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Diabetic foot

Pregnancy diabetes

Pregnancy diabetes
Its definition: Gestational diabetes is a disorder in glucose tolerance, or real diabetes that appears or is diagnosed for the first-time during pregnancy. The definition does not relate to the type of treatment given to a pregnant woman (nutrition or insulin and is also comprehensive for cases where diabetes remains after pregnancy. Six weeks after birth, the condition of the woman must be determined again according to one of the following categories: diabetes, glucose disorder when fasting, glucose tolerance) (Low glucose tolerance) or normal blood sugar. The degree of glucose in the normal range. Women who have gestational diabetes are older, on average, than all pregnant women and most of them are overweight. The reaction to glucose in these women is normal before pregnancy, and most of them will return to normal immediately. However, these women have a very high risk of developing diabetes in every additional pregnancy (60% -90%) and an excessive risk that they may develop, during their lifetime, impaired glucose tolerance, type 1 diabetes, or, type 1 diabetes. In fact, 40-60% of them develop diabetes during pregnancy 5 to 15 years after gestational diabetes. Hormonal changes occur that make it difficult to tolerate glucose. Pregnancy in the woman’s body causes a physiological stress condition that leads to increased stress hormones, adrenaline and cortisol. The hormone works to a certain degree in all people all the time, and part of their effect is to raise the level of glucose in the blood. The states of distress increase their secretion, so the level of glucose in the blood increases. Among other hormones that raise sugar in the blood, we also find glucagon secreted by the pancreas, in addition to hormones for pregnancy and secreted from the placenta. These hormones raise blood glucose and counter insulin activity. This is the insulin resistance mechanism that exists in every normal pregnancy. Pregnant women without diabetes increase insulin secretion and balance themselves in pregnancy sugar, as in cases leading to the emergence of type 2 diabetes, this mechanism is defective and insufficient insulin secretion alone is unable to overcome the insulin resistance described here. Against the background of the processes, gestational diabetes generally occurs in the second and third trimesters of pregnancy. Symptoms of gestational diabetes: In most women with gestational diabetes, there are no symptoms of the disease. Since complications can arise in the fetus, starting with relatively low levels of diabetes, which do not cause the mother any disorder, it is important to distinguish and detect gestational diabetes as early as possible. Complications of gestational diabetes: the development of gestational diabetes during pregnancy, exposes pregnant women and their fetus to possible risks. There is no excess risk here for malformations (unless the pregnant woman has hidden diabetes that was not previously discovered), because the organs of the fetus are developed at the end of the first trimester of pregnancy, before the onset of gestational diabetes. Other complications of diabetes that appear late in pregnancy, such as: Older children, amniotic hydration (amniotic fluid), delayed maturation of the lungs, may appear during gestational diabetes, although they are generally of low risk. Complications of the mother, caused by this condition, include a higher probability of caesarean section. Diagnosis of gestational diabetes: it does not appear in the majority Most of the women have gestational diabetes, no symptoms . Since complications can arise in a fetus, starting with relatively low levels of diabetes, which do not cause the mother any disorder, it is important to distinguish and detect gestational diabetes as early as possible. The blood glucose level is measured in the test, one hour after drinking a 50 g glucose meal. The glucose level is considered healthy if it is not more than 140 mg / dL. If the degree is higher, it is defined as satisfactory, and full sugar loading is required by drinking 100 g glucose in the morning, after fasting for 8-14 hours. Before testing, preserve for a period of at least three days a diet rich in carbohydrates (sugars) ( More than 150 grams per day). During loading, the subject of the test should refrain from smoking and physical exertion. The concentration of sugar should be checked before eating glucose by drinking, and after an hour, two and three hours after drinking the 100 g meal, sugar will be drunk. Two normal abnormal checks are required to define the condition as gestational diabetes. The maximum glucose values are: up to 95 mg / dL when fasting, up to 180 mg / dL after an hour has passed, up to 155 mg / dL after two hours and up to 140 mg / dL After three hours. Gestational diabetes treatment: The treatment depends from the moment of the diagnosis on pregnancy-specific nutrition, which is low in sugar. If the desired sugar levels that appear in the test for any less than 6% are not reached, insulin must be added. Medication therapy is the only approved day to reduce glycemic levels in pregnancy. In addition to the accurate balance of glucose levels, it is important, in the case of a woman with gestational diabetes, to carefully follow the development of pregnancy and the fetus.

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