Thursday, February 17, 2011

Gestational Diabetes Mellitus (GDM) - Important Information for Pregnant Women

Today let's talk for a very serious topic - Diabetes in pregnant women.

Gestational diabetes mellitus (GDM) - a disease which is associated with carbohydrate metabolism, it is found only during pregnancy. Like any other form of diabetes, gestational diabetes is associated with a genetic predisposition.

During pregnancy in the expectant mother's hormonal changes occur. Sometimes arise and reject - the pancreas produces insufficient amounts of insulin, resulting in characteristic symptoms arise HSD.

Gestational diabetes mellitus manifests itself in 5-6 months of pregnancy. Expectant mother should not be afraid, because this is a temporary condition, which successfully controlled through diet and exercise, and usually goes away after childbirth.

A pregnant woman is very important to monitor blood glucose levels, otherwise complications can affect both the health of both mother and unborn child.

Women who had gestational diabetes, more than others, at risk of disorders of glucose metabolism and obesity, as well as have a high likelihood of developing DM-2 in the next 20 years of life.

According to statistics HSD suffer from 3 to 10% of pregnant women.

Major risk factors for GDM:

   1. Age of women over 30 years.
   2. High rates of sugar in the past, the GSD during a previous pregnancy, large fruit (more than 4,5 kg.)
   3. Family History - HSD, DM-2 and cases of major birth children in previous generations.
   4. Rapid weight gain in women and the development of obesity.
   5. Cases of unexplained stillbirth and congenital malformations in previous generations.
   6. Chronic vaginal candidiasis.
   7. Early preeclampsia and hydramnios.
   8. Multiple pregnancies.

Diagnosis of gestational diabetes:

   1. Typically, the disease is diagnosed at 26 weeks (or even earlier). There are special tests that determine the degree of glucose tolerance. A one-hour 50 mg. load of glucose helps to establish the risk factors and the presence of glucosuria.
   2. Gestational diabetes is diagnosed if the post-test blood sugar levels higher than 7.8 mg / dL.
   3. You should always confirm the test repeated 3-hour 100 g glucose tolerance test preoral.
   4. For the final diagnosis of GDM is necessary to investigate the dynamics of change of glucose for 2-4 interim analysis:
          * Fasting> 5.8 mmol / l
          * 1:00:> 10.6 mmol / l
          * 2:00:> 9.2 mmol / l
          * 3:00:> 8.1 mmol / l

Control of gestational diabetes before and after birth:

   1. The purpose of the doctor - after a meal, the patient achieved blood glucose <6.7 mmol / l
   2. Transfer of patients on dietary diet (diet number 9)
   3. If within 2 hours after a meal blood sugar level is> 6.7 mmol / l, usually appointed by insulin.
   4. Oral drugs that cause hypoglycemic reaction during pregnancy contraindicated.
   5. Be sure to monitor the status and development of the fetus.
   6. After giving birth to stop insulin injections and diet.
   7. Monitor glucose at 6 weeks after birth to analyze the OGTT.

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