situation must also be kept under control in the second trimester, with the so-called glucose load curve. In practice, the woman drinks a solution containing 75 grams of sugar in the morning on an empty stomach, after which three successive blood samples are taken for blood glucose measurement (immediately after ingestion, after one hour and after two hours) . Between risk factors: if you are obese or have had a previous pregnancy with gestational diabetes; maternal age over 35 years, mildly overweight, fetal macrosomia, close relatives with diabetes, mild gestational diabetes, if you gain weight more than 3 kg per month, if there is a significant increase in amniotic fluid levels.
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3. How to cure
Spesso no drugs are needed, but lifestyle changes are enough. The first approach is represented by the diet, established on the basis of the body mass index and fetal growth. "Generally we recommend a Mediterranean-type diet that favors whole carbohydrates (bread, pasta, rice), which have a low glycemic index," he explains. "Better to eat little and often during the day, to avoid prolonged periods of fasting." Yes even to moderate physical activity. If these strategies are not enough to keep the situation under control, it is necessary to resort to therapy with insulin. By the way: blood sugar must be kept under strict control: there are portable instruments that allow you to do it safely at home.
4. Checkups and childbirth
If there is gestational diabetes, pregnancy must be followed with particular attention: ultrasound checks are done approximately every 15 days to measure the growth of the fetus (and evaluate if it's getting too big) and the amount of amniotic fluid, which tends to increase if diabetes is not well compensated. As for the birth, it is not necessary to anticipate it - indeed, when possible, we try to reach term - or that it is caesarean: "This modality is evaluated only if the fetus has an estimated weight of more than 4,5 kg", he specifies.
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Updated on 10.11.2022
TAG:- diabetes
- glycemia
