Should expectant mothers take medicine?

The young female young Liu checked blood pressure, blood sugar, and blood lipids before marriage, but when she was pregnant, she found that blood sugar was higher.After further examination, the result was gestational diabetes.Gestational diabetes is a special type of diabetes. It refers to the phenomenon of high blood sugar before pregnancy without diabetes before pregnancy, and its incidence rate is about 1%to 3%.So, how does this 1%to 3%probability happen to Xiao Zhang?It turned out that gestational diabetes "favored" some specific people.

pregnancy

Preventing diabetes is important

For pregnant women, it is important to prevent diabetes. Diabetes should be performed at 24 to 28 weeks of pregnancy: drink 50g of sugar water, and after 1 hour of blood glucose test, if the blood glucose value exceeds the standard, it must be further performed by 100g sugar resistance.

Of course, high blood sugar for pregnant women is not necessarily diabetes.High blood glucose during pregnancy is actually very different from real diabetes.Diabetes is mainly marked with passulatory dysfunction and hyperglycemia. If diabetes is not effective, it will cause more physical system damage.As long as the female hyperglycemia during pregnancy should pay attention to control the diet, adjust the diet structure in time, exercise appropriately, the blood glucose control is good, and the body can return to normal at the end of pregnancy.

According to the "Guidelines for Prevention and Control of Diabetes in China" (2017 edition), gestational diabetes should control blood sugar.Blood glucose target before pregnancy: On the premise of not halceizing, the blood glucose is as close as normal as much as possible on an empty stomach.Insulin therapy can be used to glycolize hemoglobin <7.0%, pre -meal blood glucose is controlled at 3.9 ~ 6.5 mmol/L, and blood sugar after meals is below 8.5 mmol/L.Therefore, it is recommended that diabetic patients with glycated hemoglobin <6.5%plan to be pregnant to reduce the risk of congenital abnormalities.

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Guide to use hypoglycemic drugs during pregnancy

For pregnant women with diabetes, there is another question: Should I stop the medicine during pregnancy?Because I often hear that "it is three -point poison", but if you stop taking hypoglycemic medicine, blood sugar may soar immediately.How to do it?Do you continue to take medicine or stop taking medicine?

The "Guidelines for Prevention and Control of Diabetes in China" (2017 edition) Suggestions for the use of hypoglycemic drugs during pregnancy are:

1. Insulin:

(1) Insulin types that can be used during pregnancy: including insulin: (short -acting, NPH, and premix human insulin).Insulin analogs include: dorsal winter insulin and preserved insulin.

(2) Insulin application scheme during pregnancy: For the elevated blood glucose of fasting and post -meal, it is recommended to be short -acting/fast insulin before three meals, NPH before bedtime.Due to the more significant characteristics of postprandial blood sugar caused by placental insulin resistance during pregnancy, prefabricated insulin applications have limitations and are not used as conventional recommendations.

2. Oral hypoglycemic drugs:

A number of head -to -head studies in the application of dual -metammer and insulin pregnancy confirmed the efficacy and safety of the application of dual -dual -dual -dual -duality during pregnancy. At home and abroadThe incidence of hypoglycemia is beneficial.However, due to the adaptation of the application of the second dual double -dual -dual -dual -dual -pregnancy pregnancy in my country, oral hypoglycemic drugs are still used for diabetes during pregnancy and still lack long -term safety data. This guidelines recommend that oral hypoglycemic drugs are not recommended during pregnancy.

It can be seen that patients with gestational diabetes should avoid using oral hypoglycemic drugs, and insulin therapy is used when blood sugar cannot be controlled by diet.Human insulin is better than animal insulin.Preliminary clinical evidence shows that it is safe and effective for the use of fast -acting insulin -like substances, asparagus, and sedative insulin during pregnancy.

Hylatic medicine cannot be stopped at will

Can’t eat at will either

The main point of the "Guidelines for Pregnancy with Diabetes Diagnosis and Treatment" proposed that most gestational diabetes pregnant women can meet the blood glucose through the intervention of lifestyle. Pregnant pregnant women who cannot meet the standards should first recommend insulin to control blood sugar.The most compliant insulin therapy scheme that is most consistent with the physiological requirements of gestational diabetes is: basic insulin combined with short short or short insulin before meals.Generally not recommend conventional premix insulin.Insulin is a macromolecular substance and does not affect the health of the fetus through the placenta. Diabetes patients should be treated with insulin treatment to maintain blood sugar near normal without low blood sugar, and can continue to use insulin to control blood sugar during pregnancy.

At present, the insulin (ultra -short -acting human insulin analogy) and di special insulin (long -acting insulin analog) have been approved by the former State Food and Drug Administration for pregnancy.

The insulin of the door winter is fast, the effect of the efficacy is short, and it has the strongest and best reduction of postprandial blood glucose. It is not easy to cause hypoglycemia and is used to control the level of blood sugar after meals.Ditecin can be used to control night blood sugar and pre -meal blood sugar.

The main points of the "Guidelines for Pregnancy Merge Diabetes Diagnosis and Treatment" also proposed that the potential risks of taking oral hypoglycemic drugs (dual -dual -dual -dual -binocobee) for pregnant women who consider a large amount of insulin or refusing to use insulin are considered.Blood glucose itself is harmful to the fetus.Therefore, on the basis of informed consent, some gestational diabetes pregnant women can use it with caution.

It can be seen that patients with gestational diabetes can neither stop the medicine or take medicine at will. Under the reasonable guidance of a specialist, they should seek reliable and reasonable treatment plan.

Tip

Which pregnant women are prone to gestational diabetes?

1. Older mother.

2. There is a history of gestational diabetes.

3. Once a huge child (weighing greater than 8 catties).

4. Obesity mothers with a weight of 20%of the standard weight, or blindly increase nutrition after pregnancy, eat too much, have too little activity, and increase too much weight.

5. There is a history of diabetes family, especially pregnant women with patients with gestational diabetes.

6. Early pregnancy -empty urine sugar is positive multiple times.

7. suffer from polycystic ovary syndrome.

8. There have been no obvious reasons for multiple abortion, fetal malformations or dead fetuses.

9. Fitters that have giving birth to newborn respiratory distress syndrome.

Text/Shi Shimin (Shanghai Practice Pharmacist Association)

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