Database of diseases - Diabetes

Treatment of pregnant diabetes             
ABC KNOWLEDGE ABOUT DIABETES    . How often do healthy pregnant women have gestational diabetes? In 3-5% of pregnant women this type of diabetes - so-called gestational diabetes - occur for the first time during pregnancy. .
How to recognize diabetes in pregnancy? We recognize gestational diabetes in the same way as pre-congestive diabetes - by finding an excess of glucose in the blood. We talk about diabetes when the level of glucose in blood (so-called glycemia) is: A. 2 times in fasting blood pressure measurement is equal to or higher than 126 mg%, (7.0mmol / l) B. 2 times any time of the day regardless of the meal is equal to or higher than 200 mg%, (ie 11.1mmol / l) C. in the so-called load test 75.0 glucose, at 120 min! it is equal to or higher than 200 mg%, (i.e. 11.1 mmol / l); Note: There should be no glucose or acetone in the urine. .
What should we know about the glucometer - an electoral instrument for measuring the level of glucose in the blood? A modern glucometer reads changes in glucose concentration by electrochemical method and enables measurements quickly, precisely and in a simple way. The exact result we get in in less than a minute. All you need to do is insert a test strip into the camera, designed only for this type of device, apply a small drop of blood to it at the tip of the device read the result on a large, readable display. The device constructed in this way does not it requires wiping the belt at a specific time, as in manual tests to eliminate errors. It is worth knowing that prices of glucometers are constantly cheaper and now you can buy a branded device for less than PLN 50. .

Diabetes pre-eclampsia This term defines the state of health of pregnant women who have previously had diabetes. As a rule, they are being treated with insulin. (Or they should be treated with insulin injections). These women are usually aware of the rules and regulations of diabetes treatment. In this article, however, we want to make them aware of the dangers that, due to poorly controlled diabetes, endanger the growing in their womb descendants. Especially that the pregnancy changes the course of diabetes - for example, it increases the need for insulin, which makes it difficult to control the disease and requires special vigilance and supervision. .

TREATMENT OF DIABETES DIABETES   The basic principle of treatment of pregnant diabetes In the treatment of gestational diabetes (pre-pregnancy and gestational) there is an uncompromising rule of aspiration to compensate for diabetes. First, with the help of proper diet regulation. If this is not achieved with the help of a diet, insulin is used (no oral antidiabetic agents are used during pregnancy!). In most cases, satisfactory glycemic control is obtained by using relatively small doses of insulin. Therefore, hospitalization is not generally required - the treatment is carried out on an outpatient basis, after previous training of the pregnant woman. (2) . Ideal and acceptable blood glucose levels before and after a meal - obtained thanks to insulin therapy - recommended by well-known diabetologists Jan Tatonia and Anna Czech. (1.6) Season, designation Concentration of glucose correct (ideal) in mg / dl (mmol / l) Glucose concentration allowed in practice in mg / dl (mmol / l) Before breakfast 70 -105mg / dl (3.9-5.8) 70-120mg / dl (3.9 - 6.6)
Before dinner and the first supper and the second dinner 70 -110mg / dl (3.9-6.1) 70-120mg / dl (3.9 - 6.6)
1 hour after meals
less than 140 mg / dl (7.8)
less than 160 mg / dl (8.9)
2 hours after meals
less than 120 mg / dl (6.6)
less than 140 mg / dl (7.8)
Between 2 o'clock and 4 o'clock at night
less than 100 mg / dl (5.5)
less than 120 mg / dl (6.6)

 

TREATMENT OF DIABETES DIABETES

    What threatens to neglect or improper treatment of pregnant diabetes? When insulin is lacking - we eat and ... "starve"! The presence of insulin in the blood determines the obtaining of energy from glucose, resulting from the digestion of carbohydrates. Let us remind that for man the basic source of energy are carbohydrate foods: bread, cereal, pasta, potatoes, sugar, etc. It can be simply stated that when insulin runs out - although we eat very abundantly - in practice, we "starve"! And most importantly, the deficit of energy and other valuable components applies not only to the mother but also to the rapidly growing fetus in her womb! Insulin determines not only the "burning" of carbohydrates (sugars), but also fats as an energy source for cells. And in addition - it enables storage of excessive amounts of sugars in the form of stocks and production of proteins from substances found in food. Now it's easier to understand why the level of glucose in the blood must be not only optimal but also perfect! (3.6). The individual "susceptibility" of tissues to insulin is also important - the negative image of which is the so-called insulin resistance or inability to use glucose despite the presence of insulin in the blood. In such cases, the pregnant woman receives appropriate medicines to improve the cells' response to insulin. What threatens diabetes for pregnant women? As a result of untreated (or poorly treated) gestational diabetes, very large but immature children are born. Coming to the world of a large child causes puerperal difficulties and usually the need for caesarean section. A more serious problem is the fetus immaturity. Sometimes it may be an organ hypoplasia, for example respiratory failure and the need for neonatal supervision
How is pregnant dealt with if you have gestational diabetes?
The patient is then treated for a few days with a diet, and if this effect is not achieved in the way, insulin treatment is necessary.   Diet treatment (also for pregnant women with diabetes) The rule is to serve 6-8 meals a day. The energy value of the diet should be maintained at 30-35 calories per 1 kg of so-called due weight (due weight is dependent on weight and gender - calculated from special tables - link .......). Remember that the weight of a diabetic patient increases during pregnancy by 8-10 kg.Therefore, the diet should be avoided excess and take into account the optimal proportions (quantitative and qualitative) of the most important nutrients. Usually: - about 10 - 15% of the protein diet (e.g. 1.0 g of protein per 1 kg of body weight, including 50% of meat and dairy products) - about 60% complex carbohydrates (bread, cereal, etc.) - less than 30% - fats, including half-vegetable and half-animal

- you should consume as many vegetables as possible and significant amounts of fruit - taking care to choose fetuses containing little sugar, and a lot of vitamins and microelements. - the diet should be supplemented with the administration of multivitamin supplements and mineral salts, in particular iron and calcium. (6)   If the diet does not work, you need to inject insulin(2) The most commonly used model of insulin therapy are 4 injections: - three injections of short-acting insulin - 1 injection of isophane insulin overnight. It is the model closest to the physiological standard, giving the possibility of optimal diabetes compensation, impossible when using, for example, insulin blends. Are insulin pumps used in diabetes mellitus? Sometimes, especially if a woman is professionally active and does not have enough time for precise self-control, while glycemia is highly variable. It is worth emphasizing that there are more and more pump rentals for the period of pregnancy, which allows to overcome the high price barrier of this device. In the case of diabetes with a stable course and low need for exogenous insulin - the use of pumps is not necessary. Does pregnant diabetes really disappear right after delivery? Yes. Excess sugar (glucose) in the blood and carbohydrate disorders, symptoms of hypoglycemia, etc. - disappear after giving birth to women with this type of diabetes. Then you can stop giving your insulin injections. These mothers feed their children without any diabetic burden. Does pregnancy diabetes return in the next pregnancy? Unfortunately yes. There is a very high probability that in the next pregnancy, gestational diabetes in these women will appear again. Gestational diabetes and the risk of developing diabetes Seemingly, gestational diabetes does not bring the risk of getting diabetes. This is due to the fact that this type of intolerance develops only in pregnancy and almost completely disappears after delivery. Unfortunately, the very occurrence of this disorder is of great prognostic significance. It indicates the possibility of maternal diabetes later in life. Because in 50% of women who had gestational diabetes during pregnancy, overt diabetes - usually type 2 develops over 10-20 years!  

ARE NOT TREATED DIABETES WILL DETERMINE HEALTH AND LIFE OF A PREGNANT AND A BABY

  Health risk in pregnant women It is necessary to know that diabetes in a pregnant woman disturbs the hormonal balance and causes significant energy deficiencies. As a result, the metabolism of the woman is adversely affected, the immune system weakens, which is manifested, for example, by increased susceptibility to colds and infectious infections. During pregnancy, there is sometimes a risk of life-threatening preeclampsia and eclampsia. The probability of having to terminate the pregnancy with the operating method increases - by cesarean section. The risk of postpartum haemorrhage increases. The risk of ketoacidosis in women with poorly treated type 1 diabetes In women with poorly treated (or not treated) type 1 diabetes (so-called insulin-dependent, i.e. requiring insulin), it may be enough for a situation in which long-term, high insulin deficiency generates substitute metabolic processes for energy production. The body then begins to process fat in the first place for energy substances. However, this has nothing to do with rational weight loss. The system processes (burns) excessive amounts of fat, attempting to use energy even in the fat accumulated in the liver. And this leads to the production of so-called by-products. ketone bodies acting like poisons! Their high level results in the occurrence of ketoacidosis, causing brain disorder (coma). Warning! Untreated acidosis can lead to death! It should be remembered that in pregnant women - toxic ketone bodies also threaten the health and life of the fetus. (3) The impact of untreated maternal diabetes on the newborn High risk to health is caused by untreated maternal diabetes for the fetus and newborn baby.2-5 times the risk of congenital malformations increases in children of mothers with diabetes. The disadvantages may be affected by: bone, nervous, cardiovascular, urogenital and digestive systems. Genetic defects, such as Down's syndrome, may also occur. In addition, there is an increased risk of death of a newborn at birth, perinatal injury (due to the high birth weight of newborns - quite common in pregnancy complicated by diabetes), respiratory distress syndrome or the occurrence of diabetes in the next generation. What is the threat of not treating diabetes during pregnancy? In the worst case scenario, but unfortunately real - no treatment of diabetes threatens the death of a newborn baby. Perinatal mortality of newborns born by women with diabetes is often due to poorly treated c