Insulin injections for pregnant women with diabetes: What you need to know

The article was consulted professionally with MSc. Doctor Vu Thi Duyen - Nephrologist - Endocrinologist, Department of Examination & Internal Medicine - Vinmec Hai Phong International General Hospital.

Gestational diabetes is diabetes diagnosed during the second or third trimester of pregnancy and there is no evidence of prior type 1 or type 2 diabetes. Most patients with gestational diabetes have good blood sugar control by adjusting to a healthy diet and regular physical activity. When blood sugar is not controlled by adjusting diet and exercise, about 10-20% of pregnant women with gestational diabetes need to inject more insulin to control blood sugar better to ensure safety for pregnant women and children. baby.

Diabetes occurs when there is a lack of insulin in the body or a defect in insulin or insulin resistance does not work well in the body. The action of insulin moves glucose out of the blood and into the body's cells where it is converted to energy. Gestational diabetes is diabetes diagnosed during the second or third trimester of pregnancy and there is no evidence of prior type 1 or type 2 diabetes.
When the body does not produce enough insulin or does not respond to it, glucose cannot enter the cells and instead remains in the blood. This leads to an increase in blood glucose levels over time. High blood sugar can damage the body and cause serious health problems like heart disease and kidney disease.

If gestational diabetes is not well controlled, it will lead to an increased risk of bad complications affecting the mother and baby. Here are the possible problems in women with diabetes:
Birth defects for the baby. High blood pressure in pregnant women. Polyhydramnios: It is an increase in amniotic fluid in the amniotic sac surrounding the fetus that can lead to premature delivery or difficulty during delivery. Enlarged fetus: A phenomenon in which the fetus receives too much sugar from the mother, leading to its growth. A large pregnancy makes delivery more difficult and even increases the risk of having a cesarean section. Babies born to mothers with gestational diabetes or at risk of respiratory diseases such as pneumonia, respiratory failure, hypoglycemia and jaundice. Most babies are healthy after birth, but babies need special care and monitoring after birth for some time.
2.1. Causes of complications Gestational diabetes is due to changes in the insulin response of the pregnant woman's body during pregnancy. Insulin is a hormone that helps move sugar out of the blood and into the body's cells where it can be converted into energy.
During pregnancy a woman's cells naturally become mildly resistant to the effects of insulin. This change is intended to increase the mother's blood sugar level to provide more nutrients to the baby. The mother's body makes more insulin to keep blood sugar levels normal. In a small number of women even this increase is not enough to keep their blood sugar within normal limits. This is the mechanism of the development of gestational diabetes.

2.2 High-risk subjects gestational diabetes is more common in the following high-risk subjects:
Age > 25. Obesity, overweight. Previous history of gestational diabetes. History of giving birth to a baby weighing > 4 kg. Having a close relative with diabetes (parents and siblings). History of a stillbirth in a previous pregnancy. Be African-American, American Indian, Asian-American, Hispanic, Latino, or Pacific Islander. 2.3 Controlling blood sugar in gestational diabetes patients with insulin When gestational diabetes is diagnosed, endocrinologists always advise blood sugar control by adjusting blood sugar by adjusting diet and If you do not succeed within 2 weeks of exercise, then you need to switch to insulin control.
Insulin is a hormone secreted by the pancreas. This type of insulin used to treat blood sugar control is called synthetic insulin. The aim of insulin therapy is to lower the blood sugar levels of a person with gestational diabetes to the same level as that of a normal woman.
The endocrinologist will teach how to inject insulin (proven to be safe for the fetus) and the patient will have to have several injections a day. In addition, pregnant women also need to build a healthy and reasonable diet. To do this well, pay attention to carbohydrates (such as sugars, flours) and use foods that, when eaten, change blood sugar levels such as whole grains, beans and vegetables.

When do you need insulin injections for gestational diabetes? Injectable insulin therapy is an effective treatment modality, but giving insulin to pregnant women requires careful instruction and monitoring. Pregnant women need to test capillary blood glucose at least 4 times a day (using a home blood glucose test kit) and note the results to monitor the treatment process.
In addition, the patient also needs to record the specific number of insulin units used in each injection and the total dose injected during the day. The need for insulin doses for pregnant women will increase with gestational age. If treatment is effective, blood sugar levels should be within normal limits. However, blood sugar levels can change rapidly throughout pregnancy. So even if the patient is having good results, it is still necessary to continue to check the blood sugar level as advised by the doctor.
If the pregnant woman feels that her blood sugar is stable and the doctor is satisfied with the results of the blood sugar test, this is a sign of peace of mind because the treatment is going very well.
Gestational diabetes can make the fetus grow more than normal. So your doctor will likely have to regularly check your baby's growth rate. You may need to have an ultrasound to determine your baby's size.
If medication is needed to control blood sugar, you'll need to have a fetal nonstress test around 32 weeks of pregnancy. This is a safe test that helps your doctor check for signs to see if your baby is getting enough blood from the placenta.
Vinmec International General Hospital offers a Package Maternity Care Program for pregnant women right from the first months of pregnancy with a full range of antenatal care visits, periodical 3D and 4D ultrasounds and routine tests to ensure that the mother is healthy and the fetus is developing comprehensively.
Pregnant women will be consulted and checked for health under the close supervision of experienced and specialized Obstetricians, helping mothers have more knowledge to protect their health during pregnancy as well as reduce reduce complications for mother and child.