Gestational diabetes mellitus belongs to the category of diseases that often develop during pregnancy. The occurrence of pathology is associated, first of all, with the need for the mother's body to adapt to new conditions. The fetus and placenta consume the glucose they need from the mother's blood. At the same time, in the second trimester of pregnancy, there is a decrease in the sensitivity of body tissues to insulin, as a result of which insulin resistance develops. Gestational diabetes mellitus is a dangerous pathology that threatens to develop serious complications. Read about methods of effective treatment of gestational diabetes at estet-portal.com.
Gestational Diabetes Management: Diet plus Insulin Therapy
There are certain risk factors that distinguish pregnant women at risk for developing gestational diabetes. If such factors are present in a pregnant woman, it is necessary to conduct special studies and confirm or exclude the presence of this pathology of the endocrine system in her. Timely diagnosis plays a fundamental role in the treatment of gestational diabetes, since after the correct diagnosis is made, an effective therapeutic regimen is selected.
At the first stage of treatment for gestational diabetes, a woman is prescribed a diet and recommended moderate exercise, while monitoring blood glucose levels.
If these measures are ineffective, the patient is prescribed insulin therapy.
Gestational Diabetes Treatment:
- diet and exercise in the treatment of gestational diabetes;
- specific features of insulin therapy in the treatment of gestational diabetes;
- postpartum management of patients with gestational diabetes.
Diet and exercise in the management of gestational diabetes
When prescribing dietary therapy to a pregnant woman for the treatment of gestational diabetes, the following principles should be observed:
- calorie content - about 30 kcal/kg of ideal body weight;
- carbohydrate content - 35-40%;
- protein content - 20-25%.
The diet of a pregnant woman should include 6 meals throughout the day: three main meals, and three snacks. The required number of daily calories is calculated by body weight or by the woman's body mass index before pregnancy. Reducing daily caloric intake to 1600 kcal/day in obese patients reduces hyperglycemia without causing ketonuria. Physical activity for such patients is recommended for 20 minutes three times a week.
Peculiarities of insulin therapy in the treatment of gestational diabetes
In the absence of the desired effect of diet therapy in combination with moderate physical activity, the treatment of gestational diabetes should be to prescribe insulin therapy to the patient.
Oral antidiabetic drugs are contraindicated in gestational diabetes mellitus. Insulin therapy is started when the fasting glucose level is more than 5.3 mmol / l, and 2 hours after eating - more than 6.7 mmol / l against the background of physical exertion and diet therapy. Depending on the severity of hyperglycemia, patients may be advised to use intermediate-acting insulins 1-2 times a day, or a combination of short-acting insulins with intermediate-acting insulins before meals and at bedtime.
Postpartum management of patients with gestational diabetes
The criteria for compensation of carbohydrate metabolism during the treatment of gestational diabetes are a normal fasting glucose level and glycemia 2 hours after a meal at a level of 5-7.8 mmol / l. In 50% of patients with gestational diabetes mellitus, against the background of insulin therapy, antibodies to insulin appear in the blood, which gradually disappear after childbirth. Therefore, it is important to pay due attention to the management of such patients in the postpartum period. Maternal carbohydrate metabolism should be reclassified approximately 45-60 days postpartum. Repeated examinations for such women are indicated once a year with normal blood glucose levels. If impaired glucose tolerance is detected, the patient should be re-examined once every three months.
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