Insulin during pregnancy: effects on the fetus and consequences for the child

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

Insulin is a hormone produced by Langerhans cells in the pancreas. It is needed to reduce hyperglycemia, which is observed in diabetes. When carbohydrates are consumed with food, sugar always rises. It needs insulin to be absorbed. Is insulin safe during pregnancy? You will find the answer to this question in the article.

About illness

Diabetes is a disease that greatly 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 control it so that it is always normal. Else:

1. There is a risk of miscarriage.
2. Complications of diabetes may occur.
3. Probably getting an infection after giving birth.
4. Polyhydramnios develops.
5. Preeclampsia appears.

Baby too at risk from mother's diabetes:

1. Increased risk of death in childbirth.
2. Complications on organs.
3. appearsrisk of developing diabetes.
4. Macrosomia develops - excessive growth of the baby in the womb.
5. Congenital anomalies 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 reviewing the anamnesis.

Basic Problem

In diabetes, tissue cells are insensitive to insulin and insulin accumulates in the blood, glucose is not absorbed, and metabolism slows down. This condition is called insulin resistance or type 2 diabetes. In comparison, type 1 diabetes is considered an insulin-dependent disease.

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, a hereditary factor, malnutrition.

Although there are several forms of the disease, the main symptom is hyperglycemia. Diabetes can develop at any age, including during pregnancy. Because of this, the observation of a woman is complicated and it is necessary to take measures, the supervision of a doctor.

Is it possible to inject insulin during pregnancy, the doctor must decide. If the disease appeared on the 20th week of carrying the fetus, insulin resistance arose, then it is called gestational diabetes. When an ailment is detected before pregnancy, it is calledpregestational.

Types of pathologies

Pregestational diabetes is called type 1 and type 2 diabetes in pregnant women who had this disease before pregnancy. There are 1 and 2 degrees of the disease. The doctor, based on the state of he alth, prescribes a diet, medicines. Diabetes of various types is complicated by impaired functioning of the kidneys and even the brain.

SD is also divided into:

• compensated - considered to be managed;
• subcompensated - has severe symptoms;
• decompensated - the disease is severe.

GDM usually occurs in the 2nd half of pregnancy. This is detected by tests, although the symptoms are often ignored. The disease manifests itself in the form of constant thirst, frequent urination. To understand whether to inject insulin during pregnancy, you should familiarize yourself with the consequences of its use.

Effect on the body of a pregnant woman

What are the consequences of insulin during pregnancy? Probably the appearance of allergies due to hypersensitivity. This is usually manifested by a skin ailment, bronchospasm. There may be vision problems. Sometimes the body produces antibodies to the drug. At the beginning of taking insulin, there is a danger of swelling, which disappears after a few days. In this case, a doctor's consultation is necessary.

Insulin during pregnancy should be prescribed by a doctor. With hyperglycemia, there is a violation of blood circulation, red blood cells increase in the composition of the blood. Vessels become fragile and lose their elasticity. There is a violation inthe work of the kidneys, the clarity of vision noticeably decreases, a veil appears before the eyes.

The risk of coronary artery disease increases due to vascular damage. 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 pronounced in pregestational diabetes. The state of ketoacidosis is likely - with it, decay products of fatty acids accumulate in the blood.

Complications

Insulin during pregnancy is prescribed by the doctor to protect against complications. With diabetes, their risk increases 10 times. There is swelling, eclampsia and preeclampsia, kidney damage. Urinary tract infections, early birth are also likely. Puffiness is a common symptom of late toxicosis. First there is swelling of the feet, lower legs, then the abdomen, arms and face.

Complications include weight gain, frequent nighttime urination, kidney damage. With the progression of the process, the symptoms intensify. As a result, preterm labor may occur.

Effect on fetus

With pregestational diabetes, the child will have increased weight, which is considered a manifestation of fetopathy (this is the name of fetal ailments with deviations and malformations). From hyperglycemia in the mother, the pancreas in the child will work with a strong load. Therefore, he may enter a state of hypoglycemia.

Another complication is respiratory distress syndrome in children. When breathing, the alveoli stick together, because the child has little surfactant in the lungs -a component that protects the alveoli from sticking together.

If pregestational diabetes is diagnosed, the diet is effective. Avoid simple sugars. Fractional nutrition, moderate physical activity is necessary. Regular ultrasounds are also required.

If insulin is taken during pregnancy, what are the consequences for the baby? These children tend to get sick more often and have reduced immunity.

Indications

Insulin during pregnancy is prescribed if diet and exercise are ineffective. But why are these injections required? They allow you to maintain the 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. It is also prescribed for the detection of fetopathy in the fetus.

The scheme and dosage of insulin during pregnancy is individual, there is no single scheme. Sugar is measured and recorded 8 times a day - on an empty stomach in the morning and an hour after dinner. If you feel unwell, measure it at 3 o'clock in the morning. The norm for pregnant women is 3, 3-6, 6 mmol / l.

Women also need to be able to set the dose of insulin, acetone in the urine using test strips, measure blood pressure at home. To do this, it is advisable to keep a diary. If all this is difficult to do at home, then the work of the laboratory will help. Tests should be taken 2 times a day.

Who should I contact?

Insulin during pregnancy is prescribed for treatment in order tonormalize 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 decreased vision due to the detrimental effect on blood vessels. The laboratory donates blood for glycated hemoglobin.

Doses

Insulin dosage during pregnancy is determined based on blood sugar levels, 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 of it is 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 given as an injection or pump. If there is a caesarean section, then on the date of the operation, injections are not given and food is not given.

Insulin is administered only with high hyperglycemia - over 8 mmol / l. After childbirth, the dose is reduced by 2-3 times. After 4-5 days after that, prolonged insulin is used. It is allowed to be used for night administration.

Views

Which insulin to use during pregnancy? Must be prescribed by a doctor. It is divided by the beginning, peak, duration of action. Therefore, insulin is ultrashort, short, medium, prolonged. In diabetes during pregnancy, ultrashort insulin is desirable to choose.

There may still be a different origin of the substance. Insulin is human, whale, pig, cattle. During pregnancy, only 1 option is suitable. In Russia, a preparation based on bovine insulin is not used. According to the level of purification, insulin istraditional, monopeak, monocomponent. There are many drugs available, so the doctor should choose the right one.

Schemes of use are also 2 - basis-bolus and traditional. A he althy person has almost constant insulin - this is the basic concentration. The drug maintains the level with partial consumption and most of it remains in reserve. This is a food bolux. It is consumed when eating:

1. Long-acting insulin is used to provide basal concentration.
2. bolus concentration required after meals.

In the traditional program, the doses and times of administration are the same. Changes are rare. You need 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 each - short and medium action. The drug is injected into the abdomen, thigh, shoulder, using special syringes. But, according to reviews, insulin is not always prescribed during pregnancy.

Food

For the safety of the he alth of a woman and a child with diabetes, a special diet must be followed. Its purpose is to maintain blood sugar levels at the level that a he althy person has. The basis of the diet is to reduce the consumption of foods with carbohydrates. Since it is precisely because of them that interruptions in glycemia occur, it will not work to eliminate the disease with insulin therapy alone.

The daily calorie intake should be 1800-2400 kcal. The low-carbohydrate diet consists of:

• fat – 30%;
• protein – 25%;
• carbs – 45%.

It is important to follow the rules of nutrition:

1. Remove sugar by replacing it with a sweetener or non-caloric sweetener.
2. Requires fractional meals - in small portions 6 times a day.
3. Inject insulin before meals.
4. Need to give up alcohol.
5. Consider prohibited and permitted foods.
6. Do not eat food with chemical additives.

Reception denied:

• sugar;
• alcohol;
• pastry;
• honey, jam;
• fat dairy;
• sweet soda;
• soups with meat or fish broth;
• sausages;
• hams;
• bacon;
• pasta;
• chocolate.

But the diet should consist of:

• soups with vegetable broth;
• vegetables;
• fruits and dried fruits;
• berries;
• greenery;
• nuts;
• legumes;
• porridge;
• water;
• mineral still water;
• juices;
• smoothies.

After childbirth

After the baby is born, insulin is cancelled. It is not dangerous for a woman and a baby. Within 3 days, a blood test for sugar is required. After 8-12 weeks, a glucose sensitivity test should be done.

Need to normalize food. Walking should be introduced gradually. If you are overweight, you need to go on a weight loss diet. The pediatrician must be notified that during pregnancy the woman took insulin forcorrection of blood sugar. This will allow her to prescribe preventive measures for the child.

Recommendations

If you had gestational diabetes during pregnancy and then passed, it is still important to monitor the condition. Because there is a risk of developing type 2 diabetes. The gestational appearance of the disease is evidence of poor insulin sensitivity of the pancreas.

It turns out that she is already functioning at the limit of her capabilities. During pregnancy, the load on it increased, so the functions of the gland failed. She is unable to produce the required amount of insulin, and her glucose rises above the upper limit of normal.

With age, there is an increase in insulin resistance of tissues, 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 follow preventive measures.

After giving birth, it is advisable to re-test for diabetes mellitus in 6-12 weeks. If everything is normal, then the check should be performed after 3 years. It is advisable to take a blood test for glycated hemoglobin for this.

The best way to prevent disease is a carbohydrate-restricted diet. This means that the emphasis should be on protein foods and natural he althy fats. At the same time, it is better not to eat foods rich in carbohydrates, because they increase the likelihood of diabetes. A low-carb diet is forbidden during pregnancy, but is great after breastfeeding.

Physicalexercise is also a preventive measure for type 2 diabetes. You just need to choose the option of physical activity that is more suitable. Swimming, jogging, aerobics have an excellent effect on human he alth.

Glycemic norms

In the morning on an empty stomach, the level should be 3, 3-5, 3 mmol / l, 2 hours after eating - 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 prohibitions on taking drugs, except for 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 be constantly observed by him.

Thus, you can inject insulin during pregnancy or not, the specialist decides. Only a doctor can determine the dosage and duration of such therapy.