Insulin is a hormone produced by Langerhans cells in the pancreas. It is needed to lower the hyperglycemia that occurs with diabetes. When carbohydrates come with food, sugar always rises. For it to be absorbed, insulin is required. Is it possible to insulin during pregnancy? You will find the answer to this question in the article.
About ailment
Diabetes is a disease that many times increases the risk of complications during pregnancy and childbirth. Therefore, it is necessary to pay attention to the concentration of glucose in the blood and to ensure that it is always normal. Otherwise:
- There is a risk of miscarriage.
- Complications of diabetes may appear.
- Probably getting an infection after giving birth.
- Polyhydramnios is developing.
- Gestosis appears.
The child is also at risk due to diabetes in the mother:
- Increased risk of death during childbirth.
- Complications on the organs.
- There is a danger of developing diabetes.
- Macrosomia develops - excessive growth of the child in the womb.
- Congenital abnormalities appear.
The risk of complications is determined by the duration of the disease and its symptoms. Only a specialist can assess the degree of this risk after familiarizing himself with the anamnesis.
Basis of the problem
In diabetes mellitus, tissue cells are insensitive to insulin and its accumulation in the blood occurs, glucose is not absorbed, and a slowdown in metabolism occurs. This condition is called insulin resistance or type 2 diabetes. In comparison, type 1 diabetes is considered an insulin-dependent illness.
To determine whether it is possible to inject insulin during pregnancy, you should familiarize yourself with its effect. It has another function - it provides the formation of protein in the muscles, as well as the transformation of glucose into fat, so it accumulates - and obesity appears.
The basis of the disease is the insensitivity of pancreatic cells. This disease has an endocrine etiology. The disease develops from stress, hereditary factor, malnutrition.
Although there are several forms of the disease, the main symptom is hyperglycemia. DM can develop at any age, including during pregnancy. Because of this, the observation of a woman is complicated and measures are required, and the supervision of a doctor.
Is it possible to inject insulin during pregnancy, the doctor must decide. If the disease appeared at the 20th week of the fetus, insulin resistance arose, then it is called gestational diabetes. When an ailment is detected before pregnancy, it is called pregestational.
Types of pathologies
Type 1 and type 2 diabetes in pregnant women in whom this ailment was even before the onset of pregnancy are called pre-gestational diabetes. Distinguish between 1 and 2 degrees of the disease. The doctor, based on his state of health, prescribes a diet, medicines. Different types of diabetes are complicated by impaired functioning of the kidneys and even the brain.
More diabetes is divided into:
- compensated - is considered manageable;
- subcompensated - has severe symptoms;
- decompensated - the disease is characterized by a severe course.
Usually, GDM occurs from 2 halves of pregnancy. This is found by analysis, although the symptoms are often ignored. An ailment manifests itself in the form of constant thirst, rapid urination. To understand whether injecting insulin during pregnancy, you should familiarize yourself with the consequences of its use.
Effects on the pregnant woman
What are the consequences of insulin during pregnancy? Allergies are likely due to hypersensitivity. Usually this is manifested by a skin ailment, bronchospasm. There may be vision problems. Sometimes the body produces antibodies to administer the drug. At the beginning of insulin intake there is a danger of edema, which disappears after a few days. In this case, a doctor’s consultation is necessary.
During pregnancy, insulin should be prescribed by a doctor. With hyperglycemia, circulatory disorders occur, red blood cells increase in the blood. Vessels become fragile and lose elasticity. There is a violation in the work of the kidneys, the clarity of vision decreases noticeably, a veil appears in front of the eyes.
The risk of coronary heart disease due to vascular damage increases. There is a change in the tactile sensitivity of the skin of the legs: pain and vibration sensitivity are reduced, the legs hurt in a calm state. These symptoms are more manifested in pregestational diabetes. The state of ketoacidosis is likely - with it, fatty acid decomposition products accumulate in the blood.
Complications
The doctor prescribes insulin during pregnancy to protect against complications. With diabetes, their risk increases by 10 times. Swelling, eclampsia and preeclampsia, kidney damage appear. Urinary tract infections, early childbirth are still likely. Swelling is a common symptom of late toxicosis. First there is swelling of the feet, legs, then the abdomen, hands and face.
Complications include weight gain, frequent nightly urination, and kidney damage. As the process progresses, the symptoms intensify. As a result, premature birth can occur.
Effects on the fetus
With pre-gestational diabetes, the child will have an increased weight, which is considered a manifestation of fetopathy (this is the name of the ailment of the fetus with deviations and malformations). From hyperglycemia in the mother, the pancreas in the child will work with a strong load. Therefore, he may have a state of hypoglycemia.
Another complication is respiratory distress syndrome in children. When breathing, adhesion of the alveoli occurs, because the child has few surfactant in the lungs - a component that protects the alveoli from gluing.
If gestational diabetes is detected, a diet is effective. Simple sugars should be discarded. It is necessary fractional nutrition, moderate physical activity. Still requires regular ultrasound.
If insulin is taken during pregnancy, what are the consequences for the baby? These children are usually sick more often, they have reduced immunity.
Indications
During pregnancy, insulin is prescribed if diet and exercise are ineffective. But why are these injections required? They allow you to maintain a normal state of the mother during the bearing of the child. The drug does not penetrate the BBB. The body does not get used to it, and after childbirth it can be canceled. In this case, insulin is the main aspect of treatment. He is also prescribed for the detection of fetopathy in the fetus.
The scheme and dosage of insulin during pregnancy are individual, a single scheme does not exist. Sugar is measured, and its level is recorded 8 times a day - on an empty stomach in the morning and one hour after dinner. If you feel unwell, measure it at 3 a.m. The norm for pregnant women is 3.3-6.6 mmol / L.
Women should also be able to set the dose of insulin, acetone in the urine with the help of test strips, and measure the pressure at home. To do this, it is advisable to keep a diary. If all this is difficult to perform at home, then the work of the laboratory will help. Analyzes should be taken 2 times a day.
Who to contact?
During pregnancy, insulin is prescribed for treatment to normalize sugar. Another woman will need to be constantly monitored by a nutritionist, endocrinologist, gynecologist. It is also important to go to the optometrist, as diabetes causes a decrease in vision due to the harmful effects on the vessels. The laboratory donates blood for glycated hemoglobin.
Doses
The dosage of insulin during pregnancy is determined on the basis of blood sugar, gestational age, weight. In the 1st trimester, the norm is 0.6 U / kg, for 14-26 weeks - 0.7 U / kg, from 27 to 40 - 08 U / kg. These are average values. Most are administered in the morning before meals, and the rest - in the evening before meals. According to reviews, during pregnancy, short-acting insulin is considered the most suitable. It is administered as an injection or pump. If there is a cesarean section, then no injections are given on the date of surgery and no food is given.
Insulin is administered only with high hyperglycemia - over 8 mmol / L. After childbirth, the dose is reduced by 2-3 times. 4-5 days after this, extended insulin is used. It can be used for nightly administration.
Views
What type of insulin to use during pregnancy? A doctor should prescribe. It is divided by the beginning, peak, duration of action. Therefore, insulin is ultrashort, short, medium, prolonged. In diabetes with pregnancy, it is advisable to choose ultrashort insulin.
There may also be a different origin of the substance. Insulin is human, cetacean, pork, cattle. During pregnancy, only 1 option is suitable. In Russia, a cattle insulin-based drug is not used. By the level of purification, insulin is traditional, monopic, monocomponent. Many drugs are available, so the doctor should choose the right one.
Usage schemes are also 2 - the basis bolus and traditional. A healthy person has almost constant insulin - this is the base concentration. The drug maintains the level of partial consumption and most remains on stock. This is a food bolus. It is consumed when eating:
- Long-acting insulin is used to provide the baseline concentration.
- A bolus concentration is required after a meal.
In the traditional program, the doses and time of administration are the same. Change is rare. It is necessary to follow a diet, its calorie content should not change. This scheme is the most inflexible when the patient depends on the schedule of injections and diet. At the same time, they are made 2 times a day and 2 times - short and medium action. The drug is injected into the abdomen, thigh, shoulder, using special syringes. But, according to reviews, insulin during pregnancy is not always prescribed.
Food
For the safety of the health of women and children with diabetes, you must adhere to a special diet. Its purpose is to maintain blood sugar levels at a level that a healthy person has. The basis of the diet is considered to reduce the intake of carbohydrate foods. Since it is precisely because of them that interruptions in glycemia occur, eliminating the ailment with insulin therapy alone will not work.
The daily calorie intake should be 1800-2400 kcal. A low-carb diet consists of:
- fats - 30%;
- proteins - 25%;
- carbohydrates - 45%.
It is important to follow the rules of nutrition:
- Exclude sugar by replacing it with a sweetener or non-nutritive sweetener.
- Partial nutrition is required - in small portions 6 times a day.
- Inject a dose of insulin before meals.
- Need to give up alcohol.
- Observe prohibited and permitted products.
- Do not eat food with chemical additives.
Forbidden reception:
- Sahara;
- alcohol
- flour products;
- honey, jam;
- fatty dairy products;
- sweet soda;
- soups on meat or fish broth;
- sausages;
- ham;
- bacon;
- Macaroni
- chocolate.
But the diet should consist of:
- soups on vegetable broth;
- vegetables;
- fruits and dried fruits;
- berries;
- greens;
- nuts
- legumes;
- porridge;
- water;
- mineral still water;
- juices;
- smoothie.
After childbirth
After the appearance of the child, insulin is canceled. It is not dangerous for a woman and a baby. Blood donation for sugar is required within 3 days. After 8-12 weeks, you need to do a glucose sensitivity test.
It is required to normalize nutrition. Gradually, hiking should be introduced. If you are overweight, you need to go on a diet for weight loss. A pediatrician must be informed that during pregnancy, a woman took insulin to correct blood sugar. This will allow her to prescribe preventive measures for the child.
Recommendations
If during pregnancy there was gestational diabetes, and then passed, it is still important to monitor the condition. Since there is a risk of developing type 2 diabetes. A gestational form of the disease is evidence of poor pancreatic insulin sensitivity.
It turns out that it already functions at the limit of possibilities. During pregnancy, the load on her increased, so the function of the gland failed. It cannot produce the required amount of insulin, and glucose rises beyond the upper limit of normal.
Tissue insulin resistance increases with age, and the function of insulin production decreases. Because of this, diabetes and its complications develop. If gestational diabetes was detected during pregnancy, then the risks of these consequences are high. Therefore, it is important to observe preventive measures.
After giving birth, it is advisable to perform a second diabetes test after 6-12 weeks. If everything is normal, then the check must be performed after 3 years. It is advisable to take a blood test for this glycated hemoglobin.
The best method for preventing the disease is a carbohydrate-restricted diet. This means that the emphasis should be on protein foods and natural healthy fats. In this case, it is better not to eat foods rich in carbohydrates, because because of them, the likelihood of diabetes increases. A low-carb diet is forbidden during pregnancy, but is great after breastfeeding.
Exercise is also a prevention of type 2 diabetes. You just need to choose the option of physical activity that is more suitable. An excellent effect on human health has swimming, jogging, aerobics.
Glycemic norms
In the morning on an empty stomach, the level should be 3.3-5.3 mmol / l, 2 hours after a meal - 5.0-7.8. Glycated hemoglobin - not higher than 6.5%. If the norms are not violated, the risk of complications for the baby is minimal.
Contraindications
There are no bans on taking drugs, excluding individual intolerance. Insulin is a natural hormone that is vital to the body. The main thing is that the dose and type of the drug are correctly selected. To do this, you need to visit an endocrinologist and constantly have an appointment with him.
Thus, it is possible to inject insulin during pregnancy or not, the specialist decides. Only a doctor can determine the dosage and duration of such therapy.