A Comprehensive Guide to Preventing Gestational Diabetes: Scientifically Controlling Blood Sugar to Protect Maternal and Infant Health

How to prevent gestational diabetes: To ensure a smooth pregnancy for pregnant women with diabetes and reduce fetal mortality, it is essential to strengthen monitoring and management and implement preventative measures. Specific measures include:

Termination of pregnancy: Severe diabetes in pregnant women not only increases fetal mortality and malformation rates but can also lead to intellectual disability in infants. Furthermore, the mother's own recovery is poor. Continuing the pregnancy is not advisable. In the early stages, an abortion should be performed, and in the later stages, labor should be induced.

Regular prenatal checkups: Newly diagnosed diabetes should undergo thorough examinations and relevant information. Checkups should be every two weeks before 28 weeks of gestation, and weekly after 28 weeks. Monitoring should begin from the 34th week, with each checkup including blood glucose, blood volume, urine protein, hemoglobin, fundus examination, ultrasound to assess fetal development and for any malformations, and measurement of urinary estriol to assess placental function. If the placenta and fetus are normal, natural delivery can continue. If function is poor, a cesarean section should be considered, generally performed between 37 and 38 weeks.

Dietary Control: Pregnant women should not restrict their diet too strictly. Generally, they should consume 300-400 grams of staple food daily, with calories calculated at 125-146 kJ per kilogram of body weight per day. Of this, at least 250 grams of carbohydrates and 1.5-2.0 grams of protein per kilogram of body weight per day are recommended. To avoid hunger during fasting, it is best to eat 4-6 small, frequent meals throughout the day. A meal should be eaten before bedtime to prevent hypoglycemia at night or in the early morning. Weight gain during pregnancy should be less than 9 kg, or less than 1.5 kg per month.

Medication: Oral hypoglycemic drugs are generally not used during pregnancy. Sulfonylureas can cross the placenta and reach the fetus, causing fetal hypoglycemia and potentially inducing birth defects. Biguanides can cause fetal lactic acidosis. Insulin does not cross the placenta and can be used.

Reproductive Issues for Women with Diabetes: If women with diabetes do not take precautions during pregnancy, their diabetes may worsen, and the risk of birth defects in the fetus is three times higher than in women of normal reproductive age. However, with careful attention and a scientific approach, these adverse consequences can be avoided, and the resulting children will be just as healthy and intelligent as children born to women with normal diabetes. Women with diabetes who wish to become pregnant should pay attention to the following:

When the condition is uncontrolled: Women with diabetes should use contraception when their diabetes is uncontrolled and their blood sugar levels are unstable. Pregnancy should only be planned after diabetes has been controlled and stabilized.

After becoming pregnant, an immediate medical check-up is necessary: ​​A doctor should examine and diagnose whether the pregnancy can continue. If any of the following diabetic complications have occurred, the pregnancy should be terminated immediately:

(1) Diabetic nephropathy.

(2) Proliferative retinopathy.

(3) Pelvic artery calcification.

Treatment for gestational diabetes: Regardless of the medication used to treat diabetes before pregnancy, insulin therapy should be used after becoming pregnant, except for dietary control. Oral hypoglycemic agents are prohibited during pregnancy.

Maintaining adequate calorie intake during pregnancy: Dietary control can be slightly relaxed to ensure the healthy growth and development of the fetus.

Regular medical check-ups: Pregnant women with diabetes should have a check-up every month or every two months from the start of pregnancy. In addition to physical examination and fetal development assessment, the following tests should be performed:

(1) Fasting and postprandial blood glucose.

(2) Urinalysis.

(3) Glycated hemoglobin.

(4) Ultrasound can be used to monitor fetal growth and development and amniotic fluid volume during the third month of pregnancy. Other tests such as blood lipids and complete blood count should also be performed, but not necessarily monthly; they can be determined as needed.

In summary, pregnant women with diabetes should continue their pregnancy under the dual monitoring of an endocrinologist and an obstetrician-gynecologist, strictly maintaining blood glucose within the normal range as much as possible, and undergoing regular testing to ensure the safety of both mother and child.