Pregnancy and diabetes affect each other negatively if they occur in the same period. Experts pointing out that the increasing cases of diabetic pregnancy all over the world affect the baby along with the mother; gestational diabetes; In addition to causing problems such as sudden miscarriage, hypertension, etc. in the mother, it causes many problems such as heart, nervous system, digestive system, urinary tract development problems in the baby in the womb.
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Üsküdar University NPISTANBUL Hospital Internal Medicine Specialist Dr. Güzin Oğuz Yıldırım made important evaluations about gestational diabetes.
Diabetic pregnancy increases with the increase in obesity
Pregnancy and diabetes are conditions that adversely affect each other when they coexist in a woman at the same time. Cases of diabetic pregnancy are increasing in our country as in the whole world." Dr. Güzin Oğuz Yıldırım listed the most important reasons for this increase as follows:
1. "Increase in life expectancy and quality of life of women with type 1 diabetes,
2. Increase in the prevalence of type 2 diabetes due to obesity and gradually decreasing at younger ages,
3. Increase in the prevalence of gestational diabetes with the increase in obesity."
Symptoms of gestational diabetes are different from normal diabetes
Uskudar University NPISTANBUL Hospital Internal Medicine Specialist Dr. Güzin Oğuz Yıldırım said, "Elevated blood sugar, which usually occurs in the 2nd or 3rd trimester (3-month period) for the first time in pregnancy and continues throughout pregnancy, is called 'gestational diabetes' or 'gestational diabetes mellitus (GDM)'. trimester (3-month period) and continues throughout pregnancy is called 'gestational diabetes' or 'gestational diabetes mellitus (GDM)', while pregnancy in a woman with type 1 or type 2 diabetes is defined as 'diabetes in pregnancy', 'overt diabetes in pregnancy', 'pregestational diabetes' or 'pregestational diabetes mellitus (PGDM)'. GDM cases constitute the vast majority of diabetes cases seen during pregnancy."
"In gestational diabetes, we cannot describe any obvious complaints that we can give such as drinking a lot of water, frequent urination, numbness in the feet and rapid weight loss seen in diabetic patients," Yıldırım said,
"Because these complaints may develop in women depending on the natural process of pregnancy and it may not be possible to distinguish whether they are symptoms of diabetes or pregnancy complaints. For this reason, screening tests are applied between 24-28 weeks of pregnancy, taking into account the risks posed by pregnancy for mother and baby, the frequency of diabetes in pregnancy in the world, and earlier blood glucose monitoring can be started in pregnant women with additional risk factors."
Gestational diabetes causes sudden miscarriages
Internal Medicine Specialist Güzin Oğuz Yıldırım stated the risks posed by gestational diabetes as follows:
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"Risks for the mother: Sudden miscarriage, hypertension, progression of diabetes-related eye and kidney diseases, frequent urinary tract infections, sudden low blood sugar levels, development of obesity and diabetes in later years.
Risks for the baby called 'fetus' during pregnancy: Heart, nervous system, digestive system, urinary tract development problems, chromosomal developmental defects, death in the womb, cleft palate, cleft lip, etc.
Diet during pregnancy is of great importance
Yıldırım said, "The main thing during pregnancy is to ensure the diet" and made the following suggestions about the nutrition of people with gestational diabetes:
"The daily calorie requirement of the pregnant diabetic is calculated according to the ideal weight; 24 kkal / kg in obese diabetics, 30 kkal / kg in the first 3 months (trimester) in non-obese diabetics and 35 kkal / kg from the second trimester. Additional energy intake of 340 kkal/day in the second trimester and 450 kkal/day in lactation is recommended.
Adequate energy intake should be ensured
Adequate energy intake should be ensured to ensure appropriate weight gain during pregnancy. Weight loss diets are not recommended in pregnant women; however, mild to moderate energy and carbohydrate restriction may be appropriate for overweight or obese women with gestational diabetes. Nutrient components of total daily calories (energy) are calculated. Of the total energy, 45-50% should be provided from carbohydrates (minimum 175 g/day), -20% from proteins (amount: 1-1.5 g/kg/day, minimum 71 g/day), 30-35% from fats (40-60 g/day), and enough fiber (28 g/day) should be included in the diet.
The number of meals should be planned as 3 main and 4 snacks
The number of meals should be planned as a total of 7 meals, 3 main meals and 4 snacks, and 3/18 of the daily calorie requirement should be given at breakfast, 4/18 at lunch and 4/18 at dinner. Three snacks should be eaten throughout the day, each containing 2/18 of the daily calorie requirement, and one snack before bedtime, each containing 2/18 of the daily calorie requirement. Carbohydrate intake at breakfast should be <45 g as tolerance to morning glucose is reduced in pregnancy.
Micronutrients: Pregnant women with diabetes should receive vitamin and mineral support with iron (18 mg/day), folic acid (0.4-1 mg/day), calcium (1200 mg/day), iodine 100-150 μg/day and 25OH-D vit (1000 U/day).
Weight gain The rate of weight gain during pregnancy should be 1-2 kg in the first trimester and 250-500 g per week from the 2nd trimester onwards, and the total weight gain should not exceed 10-12 kg. Alternatively, there is a tendency to determine weight gain during pregnancy according to pre-pregnancy Body Mass Index (BMI) values. Pre-pregnancy BMI: 18.6-24.9 kg/m2, 11.5-16 kg weight gain during pregnancy, BMI: 25-29.9 kg/m2, 7-11.5 kg weight gain, BMI: ≥30 kg/m2, 5.5-10 kg weight gain is recommended."
Who is in the risk group?
Üsküdar University NPISTANBUL Hospital Internal Medicine Specialist Dr. Güzin Oğuz Yıldırım listed those in the risk group for gestational diabetes as follows:
1. "Genetic racial predisposition,
2. Diabetes in the family,
3. Short,
4.Low birth weight,
5. Multiple pregnancy (twins, triplets),
6.Excreting sugar from urine (glucosuria),
7.Previously detected insulin resistance,
8.Taking psychiatric drugs (antipsychotic drugs), using cortisol,
9. Obese,
10.A diet based on red processed meat,
11. Sedentary lifestyle,
12.Sudden rapid excess weight gain,
13.with PCOS (multiple cystic ovarian syndrome),
14.Hypertensive,
15. Births of overweight babies (4.5 kg and over), stillbirths in past births,
16. People diagnosed with gestational diabetes in past pregnancies are in the risk group."
Postnatal babies are also affected
Uzm. Dr. Yıldırım concluded his words as follows: "Gestational diabetes affects the mother and the baby in the womb, as well as postnatal babies as follows: Premature birth and related disease risks, damages that may develop during cesarean section and normal delivery, congenital abnormal developmental diseases, low blood sugar, jaundice, mineral disorders, heart diseases, infant death, obesity and type 2 diabetes in later years."
