How to manage gestational diabetes?

The article was professionally consulted by Specialist Doctor I Nguyen Thi Man - Department of Obstetrics and Gynecology - Vinmec International General Hospital Da Nang. The doctor has more than 10 years of experience in diagnosing, consulting and treating in the field of Obstetrics and Gynecology.

Gestational diabetes affects blood sugar metabolism, causing hyperglycemia, which can lead to many complications affecting the health of mother and baby. Good detection and management of gestational diabetes is very important in reducing the risk of complications.

Gestational diabetes is impaired glucose tolerance and/or hyperglycemia first diagnosed during the second or third trimester of pregnancy, without prior history of type 1 diabetes. or type 2.
When you have gestational diabetes, some complications can occur if not well controlled.
For children:
Fetal malformations ; Large fetus or intrauterine growth retardation for normal gestational age; Stillbirth ; The fetus has a lack of surfactant in the alveoli; Neonatal metabolic disorders: Polycythemia vera, hyperbilirubinemia causing jaundice.

Hypocalcaemia, hypoglycemia in neonates. For pregnant women:
Gestational hypertension increases the risk of pre-eclampsia Polyhydramnios, the risk of premature rupture of membranes Gestational diabetes can seriously affect the health of mother and baby if not controlled and stabilized. blood sugar regulation during pregnancy.
See more: When does gestational diabetes need drug intervention?

Pregnant women are screened for diabetes by testing and using diagnostic criteria. Most pregnant women are examined and detected risk factors for diabetes, blood sugar test if abnormal, need to have blood sugar test at 24-28 weeks gestation.
People with risk factors that need to be screened for gestational diabetes include:
High gestational age, older than 37 years Being overweight, obese Family history of inbreeding with diabetes (such as parents, siblings) History of high birth weight baby (birth weight > 4000g), polyhydramnios History of stillbirth without cause Polycystic ovary syndrome

Steps to diagnose and screen for gestational diabetes by one of the following two methods: The time to perform is a pregnant woman from 24-26 weeks of age, who has not been diagnosed with diabetes before.
Method 1:
Oral glucose tolerance test must be performed in the morning after fasting overnight for at least 8 hours Maternity is tolerated 75g oral glucose Plasma glucose test at fasting times , 1 hour and 2 hours after glucose ingestion Evaluation of results: The patient is defined as gestational diabetes when satisfying one of the criteria below Fasting blood glucose ≥ 92 mg/dL (5.1 mmol/ L) Blood sugar at 1 hour 180 mg/dL (10.0 mmol/L) Blood sugar at 2 hours 153 mg/dL (8.5 mmol/L) Method 2:
Pregnant women before time do the test without fasting Drink 50g of glucose Measure plasma glucose at 1 hour, if blood glucose at 1 hour is ≥ 180mg/dL (10.0mmol/L), follow the next step. , do a glucose tolerance test with 100g of glucose mixed in 250-300ml of water, measure fasting blood glucose and at 1 hour, 2 hours, 3 hours, after taking glucose. Gestational diabetes was diagnosed when at least 2 out of 4 blood glucose levels after taking 100mg were greater than or equal to the following thresholds: Fasting ≥ 95 mg/dL (5.3 mmol/L). 1-hour blood sugar ≥ 180 mg/dL (10.0 mmol/L) 2-hour blood sugar ≥ 155 mg/dL (8.6 mmol/L) 3-hour blood sugar ≥ 140 mg/dL ( 7.8 mmol/L).

After making a definitive diagnosis of gestational diabetes, it is necessary to determine the extent of the disease, thereby providing a treatment and management method for gestational diabetes that is appropriate for each woman.
Pregnant women with gestational diabetes need to be treated for optimal blood sugar levels with drugs, nutrition, and exercise; Monitor blood sugar regularly, at birth and after birth. The goals to manage gestational diabetes include:
Treatment goals for gestational diabetes:
Preprandial blood sugar less than or equal to 95 mg/dl (5.3 mmol/L). The 1-hour postprandial blood sugar is less than or equal to 140 mg/dL (7.8 mmol/L). 2 hours postprandial blood sugar less than or equal to 120 mg/dL (6.7 mmol/L). Guidelines for the management of gestational diabetes
It is recommended to achieve the target or as close to the goal as possible, but avoid the risks of hypoglycaemia. If blood sugar is not too high, it can be treated with changes in diet and exercise. If exercise and dietary changes still do not reach the target blood sugar level, insulin is the first choice for blood sugar control. Exercise, exercise:
Exercise at an average level of about 30 minutes a day. Let your heart rate increase about 10-20%. It is recommended to walk gently after eating for about 1 hour from 15-20 minutes, blood sugar measurement tends to increase after eating. See also: Notes in the diet for people with diabetes in pregnancy

Note: Exercise is contraindicated in cases of threatened preterm birth, premature rupture of membranes, ischemic ectopic pregnancy, vaginal bleeding in the last 3 months of pregnancy, placenta previa and preeclampsia. Nutrition
Nutrition is very important, can control blood sugar in most pregnant women. Control your calorie intake. Prioritize the use of foods with low sugar, increase protein and fat in meals. Follow up by an endocrinologist and coordinate with an obstetrician to have the most appropriate treatment. Control blood sugar well and monitor possible complications for the mother and fetus. When a woman goes into labor, her blood sugar should be monitored regularly. Watch for abnormalities during labor. In some cases, women are prescribed insulin to achieve target blood sugar levels before vaginal delivery or caesarean section.
After giving birth, women will be screened for diabetes at about 6-12 weeks and continue to follow up after that at least every 3 years to detect diabetes or pre-diabetes.
Good gestational diabetes management reduces the risk of complications for mother and baby. Pregnant women should not neglect and neglect to regularly monitor their condition with a specialist to have the best birth health for themselves and their babies.
At Vinmec International General Hospital, there is a package maternity service as a solution to help pregnant women feel secure because of the companionship of the medical team throughout the pregnancy. When choosing Maternity Package, pregnant women can:
The pregnancy process is monitored by a team of qualified doctors Regular check-up, early detection of abnormalities Maternity package helps to facilitate the process. birthing process Newborns receive comprehensive care.