Gestational Diabetes is defined as a condition of high blood glucose of a pregnant women who is experience such diseases or symptoms only during pregnancy as a result of hormonal change, but return to normal blood sugar after giving birth. Gestational diabetes is considered as an indication of type II diabetes. It affects approximately 3% of pregnant women.
Symptoms
Symptoms is similar to those with diabetes, including
1. Frequent thirst
As a result of high concentration of glucose in the blood
2. Infections
Women who have gestation diabetes prone to have frequent infection, it may be result of high levels of glucose in the urine that cause bacteria invasion.
3. Nausea and vomiting
Nausea and vomiting is associated to early pregnancy, but in some cases, it can be a symptoms of gestational diabetes.
4. Fatigue
Fatigue may be a result of high blood sugar cause of inability of the body in sugar metabolism.
5. Increased urination
It is caused by the affect high blood sugar in the function of the kidney, instead of over growth of the uterus putting pressure to the bladder.
6. Blurred vision
Blurred vision can be caused by accumulation of fluid in the retina of your eye.
7. Weight loss
Women who are losing weight during pregnancy can be caused high blood sugar in the blood.
8. Etc.
Causes and risks factor
1. Insulin resistant
Insulin resistant may be caused by the body normal reaction if the body to secure glucose supply to the growing fetus.
According to the article "Gestational Diabetes: Detection, Management, and Implication" by Darcy Barry Carr, MD, and Steven Gabbe, MD, the authors wrote that The mechanism of insulin resistance is likely a postreceptor defect, since normal insulin binding by insulin-sensitive cells has been demonstrated.16 The pancreas releases 1.5–2.5 times more insulin in order to respond to the resultant increase in insulin resistance.17 Patients with normal pancreatic function are able to meet these demands. Patients with borderline pancreatic function have difficulty increasing insulin secretion and consequently produce inadequate levels of insulin. GDM results when there is delayed or insufficient insulin secretion in the presence of increasing peripheral resistance.
2. Placental hormones
Some researchers suggested that gestation diabetes in pregnancy may be caused by placental hormone as a result of increased fat deposits during pregnancy.
3. According to study of " Gestational diabetes mellitus by Thomas A. Buchanan and Anny H. Xiang, researchers found that
a. Autoimmune diabetes and GDM
Type 1 diabetes results from autoimmune destruction of pancreatic β cells....A small minority (less than 10% in most studies) of women with GDM have the same markers present in their circulation. Although detailed physiological studies of these women are lacking, they most likely have inadequate insulin secretion resulting from autoimmune damage to and destruction of pancreatic β cells. They appear to have evolving type 1 diabetes.
b. Monogenic diabetes and GDM
Monogenic diabetes mellitus has been identified outside of pregnancy in 2 general forms. Some patients have mutations in autosomes (autosomal dominant inheritance pattern, commonly referred to as maturity-onset diabetes of the young [MODY].... Mutations that cause several subtypes of MODY have been found in women with GDM.
c. Insulin resistance, β cell dysfunction, and GDM
The majority of women with GDM appear to have β cell dysfunction that occurs on a background of chronic insulin resistance.
4. Family history
Women who have a previous record of the incidence are at higher risk of Gestational diabetes.
5. Age
Women who are pregnant at age of 30 and older are at higher risk of the incidence.
6. Obesity
Obesity is a major risk of gestational diabetes or especially when developing rapidly after pregnancy.
7. History of an unexplained miscarriage or stillbirth
Nevertheless, on the assumption that repeated unexplained abortions might be a prediabetic
or latent diabetic phenomenon, Williams,24 Gilbert14 and Hoet25 have performed glucose
tolerance tests in the mothers, and frequently found them to be abnormal, according to the article of PREDIABETES A Synthesis By W. P. U. JACKSON, M.A., M.D., M.R.C.P., D.C.H..
8. History of giving birth to over weight baby (9 Lbs or more)
Women who have had a previous history of giving birth to one or more over weight baby are at higher risk of developing gestation diabetes, according to the article of"PREDIABETES A Synthesis" By W. P. U. JACKSON, M.A., M.D., M.R.C.P., D.C.H.
9. Hydramnios
Birth defect is a very frequent concomitant of the diabetic pregnancy. Its incidence in prediabetes has not yet been elucidated., according to the article of " PREDIABETES" A Synthesis By W. P. U. JACKSON, M.A., M.D., M.R.C.P., D.C.H.
8. Glycosuria
The excretion of glucose into the urine as a result of the kidneys are unable to reclaim all of the filtered glucose back into the bloodstream may be a sign of gestational diabetes.
9. Toxaemia
Women who are pregnancy of pre-eclampsia or eclampsia are at high risk of gestational diabetes due to presence of bacterial toxins in the blood.
10. Etc
Diagnosis and test
Women who have some of above symptom or at high risk, are recommended to have blood glucose test between 24-28 weeks of pregnancy.
1. A fasting glucose blood test
There is requirement of the test but you can not eat for a period of 10 hours but no more than 16 hours. If you blood glucose levels are in the normal range, no further test are required. If you blood glucose levels are higher than normal range, here are some additional tests. 2. Oral Glucose Tolerance Blood Test
Preparation same as the above test, but in this test, your blood glucose is tested when you arrive at the clinic, test again at one hour after drinking a sugary beverage. If your blood glucose level is above normal range, you are be diagnosed with gestational diabetes.
3. If you are diagnosed with gestation diabetes, then there are more tests to ensure a healthy pregnancy, including ultrasound (general health of the baby), fetal movement records (movement of the baby every 2 hours), fetal monitoring ( heart beat of the baby). etc.
Preventions
1. Lose weight
Obesity is one of the major factor which contribute to diabetes and gestational diabetes, you make sure that you lose weight before you want to get pregnant.
2. Age
Since age is associated to the risk of gestational diabetes, getting pregnant before the age of 30 will avoid any complication, including gestation diabetes.
3. Eating and living healthy
Eating healthy and living healthy such as quick smoke and drinking can provide you with optimal health for a healthy conception and delivery.
Please read 100+ Healthy Foods Classification
4. Moderate exercise
Moderate exercise enhances conception while rigid exercise reduces it
5. Reduce stress
Stress is proven to be a big factor in contributing to gestational diabetes, taking yoga or meditation class will be beneficial for relaxation.
6. Etc.
Complication of untreated gestation diabetes
Although it is rarely happened in the western world but in some underdevelopment countries, untreated gestational diabetes can cause below complication if left untreated
1. Dead of the fetus
According to the "PREDIABETES A Synthesis" By W. P. U. JACKSON, M.A., M.D., M.R.C.P., D.C.H, the authors wrote that Malins has observed an interesting relationship between the diabetogenic effect of pregnancy in the mother with established diabetes and the survival of the infant. He found that the foetus was less likely to survive in those cases where the mother needed a considerable increase in insulin dosage during pregnancy, and particularly where this higher insulin.
2. Develop respiratory distress syndrome
As we mentioned above.
3. Hypoglycemia
It is a result of over production of the baby pancreas to counter the high blood glucose during pregnancy.
4. Over size baby
As a result of high levels of glucose in the mother blood
5. Jaundice
As a result of the immature of the baby in breakdowning of red blood cells, causing bilirubin build up that leads to yellowish skin color and the white parts of the eye.
6. Etc.
Treatments
A. In conventional medicine
A.1. Diet
Depending to the diagnosis and meeting with gestation diabetes nutritional specialist or dietitian, you may be given a specific plan to keep your blood glucose within the normal range. Here is some guide line, from the article of "Nutrition Basics For Women with Gestational Diabetes" posted in diabetesmommy online magazine. (Source)
1. Eat and drink at least 4 servings of dairy products and calcium-rich foods a day to help ensure that you are getting 1200 mg. of calcium in your daily diet. Sources of calcium include dairy products, some nuts, green vegetables and foods and beverages fortified with calcium, such as calcium-fortified, unsweetened ready-to-eat cereals.
2. Eat at least three servings of iron-rich foods per day to ensure you are getting 30 mg. of iron in your daily diet. Sources of iron include enriched grain products (rice); lean meat, poultry and fish; eggs and leafy green vegetables.
3. Choose at least one source of Vitamin C every day. Sources of Vitamin C include oranges, grapefruits, strawberries, honeydew, broccoli, cauliflower, brussel sprouts, green peppers, tomatoes and mustard greens.
4. Choose at least one source of folic acid every day. Sources include dark green leafy vegetables, veal, fortified grain products, legumes (lima beans, black beans, black-eyed peas and chickpeas) and fruits.
5. Choose at least one source of Vitamin A every other day. Sources rich in Vitamin A include carrots, pumpkins, sweet potatoes, spinach, water squash, turnip greens, beet greens, apricots and cantaloupe.
6. Avoid alcoholic beverages during pregnancy. Alcohol has been linked to premature delivery and low birth weight babies. If you think you may have a problem with alcohol use, please talk to your health care provider so he or she can help protect you and your baby.
7. Limit caffeine to no more than 300 mg. per day (two 8-ounce cups of coffee, three 8-ounce cups of tea or three 12-ounce glasses of caffeinated soda). Remember, chocolate contains caffeine -- the amount of caffeine in a chocolate bar is equal to 1/4 cup of coffee.
8. DO NOT DIET or try to lose weight during pregnancy -- both you and your baby need the proper nutrients in order to be healthy. Ask your health care provider how much weight you should gain during pregnancy. A woman of average weight before pregnancy can expect to gain 25 to 35 pounds during pregnancy. You may need to gain more or less weight, depending on what your health care provider recommends.
9. Eat a variety of foods to get all the nutrients you need. The Food Guide Pyramid on the next page provides an example of the number of servings you should eat from each food group every day.
10. The use of non-nutritive or artificial sweeteners approved by the Food and Drug Administration is acceptable during pregnancy. These FDA-approved sweeteners include aspartame and acesulfame-K. The use of saccharin is strongly discouraged during pregnancy because it can cross the placenta and may remain in fetal tissues. Talk with your health care provider about how much non-nutritive sweetener is acceptable during pregnancy.
|
Foods to Choose to Lower Blood Sugar
| ||
|
Breads and Grains
6-11 servings/day |
Fruits and Vegetables
2-4 servings/day |
Dairy
4 servings/day |
| 1 slice of bread
1/2 bagel or English muffin 1 plain rice cake 6 crackers (such as matzo, bread sticks, rye crisps, saltines) 3 graham crackers 3/4 cup ready-to-eat cereal 1/2 cup pasta or rice 1/2 cup corn Small plain baked potato 1 small pancake 1 6-inch tortilla | 1 piece of fresh fruit
1 melon wedge 1/2 cup chopped, cooked, frozen or unsweetened canned fruits
3-5 or more vegetable servings/day
1/2 cup cooked or canned vegetables
1 cup chopped, uncooked or frozen vegetables | 1 cup low-fat milk
1 cup soy milk 1 cup low-fat unsweetened yogurt 1 1/2 ounces of cheese 1/2 cup low-fat cottage cheese |
|
Meat, Fish, Poultry
2-3 servings/day |
Fats and Oils
In limited amounts (approximately 5-8 tsp/day) |
Sweets and Snacks
In limited amounts |
| 2 ounces cooked lean meat, fish or poultry
2 ounces of cheese 2 eggs or the equivalent in egg substitutes 1 cup cooked dried beans or peas 2 tbsp peanut butter 1/4 cup tofu (bean curd) | Vegetable oil (olive, canola or peanut oils)
Tub margarine Fat-free or low-fat salad dressing | Peanut butter and crackers
Cheese and crackers Vanilla wafers Plain popcorn, pretzels
"Free" foods
Raw vegetables
Diet soda Sugar-free gelatin Sugar-free syrup Low-sugar jelly Sugar-free candy and gum Unsweetened popsicles |
At you are following the diet, you will have to record your blood glucose in the morning when you wake, before and after each meal, depending to the recommendation of the dietitian. ( It is frustrate, if you hate blood and needle punctuation)
A.2. Insulin
If diet can not lower the blood glucose after 1 week or 2, insulin injection once or twice daily, with adjustments may be necessary to lower the blood glucose after meal to prevent nay unwanted pregnant complication, depending to the blood diagnosis.
B. Herbal medicine
Please consult with your doctor or related field specialist before applying
1. Astragalus
Research suggests that the herb astragalus may help to prevent and treat gestational diabetes. In a study of "Clinical evaluation of the antioxidant activity of astragalus in women with gestational diabetes", (Article in Chinese) by Liang HY, Hou F, Ding YL, Zhang WN, Huang XH, Zhang BY, Liu Y., researchers found that astragalus can effectively control blood glucose, reduce the free radicals, and promote the antioxidative activity, and may play a role in the prevention and treatment of gestational diabetes.
2. Cinnamon
According to the study of Cinnamon, Glucose Tolerance and Diabetes Nutrient Requirements and Functions Laboratory (NRFL) of the Beltsville Human Nutrition Research Center (BHNRC) , researchers indicated that the results of this study demonstrate that intake of 1, 3, or 6 g of cinnamon per day reduces serum glucose, triglyceride, LDL cholesterol, and total cholesterol in people with type 2 diabetes and suggest that the inclusion of cinnamon in the diet of people with type 2 diabetes will reduce risk factors associated with diabetes and cardiovascular diseases.
3. Garlic (Allium Sativum)
Garlic have been used by herbalists over thousand of years in treating diabetes. In a study of "Antidiabetic effects of S-allyl cysteine sulphoxide isolated from garlic Allium sativum Linn." by
Sheela CG, Augusti KT., researchers found that Garlic (Allium Sativum) increased significantly liver and intestinal HMG CoA reductase activity and liver hexokinase activity.
4. Ginkgo Biloba
Ginkgo biloba has also been used in the traditional Chinese medicine practice for the treatment of diabetes. In a study of Ginkgo Biloba Extract and the Insulin Resistance Syndrome,
by Principal Investigator: G B Kudolo, Affiliation: University of Texas Health Science Center
Country: USA, researcher found that (The
results of this study) when taken together should provide very
important information on balancing the risk of accelerating pancreatic
beta-cell dysfunction, with its beneficial effects on delaying the
onset of cognitive function. The results of this study should also
provide valuable information for designing new therapeutic strategies
for the treatment of diseases in the insulin resistance syndrome.
5. Fenugreek and other herbs
In a study of "Complementary and alternative medicine for the treatment of type 2 diabetes.", byNahas R, Moher M., researchers concluded that Chromium, and possibly gymnema, appears to improve glycemic control. Fibre, green tea, and fenugreek have other benefits but there is little evidence that they substantially improve glycemic control. Further research on bitter melon and cinnamon is warranted. There is no complementary and alternative medicine research addressing microvascular or macrovascular clinical outcomes.
6. Etc.
C. Traditional Chinese medicine
Please consult with your doctor or related field specialist before applying Qi Wei Bai Zhu San (Chniese herbal formula)
C.1. Ingredients
1. Ren Shen (Ginseng Root) 6 g
Main uses; Strongly tonifies Original Qi, Tonifies the Lungs and Spleen, Promotes generation of Body Fluids, Calms thirst,...
2. Fu Ling (Poria) 10 g
Mian uses; Eliminates Water, Strengthens the Spleen, Calms the Mind,....
3. Bai Zhu (White Atractylodes) 10 g
Main uses; Tonifies Qi, Strengthens the Spleen, Dries Dampness, Stops sweating, Prevents miscarriage,...
4. Gan Cao (Licorice Root) 12 g
Mian uses; Tonifies the Spleen, Benefits the Qi, Moistens the Lungs, Regulates the nature of other herbs,...
5. Mu Xiang (Costus Root) 6 g
Main uses; Moves Qi, Regulates the Middle, Calms pain,...
6. Ge Gen (Kudzuvine Root) 15 g
Mian uses; Raises Yang, Clears Heat, Promotes generation of Body Fluids,...
7. Huo Xiang (Agastache) 10 g
Maim uses; Transforms Dampness, Disperses Summer-Heat, Stops vomiting,..
C.2. Clinical study
According to the article of Clinical Studies on Gestational Diabetes Mellitus with Formula of Qi Wei Bai Zhu San June 16, 2010 , researcher found that
1. Treatment group (is better) than in the control group, but glycemic control to significantly reduce the time the normal range;
2. Two groups of Chinese (medicine) history treatment; symptoms the observation group of Chinese medical symptoms of improved obviously superior to the controls
3. Treatment group (is better) than control group women, the morbidity can be reduced
4. Treatment group (is better) than the control group to better regulate blood lipid
5. Treatment group (is better) than in the control group to control blood gluose fluctuations and maintain long-term steady state plasma glucose
6. Groups can all reduce the 2-hour postprandial blood glucose, but the treatment group (is) more effective.
7. Two groups can reduce the class blood sugar, and lower blood sugar. The effect of the same class
Researchers concluded that Qi Wei Bai Zhu San is good at strengthening spleen. By application of strengthening spleen and personal diet guide can effectively reduce blood glucose, reduce lipid and maternal complications.It clinically has good effect for pregnant women of weakness of spleen and stomach type…
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