Diabetes is one of the most common endocrine diseases. There are two types of this disease (insulin-dependent) and (non-insulin-dependent).
It should be noted that in 80-90% of cases, non-insulin-dependent type 2 diabetes occurs. People over the age of 35-40, most of whom are obese, are more likely to be affected.
In addition to the two main types of diabetes, gestational diabetes is also common.
Prior to the introduction of insulin into medical practice, 50-60% of women with diabetes died in the womb. Complications in pregnant women with diabetes gradually decreased after the introduction of insulin therapy.
Pregnant women are differentiated into pre-pregnancy type 1 and type 2 diabetes (pregestion diabetes), gestational diabetes mellitus (gestational diabetes), and glucose intolerance disorders.
Metabolic disorders are almost identical in gestational diabetes and type 1 and type 2 diabetes. Fetal death in the womb is one of the most serious complications of pregnancy with diabetes.
In addition, infants are more likely to have birth defects, weight gain (more than 4,5 kg), and delayed lung development.
Women with diabetes can have severe pregnancies, miscarriages, multiple sclerosis, late toxicosis, edema, and eclampsia.
Women with diabetes should be treated for 2-3 months before pregnancy, or even earlier. Because high blood sugar in the first 8-10 weeks of pregnancy can lead to birth defects in the fetus. All co-morbidities need to be identified and treated.
Pregnancy is not recommended in women over the age of forty with hemoglobin above 10% in early pregnancy or diabetic ketoacidosis.
If the fetus is preserved, women should be monitored by an obstetrician-gynecologist, ophthalmologist, diabetologist, etc.
Short-acting normal insulin is taken three times a day before meals and medium-acting insulin before bedtime. The amount of sugar detected in the meal should not exceed 5,3 mmol / l.
Insulin levels can fluctuate during pregnancy. The need for insulin decreases in the first half of pregnancy due to the transfer of blood sugar from the mother to the fetus.
During the second half of pregnancy, blood sugar levels rise and insulin requirements increase.
A pregnant woman's body weight and blood pressure are monitored regularly. Prescribed diets should ensure that the body weight increases by 1-2 kg in the first trimester of pregnancy, and more than 300-400 g per week in the second and third months of life. During pregnancy, a woman's weight should not exceed 10-11 kg before the tear.
It is very important to follow a certain diet in diabetes. Patients should eat at least 5-6 times a day. It is not possible to take blood thinners during pregnancy. Sugar substitutes are also not recommended.
Ultrasound examinations are also performed to monitor fetal development. However, this method should be used as little as possible.
When diabetes and pregnancy go smoothly, the woman's eyes light up easily.
It is recommended that women avoid contraception and use contraception for this purpose. It is sometimes necessary to increase the amount of insulin when taking contraceptives.
Dilorom NAJMUTDINOVA,
endocrinologist, doctor of medical sciences, professor.
