During normal pregnancy metabolic adaptations occur, aimed at correcting the imbalance that occurs when you need a higher nutritive supply to the fetus. One of these imbalances is that the body needs more insulin delivery to require a greater use of glucose.
Pregnant women undergoes many changes during its gestation process nausea, drowsiness, tiredness, weakness, among others but when they are diabetic are more noticeable changes.
As pregnancy progresses, metabolic adaptation intensifies, reaching great importance during the last 20 weeks of pregnancy.
As should take into account certain considerations.
* In some patients diabetes first appears during pregnancy.
* The conventional criteria for diagnosing diabetes are not applicable during pregnancy.
* As pregnancy progresses there is an increase in insulin requirements.
* The usual criteria of strict metabolic control are not applicable during pregnancy.
Screening for gestational diabetes mellitus (DMG), the data suggest the possibility of DMG are:
Family history of diabetes, especially among first-degree relatives.
* Glycosuria (glucose in urine) in a second fasting urine sample Newborns large for gestational age.
* Abortions unexplained.
* Malformations in the newborn.
* Significant maternal obesity (90 kg or more).
The presence of more than one data increases the probability of having a disorder in glucose metabolism.
Glycosuria (glucose in urine) is a common finding, as 15% of pregnant women have it, so the search for cases based on this information alone is ineffective. The validity of this test may increase when using a second sample Fasting urine issued upon awakening is neglected and collected a second sample 15 minutes later when the patient is still fasting.
If suspicion of GDM should be seen every 15 days by the endocrinologist, working together he and the obstetrician. It should take the usual prenatal measures. It should place special emphasis on weight control.
At each visit, you must perform a blood glucose after eating. If this test does not exceed 120 mg / dL), evidence of oral glucose tolerance should be deferred until the week 37 th -38 th of gestation, at which time more likely to test positive. If at any visit after eating glucose exceeds 120 mg / dL, should be tested for glucose tolerance without delay.
If the test is negative in early pregnancy does not, however, the diagnosis and the test should be repeated at 37-38 weeks, before making a final decision.
Patients who have a negative tolerance test at 37-38 weeks is considered normal.
If the test is positive diagnosis can be made of gestational diabetes and is offered to patients on a diet and was controlled in the same way as a diabetic clinic.
The existence of an increased need for insulin during pregnancy does not necessarily indicate that diabetes persists after delivery.
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