Gestational Diabetes Risk management
What are the risk factors for gestational?
- Family history of diabetes or gestational diabetes personal,
- Obesity,
- Age over 35 years,
- Obstetric history of preeclampsia,
- A history of fetal death in utero, or baby with macrosomia or malformation
What are the terms of support?
Medical teams opt for intensive management of these women in order to reduce maternal and fetal consequences. They are first order food (diet 50 to 55% of calories as carbohydrates, 15% from protein, 30-35% fat, more fiber, especially saturated fat little ...). Then we promote physical activity.
Insulin is available in almost 40% of cases when the system is ineffective after one to two weeks (if fasting glucose levels are higher than 0.95 g / l or 5.3 mmol and / or blood glucose measured two hours after a meal 1,20 g / l (6.7 mmol). Insulin, however, is established immediately if fasting glucose is greater than 1.30 g / l (7.2 mmol) in diagnostic test.
Oral medications are not prescribed date in gestational diabetes.
In all cases, it is desirable to maintain the average blood glucose below 1.05 g / l (5.8 mmol). These are obtained by a blood glucose self-monitoring with daily meter capillary.
Management of gestational diabetes is effective if glycemic targets are achieved: when we normalize maternal-fetal risks.
What follow-up post-partum (after delivery)?
Gestational diabetes disappears in nine cases out of ten after childbirth. A check is performed three to six months after birth, through a OGTT with 75 g oral glucose (OGTT).
More elevation of fasting glucose during pregnancy is important, the greater the risk of type 2 diabetes later. This is why some medical teams offer these women who gave birth screening every 12 to 24 months, along with other preventive measures such as normalization or stabilization of weight, maintaining regular physical activity while limiting other vascular risk factors.
About the child's risk of overweight and obesity in the long term would be increased in case of macrosomia.
So a healthy nutrition and sufficient physical activity are also desirable for the child.
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