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"description": "Гестационный сахарный диабет - один из вариантов диабета, который возникает или впервые диагностируется в период беременности. В основе заболевания лежит нарушение обмена углеводов различной степени, а именно снижение толерантности к глюкозе в организме беременной женщины. ",
"etiology": "<p>К основным факторам риска развития сахарного диабета беременных относят: </p>\r\n<ul>\r\n<li>Гормональная перестройка в организме беременной женщины; </li>\r\n<li>Аутоиммуные заболевания; </li>\r\n<li>Избыточный вес, ожирение; </li>\r\n<li>Вирусные инфекции на ранних сроках беременности; </li>\r\n<li>Курение, употребление алкогольных и наркотических веществ; </li>\r\n<li>Возраст беременной младше 18 и старше 30 лет; </li>\r\n<li>Сахарный диабет у ближайших родственников; </li>\r\n<li>Гестационный сахарный диабет в предыдущей беременности; </li>\r\n<li>Поликистоз яичников; </li>\r\n<li>Хроническое невынашивание (более 3 самопроизвольных абортов в I или II триместрах беременности); </li>\r\n<li>Многоводие; </li>\r\n<li>Мертворождение.</li>\r\n</ul>",
"pathogenesis": "<p>Заболевание развивается вследствие блокировки продукции достаточного количества инсулина гормонами, которые отвечают за правильный рост и развитие плода. При беременности организм женщины нуждается в большем количестве глюкозы, которая требуется не только для матери, но и для плода. Происходит компенсаторное увеличение продукции инсулина. Данные факторы становятся основной причиной гестационного диабета. </p>",
"diagnostics": "<p>Основным методом выявления гестационного диабета является исследование крови на определение уровня глюкозы. </p>\r\n<p>Также для определения функциональности поджелудочной железы и риска формирования гестационного диабета рутинно всем беременным на сроке 24-28 недель назначается пероральный тест на толерантность к глюкозе. </p>\r\n<p>Вначале сдается анализ крови из вены натощак, после чего женщина должна выпить 75 г глюкозы, разведенной в 300 мл воды. Спустя 2 часа забор крови повторяют. </p>\r\n<p>Диагноз «гестационный диабет» устанавливается, если первый показатель уровня глюкозы составляет более 7 ммоль/л, второй – более 7,8 ммоль/л. для его подтверждения беременной назначают еще один анализ в тот же день через несколько часов. </p>",
"treatment": "<p>Лечение сахарного диабета беременных включает: </p>\r\n<ul>\r\n<li>Диетотерапия с исключением продуктов, содержащих быстрые углеводы: кондитерских изделий, крахмалистых овощей, жирных и жареных блюд, фаст-фуда, магазинных соусов, сдоб. Необходимо включать в меню нежирную рыбу и мясо, крупы, злаковые каши, макароны твердых сортов, овощи. Углеводы должны составлять 45% от ценности рациона, жиры – 30%, белки – 25%. </li>\r\n<li>Умеренные физические нагрузки - гимнастика, ходьба, плавание. Они позволяют поддерживать организм в тонусе, предупреждают чрезмерный набор массы тела, улучшают усвояемость глюкозы тканями. </li>\r\n<li>Инсулинотерапия. </li>\r\n</ul>",
"prevention": "<p>Профилактика гестационного диабета заключается в планировании беременности и контроле массы тела. Женщина должна правильно питаться, отказаться от вредных привычек. Обязательно следует придерживаться активного образа жизни, поскольку умеренные физические нагрузки позволяют уменьшить вероятность развития гестационного диабета. Важно, чтобы упражнения были регулярными и не доставляли беременной дискомфорта.</p>",
"clinical_picture": "<p>Гестационный диабет не имеет специфической симптоматики. Главным признаком патологии является увеличение концентрации глюкозы в крови, что до наступления беременности у женщины не наблюдалось. Данное нарушение чаще всего диагностируется у пациенток после 20 недели вынашивания.</p>\r\n<p>Дополнительно при гестационном диабете может наблюдаться чрезмерное увеличение массы тела пациентки (более 300 г в неделю), сильное чувство жажды, повышение суточного диуреза. Также больные жалуются на снижение аппетита, быстро возникающую усталость.</p>\r\n<p>Со стороны плода признаком развития гестационного диабета может стать быстрый прирост массы, неправильные пропорции частей тела, избыточное отложение жировой клетчатки. </p>",
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