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Gestational diabetes (FAQ)

August 18th, 2010

Question: Oleg. I have 20 weeks of pregnancy. Be tested for sugar. I do not remember how he properly called. At toschak rate – 4,2. Then drank glucose. After an hour – 8,4. After 2 hours – 8,2. I was not prescribed any lekartsvennyh funds. But they said stick to a diet. I do not quite understand how it should be observed. This site is also not found. Sorry, if bad looking. . . They said to exclude sugar, confectionery, pasta, rice and mannye porridge, bread and buns all. Tell me, sugar should be deleted altogether (ie, buy a replacement), or simply limit? The same with chocolate. And butt. To note I caused to the doctor soon, to clarify. So could you answer me now that I'm stupid not to make. And yet, where you can find a list of products that can be used with this diagnosis, and what not? In the Internet could not be found. Thanks in advance.

Answer: Improved blood sugar levels during pregnancy does not occur so rarely. Diagnosis sounds "Gestational diabetes, but this must not be afraid, because this condition is usually temporary (sugar levels to normal after childbirth). Risk group in terms of raising blood sugar are an overweight woman with an unfavorable heredity in terms of diabetes, as well as those who in previous pregnancies (if any) can not be excluded "missed" (undetected) improving blood glucose ( that, for example, leads to the birth of a child weighing more than 4. 5 kg). But the increase in blood sugar occurs against a background of pregnancy and those who are not included in this risk group. For diagnostic test is performed with a sugar load (must be all 24-28-th week). But suschestvyuut different versions of this sample (50, 75 and 100 g of glucose), you do not specify how much it was. But apparently, sugar exceeded the norm in 2 hours. Any excess of norm of sugar during pregnancy is regarded as diabetes, pregnancy (in other situations, there is the notion of "impaired glucose tolerance" – an intermediate state between normality and diabetes). Formally, to confirm the diagnosis is necessary to fix a higher sugar twice (2 points in one test or 2 test on different days against a background of normal supply), but the recommendation to comply with the diet – are justified. Basic principles of therapy: Diet: Primarily excluded bystrovsasyvayuschiesya carbohydrates (ie, all sweet: sugar, honey, confectionery, candy, and mashed potatoes, much <grinded> grains (like semolina), fruit juices, lemonades, LONG number of fruit). Instead of sugar is to use a substitute, instead of candy and chocolate – candy on the sweetener (diabetic). Medlennovsasyvayuschihsya consumption of carbohydrates (pasta, rice, buckwheat, potatoes) should be reduced, partly replacing them with vegetable garnish. Strong limit calories or carbohydrate in the diet must be avoided, because it affects the unborn child. Thus, the pregnancy – not the best time to get rid of excess weight. Calorie intake should be chosen in such a way as to place the normal pregnant small weight gain: 1.2 kg in the first trimester, then 350-400 g per week, generally about 10-12 kg during the whole pregnancy. Generally, a diet with DG (and pregnancy in general) is complex, and in its selection of desirable participation of professionals specialized centers <Diabetes and pregnancy> (there are a number of cities in Russia). However, it must be remembered that excessive weight gain during pregnancy is frequently related to edema, and this is – a symptom of late toxicosis – a dangerous condition in which the need to seek emergency medical attention. When you save a high-sugar temporarily appoint insulin (hypoglycemic tablets are contraindicated in pregnancy), which avoids the negative effects of high glucose on you and the unborn child. After birth, it usually passes. . . But, if there are other "risk factors" (eg, obesity or heredity), should beware of raising blood sugar and / or cholesterol (the latter leads to cardiovascular disease). How to avoid these problems in the future? 1). Watch your weight (but only after giving birth! Pregnancy – a bad time for the treatment of obesity) and to a sufficiently sedentary life. 2). Regularly (1 time in 1-2 years) to determine the level of sugar and cholesterol in the blood.

FAQ

Diabetes and pregnancy / contraception (FAQ)

August 18th, 2010

Question: I have diabetes type 1 st experience 6 years (I 19). My boyfriend is also diabetes mellitus (3 years). We in the future very much want to have kids. But I already have a complication (diabetic neuropathy: delayed passage of the reaction in the legs). The gynecologist told me I could not take the pill, though. . I do not really believe it. It is always the risk of unintended pregnancy – and I'm very afraid, because not always a good SC is. and so on Question 1 – Can I drink the pills, if so, what? 2 – can we continue in the future to have children and when it is best to plan pregnancy. Where can I go for advice in Saint Petersburg? Advance thank you very much, Catherine.

Answer: polyneuropathy in any case is not a contraindication kberemennosti. But diabetes in both parents (or spouses) – contraindication, because the risk of SD 1tipa a child in this case is high – about 30%. Therefore we must seriously dumato donation of sperm, etc. In order for pregnancy proceeded normally, need a good kompensatsiyai planning pregnancy in advance. To do this, contact the Center Diabetes and Pregnancy, "in St. Petersburg is, the address can be found in the directory" Who and what in the world of diabetes "at www. diabet-news. ruKontratseptivy: with good compensation allowed three phase oralnyekontratseptivy (Trikvilar, Triziston, Three-Mersey) or gormonalnyekontratseptivy Vaginal or intrauterine contraception (callow medsoderzhaschievnutrimatochnye helix) In poor compensation – barrier (prezrvativy) and chemical (Pharmatex IT. etc) is set out in national standards the treatment of diabetes, which dostupnypo address: http://diabet-news. ru/doc/14. shtm

FAQ

SD 1, and pregnancy (FAQ)

July 30th, 2010

Question: Tell me please, is it possible for LEDs of type 1 have a second child? Or is it better to abandon such thoughts? Experience 18 years of diabetes, the child 7 years old. Pregnancy was at narmalnyh sugar. In the second half of the acetone was determined continuously with a low sugar (3,2-4).

Answer: Yes, of course. Many doctors "in the old" forbidden, because priploho controlled diabetes (which in most cases imelomesto earlier), the risk of adverse outcomes for the child or for materidostigal 30-50%. But today, with good diabetes control, proper management of pregnancy (in a specialized center "Diabetes iberemennost"), its planning and preparing for her number oslozhneniyberemennosti with SD did not exceed those of women without CD (Saint Vinsentskayadeklaratsiya, 1989). Therefore, if you really want to have a baby, 'Net "diabetes" contraindications to pregnancy (they are a little bit – tyazhelayadiab. Nephropathy, a heavy defeat fundus, breach motorikikishechnika and others – set out on http://www. Diabet-news. Ru / doc / algo. shtm #, section 16) – you can be pregnant without any complications for you ilirebenka. To do this already in the planning stage to contact the Center Gestational diabetes (eg, in Moscow – in the City hospital № 1; in other cities can learn from the directory "Who's Who in the world of diabetes"). Patients with SDprovodyat re-training in the School of diabetes, with an emphasis on pregnancy, ipomogayut keep the sugar in normal before conception and throughout pregnancy. In this case, the outcome will be good.

FAQ

Lantus ® impact on pregnancy (FAQ)

July 3rd, 2010

Question: I asked about the possibility of obtaining an insulin pump. Thank you for your phones and addresses of schools diabetes. I am well aware that the only way to avoid complications before, during and after pregnancy – strict control and maintaining glucose levels within normal limits. But perhaps I'm not quite explain it properly. Talking about the insulin pump with my endocrinologist and a specialist from the MONICA was raised not because the "pump helps avoid permanent control of sugar and a large number of insulin injections per day." As short, I use humalog insulin, and as long – Lantus. That's why a LANTUS and called "negative emotions" from doctors. I was told that even a very little study on the effect of insulin in the fetus. And with the pump Lantus may be deleted and replaced with the pump I can get a brief small doses of insulin and very often. Therefore, if you think that there is no need to pump, then please explain what exactly caused such concern of doctors and what do you advise in the absence of the pump during pregnancy? replacement of Lantus ® on another long Insula? if so, what? Thank

Answer: 1. With regard to the need to frequently measure the sugar – pump to achieve good results measurement should also be frequent (at least 4 times a day, in any case). 2. With Lantus situation is this: the so-called insulin analog (slightly changed the amino acid sequence), and each new drug is formally allowed to use during pregnancy only after obtaining data on its safety in pregnant women (pre-test of any risk not identified). There must be several years that these data are accumulated, and, if all goes well, the drug was officially allowed in pregnancy). With humalogom situation was similar – but data on safety during pregnancy has been collected, so its safety in pregnancy is officially confirmed. Before the onset of pregnancy Lantus should be replaced by the usual prolonged insulin (although I'm not sure that all pregnant women with diabetes type 1 is done). 3. Yes, the application of pumps can dispense with Lantus ® without sacrificing (and even improving) the controllability of sugar, and if it is possible to buy a pump – well! If not – we must remember that, long before the advent of insulin pumps in the proper desire and ability, many women with diabetes 1 had during pregnancy blood sugar close to ideal. Including – using the usual short and extended insulin (ie, no insulin analogues). Ie, a pump – it is good, it is a step forward, but without the pump can also handle.

FAQ

SARS pregnancy

February 19th, 2010

Question: Tell me how you can cope with a cold! I have 10 weeks, 5 days ago, her temperature rose to 37.3 so far it has not decreased. morning, laid his nose, and in the corner of his lips a little cold. how to get treatment

Answer: Hello! 5 days for SARS is quite a lot, should consult a physician and a gynecologist appointment with treatment

FAQ