Wednesday, April 7, 2010

Diabetes Mellitus in Pregnancy

Diabetes mellitus - Diabetes mellitus in pregnancy in medical terms is called gestational diabetes mellitus. Diabetes mellitus may only take place during pregnancy but can also continue despite not pregnant anymore.

According to research, approximately 40-60 percent of women who had diabetes mellitus in pregnancy can proceed with diabetes mellitus after delivery. It is suggested that postpartum blood sugar examination was repeated on a regular basis such as every six months.

Risk factors for diabetes mellitus in pregnancy is a history of recurrent miscarriage, had given birth weight infants equal to or exceeding 4000 g, have had preeclampsia (pregnancy poisoning), or never gave birth to a baby die for no apparent reason or a baby with congenital defects.

In addition, a risk factor is age of pregnant women exceeds 30 years, history of diabetes mellitus in the family, as well as diabetes mellitus had experienced in previous pregnancies.

Management of diabetes in pregnancy should be integrated between the physician obstetrics, internal medicine, nutritionists, and child specialists. Management target is to achieve normal blood sugar levels are fasting blood sugar less than 105 mg/dl and two hours after eating less than 120 mg/dl. Goals can be achieved by making dinner arrangements.

If needed it is given insulin to lower blood sugar levels reach normal. Usually when fasting blood glucose levels exceeding or equal to 130 mg/dl in addition to meal planning needs to be given insulin.

When fasting blood glucose level below 130 mg/dl, treatment can be started by planning to eat alone. In meal planning recommended amount of calories by 35 cal/kg ideal body weight, except when patients fat calories reduced. In pregnancy usually need to consider the addition of calories as much as 300 cal. In order for the fetus in the womb can grow well advised to consume protein for 1 to 1.5 g.

Use of insulin usually starts with small doses and increased as needed to achieve normal blood sugar levels. Usually you will be taught to inject insulin themselves so as not to depend on others.

For that you need to learn the principles of sterility, recognize the various types of insulin, as well as understand the dosage and the provision of appropriate insulin.

You do not need to worry about bad influences of insulin on fetal growth. Instead insulin is expected to help achieve normal blood sugar levels so that the fetus can grow well and avoid labor pains.

When blood sugar is not controlled, then a state of the pregnant mother's blood sugar is high (hyperglycemia), which can pose a risk to the mother and fetus.

The risk of fetal growth restriction can occur because the resulting abnormalities in maternal blood vessels and metabolic changes during pregnancy. On the contrary may occur makrosomia ie large baby at birth due to the accumulation of fat under the skin. Also been reported due to congenital defect of untreated diabetes mellitus pregnancy time.

Another risk is the increased levels of bilirubin and the baby breathing disorders and heart abnormalities. In pregnant women with diabetes mellitus who are not treated can lead to the risk of pregnancy complications such as preeclampsia, amniotic fluid overload, and urinary tract infections.

So the management of diabetes mellitus in pregnancy needs to be done well to improving the health of mothers and babies.[]


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