But for pregnant women, besides using insulin to control blood sugar, the diet should also take into account the stability of blood sugar and the nutritional needs of themselves and their fetuses. So, what should diabetic women pay attention to during pregnancy? Let's listen to the opinions of experts.
● Strictly control the intake of carbohydrates.
Gestational diabetes mellitus (GDM) is a common disease at present, which is influenced by factors such as overnutrition and too little exercise. After the illness, pregnant women's blood pressure increased, amniotic fluid increased, abortion, premature delivery, stillbirth and diabetic ketoacidosis also increased, which cast a shadow over their original happy mood.
Zhang Xihong, deputy chief physician of obstetrics department of Zhengzhou People's Hospital, pointed out that once gestational diabetes occurs, pregnant women should pay more attention to their diet, not only to ensure that the energy needs of pregnant women and fetuses are met, but also to strictly control the intake of carbohydrates so that their blood sugar is within the normal range, and hunger ketosis does not occur. Pregnant women with gestational diabetes should eat several meals a day (5~6 meals a day), and after 3~5 days of diet control, 24-hour blood glucose spectrum test should be carried out. If the urine ketone body is still positive after diet control, the diet should be readjusted.
● Insulin should be used when necessary.
Zhang Xihong said that while controlling diet, women with gestational diabetes should also use insulin reasonably according to the results of blood glucose spectrum test and their sensitivity to insulin. If the pregnant woman's blood sugar is well controlled and the fetal intrauterine condition is good, the pregnancy should be terminated after 38~39 weeks of pregnancy. If blood sugar control is not good, fetal distress, etc. Pregnancy should be terminated as soon as possible.
Deputy Chief Physician Yang of the Department of Gynecology, the Third Affiliated Hospital of Henan College of Traditional Chinese Medicine pointed out that pregnancy complicated with diabetes is not an indication of cesarean section, and cesarean section should only be performed when there is a huge fetus, placental insufficiency, abnormal fetal position or other obstetric indications. Pregnant women with diabetes for more than ten years, accompanied by retinopathy and renal function damage, severe preeclampsia, stillbirth and stillbirth may also consider cesarean section.
● Check glucose tolerance during pregnancy.
Zhang Xihong reminded that in fact, all pregnant women should have a 50-gram glucose tolerance screening at 24-28 weeks of pregnancy. Obesity, early pregnancy urine sugar (+) pregnant women, family history of type 2 diabetes, macrosomia delivery history, gestational diabetes, repeated spontaneous abortion without obvious reasons, fetal malformation, stillbirth and respiratory distress of full-term newborns should be screened for 50g glucose tolerance at the first pregnancy, and those with normal blood sugar should be screened for 50g glucose tolerance after 24 weeks of pregnancy.
For women who have been diagnosed with diabetes during non-pregnancy, comprehensive physical examinations such as blood pressure, fundus, renal function and glycosylated hemoglobin should be carried out before pregnancy to decide whether they are pregnant. If the 24-hour urine protein of patients with diabetic nephropathy is quantified,