Gestational diabetes is defined as a sugar tolerance disorder that occurs during pregnancy. Gestational diabetes can cause many events for both mother and pregnancy that have long been proven. However, mild gestational diabetes affects the fetus and the mother is still not well understood.
1. When is gestational diabetes screening required?
Pregnant women should be screening for gestational diabetes in case of:
- Pregnant women with high risk factors
- Age > 35, obesity
- Have a history of gestational diabetes
- Giving birth to > 4kg
- Polycystic ovaries , still still life pregnancy of unknown causes
- Have a family history of diabetes
- Urinary tract (+) should be tested for pregnancy diabetes diagnosis from the first pregnancy visit.
In the case of pregnant women in the first 3 months of pregnancy, the standard of diagnosis of gestational diabetes is applied as the average person (removing the HbA1C standard). Pregnancy diabetes diagnostic tests are performed at weeks 24 –28 of pregnancy for all previously undiagnosed gestations. Perform tests to diagnose real (sustainable) gestational diabetes for pregnant women with gestational diabetes after birth from 4 to 12 weeks (applying diabetes diagnostic standards like normal people). In women with gestational diabetes should be tested to detect the progress of diabetes or pre-diabetes at least once every 3 years.
2. How to treat gestational diabetes
2.1. Blood glucose control targets
Gestational diabetics need to be controlled for positive and safe blood glucose levels for a narrow period of time, to ensure the safety of both the maternity and the fetus. Blood glucose levels during hunger < 5,8 mmol/l, đường huyết 1 giờ sau ăn < 7,8 mmol/l và 2 giờ sau ăn < 7,2 mmol/l.
2.2. Nutritional treatment
The total amount of energy per day spent on gestational diabetics is calculated based on the ideal weight. The total daily energy is 30 Kcal/kg. Nutrition should ensure the necessary weight gain during pregnancy: 0.45kg/month in the first quarter, 0.2 – 0.35 kg/week in Q2 and Q3 of pregnancy.
The total amount of energy throughout the day should be divided equally by 3 main meals and 3 side meals but it is not recommended to eat too much carbohydrates at breakfast.
2.3. Drug treatment
To date, Insulin human is the only FDA-recognized drug for the treatment of gestational diabetes. Women with gestational diabetes should measure blood glucose 4-6 times daily (before meals, 2 hours after eating and before bedtime). Besides, it is necessary to contact your doctor as soon as blood glucose levels are high or lower than normal.
In summary, pregnant women with high risk factors should be screening for gestational diabetes from the first pregnancy visit, pregnant women who have not been diagnosed with gestational diabetes should be given a screening for gestational diabetes from the 24th to 28th week of pregnancy. Pregnant women should have strict blood glucose control and regular monitoring of fetal development for early and timely detection of complications and appropriate and effective interventions.
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- The process of pregnancy is monitored by a team of specialists
- Regular examination, early detection of abnormalities
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- Infants receive comprehensive care
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