Maintaining an optimal sugar concentration during the gestation period is very important. This is necessary for active growth and full development of the fetus. In order to determine the blood sugar level of the expectant mother, blood tests are used.
About glucose in the blood while carrying a baby
Sugar constancy in the body is maintained by a number of hormones. The basic one is insulin. It is produced by special cells in the pancreas. Insulin is a special conductor that conducts glucose to all cells of internal organs. The brain and heart of the baby are most in need of this nutrient.
Glucose metabolism occurs in muscle cells. A lot of different enzymes are involved in this process. Excess sugar is further processed into fat and stored in fat cells. This leads to the expectant mother, who has carbohydrate metabolism disorders, has a problem of excess weight.
An actively growing fruit requires a lot of nutrients for its development. This physiological reaction is most pronounced in the third trimester of pregnancy.
Also, the need for nutrients, and especially for glucose, increases significantly with multiple pregnancies.
The reasons for the deviations that arise
Scientists have now established the underlying cause of metabolic disorders of carbohydrate metabolism during pregnancy. It lies in the fact that the hormonal background of expectant mothers changes significantly.
Progesterone, placental lactogen, and human chorionic gonadotropin cause a woman to become insulin resistant.
Peak concentration of these hormones increases by 14-15 weeks of gestation. This condition leads to the fact that insulin cannot have a full effect on glucose metabolism. Ultimately, this helps keep blood sugar levels fairly high.
Doctors note that a hereditary factor plays a huge role in the development of severe hyperglycemia or a persistent increase in blood glucose levels.
It has been scientifically noted that expectant mothers with a burdened family history of diabetes mellitus have a higher chance of developing this pathology during pregnancy. If a woman during a previous birth gave birth to a baby weighing more than 4 kg, then this may also be a possible sign of the gestational form of this pathology.
Who is this study assigned to?
Blood sugar should be measured in each trimester of pregnancy. Such diagnostics are now becoming extremely necessary. It is important to note that the incidence rates of diabetes mellitus in the population grow catastrophically every year. This frightening situation has contributed to the fact that doctors are paying great attention to research on the determination of glucose, carried out by all pregnant women.
Specialists identify several special risk groups. These population categories include women who have a fairly high chance of developing hyperglycemia during pregnancy. These risk groups include:
- expectant mothers over 35 years old who have sugar surges even before pregnancy;
- pregnant women who are obese or have a high body mass index (BMI) over 25;
- expectant mothers with a burdened hereditary history of the development of diabetes mellitus in close relatives;
- pregnant women who have been diagnosed with impaired glucose tolerance before conceiving a child;
- expectant mothers who, before conceiving a baby, underwent a course of hormonal therapy or special treatment for infertility.
A blood glucose test is performed for all pregnant women, regardless of their age.
Doctors recommend that expectant mothers be tested for blood sugar at least twice during the entire period of pregnancy. Usually, such studies are prescribed at 9-12 and after 31 weeks of pregnancy.
What situations does it help prevent?
Regular monitoring of blood glucose levels is essential. It helps prevent some pretty dangerous conditions. Some of them may even be life-threatening to the fetus.
Obstetricians-gynecologists note that controlling blood glucose levels helps to significantly reduce the risk of the threat of spontaneous miscarriage. It also reduces the likelihood of preterm birth.
Doctors note that timely detection of maternal hyperglycemia helps to reduce the number of congenital malformations her baby, which occurs mainly in the first half of pregnancy during the laying of all vital organ systems.
A normal blood glucose level helps the fetus to grow and develop optimally. These babies are born healthy and have a normal body weight. In women, who have persistent hyperglycemia during pregnancy, in most cases babies are born with signs of obesity. As a rule, the average weight of a child in this situation is 4 kg or more.
Timely detection of a persistent increase in blood sugar can reduce the risk of developing preeclampsia and severe arterial hypertension, which can significantly aggravate the course of pregnancy.
Timely correction of these violations can reduce the development of dangerous complications of diabetes.
Symptoms of abnormalities
Elevated level
Persistent hyperglycemia can cause a variety of disorders. They lead to the development of uncomfortable symptoms in the expectant mother, which worsen her usual well-being.
An increase in blood sugar contributes to severe thirst and dry mouth. This symptom causes the woman to start consuming quite a lot of fluids. In some cases, she drinks 5-6 liters of water per day.
Frequent drinking leads to the fact that the expectant mother puffiness appears. It usually manifests itself on the legs. The ankles become swollen. The woman notes that it becomes difficult for her to button her boots or other shoes. When wearing socks, strong marks appear on the ankles.
A large amount of water contributes to the appearance of frequent urination. The urine portions become large in volume. At the same time, the clinical indicators of analyzes change. So, the specific gravity and density of urine may decrease. Its color also changes - it becomes paler.
Expectant mothers suffering from persistent hyperglycemia begin to complain of headaches. It is usually of moderate intensity and increases in the evening.
A pregnant woman often feels very tired, even if she has not yet performed any intense physical activity. Some expectant mothers experience dizziness, which is noticeably worse when changing body position.
A strong increase in blood sugar leads to the fact that the hands and feet of women begin to feel very cold. Some people report decreased vision. Severe hyperglycemia can also manifest itself as a mood disorder.
A woman becomes more aggressive, her attention is scattered, it is difficult for her to concentrate even on simple, ordinary things.
Reduced level
The reduced concentration of glucose in the blood is called hypoglycemia by doctors. This condition is less common during pregnancy. Chronic pathologies of the gastrointestinal tract and pancreas can lead to its development.
Expectant mothers who are underweight and restricting their diet before pregnancy also may be in an area of increased risk for the development of this condition.
Moderate hypoglycemia is difficult to suspect. It practically does not manifest itself in any way. Only with a significant decrease in sugar can a woman develop severe weakness and excessive fatigue. In some women, drowsiness increases rapidly.
A critical decrease in blood sugar is an extremely undesirable pathology, since it very dangerous to the fetus. It can lead to severe deficiencies in nutrients necessary for its development.
The extreme severity of hypoglycemia is coma. With this pathology, a woman loses consciousness. In this situation, urgent hospitalization is required in a hospital and intensive therapy with intravenous infusion of glucose solutions.
How to properly prepare for delivery?
Still, one should prepare before performing the study, even though the blood glucose test is rather commonplace and routine.
Overuse of candy or chocolate on the eve of this lab test may result in an excessive spike in blood sugar levels. In this case, hyperglycemia will not be a sign of diabetes, but it will still be detected.
2-3 days before the study, doctors strongly recommend future mothers eliminate any psycho-emotional stress. Scientists have found that such effects lead to a strong increase in blood sugar levels.
You should not be worried and nervous before going to the laboratory. This is a very common procedure that is carried out for all expectant mothers, without exception.
Restricting physical activity is also an important condition before taking tests. Intense exercise can cause blood glucose to be lowered.
Sugar levels can be low even after routine cleaning or attending a yoga class for pregnant women. 2-3 days before the test is better exclude any visits to the sports center, to reduce the risk of spontaneous hypoglycemia.
No special diet is required prior to the study. On the contrary, in order to obtain a more reliable result, doctors recommend that pregnant women follow their usual diet. The only limitation is the reduction of sugar-containing foods, especially those rich in "fast" carbohydrates.
On the eve of the test, you should eat as easily as possible. It is better to give preference to protein foods with a vegetable side dish. Fatty and fried foods should be avoided, as this can adversely affect the validity of the results. Basically, such restrictions are necessary if blood sampling for analysis is performed through a vein.
How is it done?
The test should be taken on an empty stomach. It is better to do this in the morning. You can drink some water before testing. It should be noted that you cannot drink sugary drinks in the morning before the analysis. They can lead to a jump in sugar, which will be determined during the study.
The day before the test, doctors recommend limit the use of any sweets. First of all, "fast" carbohydrates are banned. These include any industrial sweets, chocolate, bananas, dried fruits and grapes. "Slow" carbohydrates contained in cereals and various grains do not need to be limited.
The analysis is allowed in several ways. Currently, more and more laboratories are performing blood sampling from a vein. In this case, the study is absolutely painless and does not cause any discomfort in the woman. Intravenous research is carried out in almost all private laboratories.
An alternative research technique involves sampling blood from a finger. It is also called capillary by doctors. This method of blood sampling is gradually being replaced by an intravenous technique. It is more traumatic and less tolerated.
The level of sugar in venous and capillary blood differs. Reference values are always indicated on medical analysis forms. The interpretation of the result obtained is performed by a therapist or endocrinologist.
If the fasting blood glucose level rises, the expectant mother will be recommended a number of additional tests. This is necessary in order to confirm or deny the diagnosis of gestational diabetes mellitus, as well as to timely identify glucose tolerance.
Associated analyzes
The basic test prescribed to determine the level of blood sugar is a blood glucose test. If the indicators of this laboratory test are within the normal range, then in such a situation, only mandatory monitoring of this indicator is required in the next trimesters of pregnancy.
Deviations from normal values are a reason for more extensive research. One of these laboratory tests is the determination of the sugar level after a sugar load. This method is also called glucose tolerance.
For this, a sugar curve is built. It shows the change in blood sugar after administration of 75 grams of oral sweet solution in three hours. The evaluation of the obtained values is carried out by an endocrinologist. This study helps to identify gestational diabetes mellitus and other pathologies of carbohydrate metabolism.
American scientists have found that this pathology occurs in 20% of women in the second half of pregnancy.
Obstetricians-gynecologists recommend taking this test to expectant mothers from 24 to 28 weeks of intrauterine fetal development. According to statistics, it is at this time that the risk of gestational diabetes is highest.
Some women believe that they can conduct this study on their own, without going to a medical institution. To do this, they replace the oral sugar solution with a specific meal containing carbohydrates. The result is assessed one hour after eating. Doctors note that it is impossible to perform such a study on your own. This self-test will not provide accurate and reliable results.
Oral glucose tests can be performed only in a polyclinic or hospitalwhen a woman is being watched by specialists. Such research will be informative and will not harm the fetus.
Glycated hemoglobin is another clinical indicator for establishing hyperglycemia. The advantage of this test is that it allows you to determine the average plasma glucose concentration in 2-3 months.
To determine this indicator, venous blood is taken. The readiness of the result, as a rule, takes several hours or 1-2 working days.
This study is necessarily assigned to all expectant mothers whose doctors suspect gestational diabetes mellitus. According to the new standards, its normal values should be less than 6%. With controlled diabetes mellitus, this figure does not exceed 6.5%.
If the blood glucose concentration is high, it can also be detected in urine. This is manifested with hyperglycemia above 9 mmol / L. In this case, a general urine test is prescribed. It is rented according to the general rules.
It should be noted that urine should be delivered within two hours of collection. If this fails, then the biomaterial can be stored in the refrigerator for up to 6-8 hours. However, it should be noted that in this case the results may be less reliable.
These studies can be carried out both in a regular clinic and in a private laboratory.
If the analysis is performed under the compulsory medical insurance policy, then before going to the hospital, you should definitely take a medical referral with you. This special medical form is given to the expectant mother by the doctor at the reception.It indicates the basic personal data of the patient, her expected gestational age, and also makes special notes for laboratory assistants, if necessary.
All analyzes carried out under the compulsory medical insurance policy are carried out in the clinic absolutely free. Also, the expectant mother can take such tests in a private laboratory. The cost of analyzes in this case varies significantly. The price for a blood glucose test in most private medical laboratories is 300-400 rubles including blood sampling.
The glucose tolerance test will cost a little more. Its cost is usually 800-1000 rubles. It is important to remember that this study takes two to three hours.
All this time, the expectant mother is better located within the walls of a medical institution. Conveniences are provided for this in the private laboratory. The mom-to-be can read a book or watch TV between the next blood draws.
Indicator standards
The blood sugar level in pregnant women is practically the same as before pregnancy. What is important is how the values are determined. So, the normal values of capillary and venous blood may differ slightly.
Blood sugar during the entire period of pregnancy should remain within the normal range. Deviations from normal values should always be an indication for additional diagnostics.
For the convenience of determining the pathologies of carbohydrate metabolism, doctors use a special table, which contains the boundaries of normal blood sugar levels in pregnant women. This form is presented below:
What do the results indicate?
Normal values obtained after this test are indicative of a healthy pregnancy. In this case, gestational diabetes is not detected. However, women who are at increased risk of developing this pathology should remember that they should carry out such an examination more often.
For this, it is not at all necessary to do a glucose tolerance test. A regular blood glucose test is also fine. It's great if you have a glucometer at home. This special device measures blood sugar levels in the peripheral bloodstream in a matter of seconds. It is easy to use and helps to carry out simple diagnostics at home.
If your fasting glucose test is high, you should definitely do a sugar load test. It is worth remembering that this study has a number of contraindications for its conduct. In the last weeks of pregnancy, it is usually not performed. Also, this study may be contraindicated if a woman has signs of a viral or bacterial infection proceeding in an acute form.
Exceeding the indicators of glucose tolerance test and glycated hemoglobin - indications for the diagnosis of gestational diabetes mellitus. If such a pathology for a pregnant woman is nevertheless established, then she is sent for a mandatory consultation with an endocrinologist.
This specialist will select the necessary treatment regimen for her, as well as develop a special complex of therapeutic nutrition. The expectant mother will have to follow such a diet throughout the pregnancy.
Danger of high blood sugar for the fetus
Hyperglycemia
This is a very dangerous condition for the fetus. At all stages of its intrauterine development, an increase in glucose in the bloodstream leads to the development of multiple pathologies. They can appear both in the first and subsequent trimesters of pregnancy.
Angiopathy
This is a pathological condition that develops with prolonged hyperglycemia in the maternal body. This pathology is characterized by a disturbed supply of nutrients to the baby developing in the mother's womb.
With angiopathy, damage occurs to the inner wall of the blood vessels that feed the fetus. This pathology leads to the impossibility of adequate blood circulation through the blood flow system common with the mother.
Nephropathy
It is a pathological condition characterized by damage to the kidney tissue. It occurs when blood sugar is significantly higher than normal for a long period of time.
In some cases, nephropathy can lead to the development of a very dangerous condition - renal failure. As a rule, this pathology is accompanied by the appearance of glucose in the urine.
Retinopathy
This is a pathology that can develop in both a woman and her baby at the stage of his intrauterine development. Most often it is registered in pregnant women with diabetes before pregnancy or receiving insulin therapy.
The danger of this pathology is that it can lead to the development of blindness.
Neuropathy
This is a nerve pathology, quite often recorded in women suffering from persistent hyperglycemia or gestational diabetes mellitus. It manifests itself as a feeling of "crawling" on the skin.
Hands and feet become constantly cold to the touch, very chilly. Neuropathy is dangerous for the fetus the development of multiple pathologies in the work of his nervous system.
Heavy weight
Persistent hyperglycemia can lead to over-growth of the fetus, which contributes to a significant increase in its body weight. This condition develops as a result of severe obesity, which occurs as a result of disorders of carbohydrate and fat metabolism.
Too much fetal weight with a narrow mother's pelvis is, as a rule, indication for cesarean section.
Respiratory distress
This syndrome occurs in children whose mothers suffered from diabetes during pregnancy. This pathology can lead to the development of pronounced respiratory disorders and persistent oxygen starvation of internal organs.
The birth of such babies is complicated by the fact that they cannot breathe on their own. In this case, intensive therapy and even resuscitation may be required.
What to do in case of deviations?
If any disorders of carbohydrate metabolism appear during glucose tests, the expectant mother is sent for a consultation with a specialist. Endocrinologists are involved in the treatment of such pathologies.
These specialists make up the entire necessary complex of treatment, which necessarily includes medical nutrition. In some cases, drugs are prescribed, before the appointment of which the risk of their effect on the fetus is necessarily assessed.
For the appointment, funds are selected that have a minimal effect on the baby developing in the mother's belly.
In the first trimester of pregnancy, if possible, doctors try to limit themselves only to the appointment of a special diet. This period is very important for the fetus. It is at this time that the laying of all its vital organs occurs.
A low-carb diet during pregnancy is slightly different. The main difference is the calorie content and nutritional value of foods. Also, all protein products and cereals remain in the daily menu of the expectant mother, as they are needed for the full growth and development of her baby.
To maintain optimal blood glucose levels, it is very important to limit fast carbohydrates. A strict limitation is imposed on industrially produced sweets, chocolate, and overly sweet fruits. These include bananas and grapes. The rest of the fruits in the daily menu of expectant mothers remain. However, the possible amount of their use is strictly determined.
Cereals are not excluded from the diet of expectant mothers. They are rich in "slow" carbohydrates that do not spike blood sugar and do not lead to sudden hyperglycemia. Also, these products are rich in vitamins necessary for the full development of the nervous tissue of the fetus.
You can supplement the main protein dish with cereals. Doctors allow expectant mothers with gestational diabetes mellitus to eat cereals made from buckwheat, oatmeal or rice.
With severe hyperglycemia, insulin therapy may be indicated. Medicines in this case are selected individually.
Insulin dosage is very important. When prescribing insulin therapy, control over the effectiveness of the selected dose is mandatory. All pregnant women who are prescribed insulin therapy, It is very important to have a meter at home to check your blood sugar yourself.
Many women make a very dangerous mistake, starting to use various biologically active food supplements with high blood sugar. Such funds can have a very adverse effect on the fetus and the course of pregnancy in general.
Some of these drugs contain ingredients that can aggravate allergic reactions. It is important to remember that taking any medications during pregnancy must be coordinated with your doctor.
Optimal physical activity Is a very important principle in the treatment of hyperglycemia. During pregnancy, it is better to refuse from intensive sports. Such loads can lead to the formation of dangerous pathologies for the fetus.
For active growth and development of the baby, walking in the fresh air at a moderate pace is perfect.
In the third trimester of pregnancy, if possible, you should limit ascents to several stairways.
Compliance with the drinking regime Is also a very important principle in normalizing blood sugar levels. It is better to drink plain water. This drink does not contain any additional carbohydrates that can lead to the development of hyperglycemia. During pregnancy, experts recommend drinking room temperature water.
Eliminating stress will help maintain optimal blood sugar levels throughout pregnancy.
Expectant mothers should always remember that anxiety and excessive worry about trifles can lead to serious disruptions in their metabolic processes. Pregnancy is a time when a woman should think not only about her health, but also about the future of her baby. The calmness of the mother is the key to good growth and development of her baby.
For information on what should be the blood glucose level during pregnancy, see the next video.
