1ST CITY CLINICAL HOSPITAL

The pancreas performs many important functions in our body, and one of them is the regulation of carbohydrate metabolism. The pancreas performs this function with the help of the hormones it produces - insulin, glucagon and some others. The main effect of insulin is to reduce the concentration of glucose in the blood, the main effect of glucagon is to increase it. When these hormones work in concert, the level of glucose in the blood is maintained at a certain, normal level.

However, a disruption in the functioning of the pancreas or a disruption in the perception of gland hormones by the organs and tissues of our body may occur. In such a situation, the level of glucose in the blood becomes higher than normal (this condition is called hyperglycemia), and we understand that our patient has developed a disorder of carbohydrate metabolism, one of the variants of which is diabetes mellitus. It, in turn, comes in several types (types 1 and 2, gestational diabetes mellitus, other types of diabetes mellitus).

This disease can be asymptomatic (which is more typical for type 2 diabetes mellitus and gestational diabetes mellitus) or have a pronounced clinical picture (type 1 diabetes mellitus) of varying severity (thirst, increased daily urine volume, increased appetite against the background of weight loss body, weakness, fatigue, decreased performance, etc.).

It is important for every person to have normal blood glucose levels. But this is especially important for a pregnant woman. Why?

Pregnant women with diabetes are at risk for developing the following complications of pregnancy and childbirth:

• spontaneous miscarriage
• premature birth
• hypoxia and intrauterine fetal death
• polyhydramnios
• fetal growth restriction
• formation of fetal malformations
• preeclampsia, eclampsia
• fetal macrosomia (large fetus)
• birth trauma of mother and fetus
• high perinatal mortality

What is important to remember?

1. Diabetes mellitus can develop in a woman’s body both before and during pregnancy.
2. If diabetes mellitus develops during pregnancy, the level of glucose in the blood is often elevated, but not sharply, and the disease occurs without obvious clinical symptoms (this type of diabetes mellitus is called gestational diabetes). Therefore, the most important role in its diagnosis is played by laboratory research methods (tests), which are prescribed by an obstetrician-gynecologist to all women during the management of their pregnancy. This helps to identify diabetes as early as possible and, accordingly, take measures as early as possible to preserve the health of the woman and the health of her child.
3. If a woman has had gestational diabetes, she is at high risk of developing it in subsequent pregnancies, as well as type 2 diabetes in the future.
4. If a woman has already been diagnosed with diabetes, it is extremely important that the pregnancy be planned and prepared for in advance. Therefore, it is necessary to undergo an examination and achieve ideal diabetes compensation 3-4 months before conception, following the recommendations of an endocrinologist. In some situations, pregnancy with diabetes may be contraindicated.
5. The pregnancy of a patient with diabetes is managed by an obstetrician-gynecologist together with an endocrinologist. If necessary, women are referred for consultation by doctors of other specialties (eg, nephrologist, ophthalmologist).
6. Diabetes schools have been established where patients receive all the necessary knowledge and skills needed to successfully control and treat diabetes.
7. Pregnant women with endocrine pathology living in the city of Minsk are observed at the City Center for Extragenital Pathology during Pregnancy at the 4th antenatal clinic and give birth in the 1st city clinical hospital.