Gestational diabetes mellitus (GDM): the danger of a “sweet” pregnancy. Consequences for the child, diet, signs. Diabetes mellitus in pregnant women during childbirth The concept of gestational diabetes

Childbirth with diabetes is determined individually, taking into account the characteristics of the course of the disease, its severity, degree of compensation and functional state of the developing fetus, as well as the presence of obstetric complications.

Today's level of medical development makes it possible to give birth with diabetes mellitus types 1 and 2 without transmitting the disease to the developing fetus. The risk of transmitting the disease to a child if only a woman has type 1 diabetes is 2%, and if the father has the disease, the risk of developing the disease increases to 5%. With diabetes mellitus type 1 or 2 in both parents, the probability of developing the disease in a newborn increases to 25%.

A pregnant woman with type 1 and type 2 diabetes mellitus should approach pregnancy planning responsibly. This is due to the fact that when a pregnant woman with diabetes carries a fetus, changes occur in the body that worsen the condition of the expectant mother’s body, and this can negatively affect the health of the child.

Such changes could be:

• postpartum general deterioration in a woman’s health;
• complications may arise that make it impossible to carry the child to term;
• During the course of intrauterine development, a child can develop various congenital pathologies.

A woman with diabetes should plan and prepare for pregnancy 3-4 months before conception. Such long-term preparation is needed in order to compensate for the effect of the developing disease on the fetus.

If the pregnancy proceeds normally, and the disease is in the compensation stage, then childbirth with diabetes does not cause problems, delivery occurs on time.

Those women who gave birth with diabetes know that if diabetes is not fully compensated, complications may develop that force the use of inducing labor for diabetes.

If you have type 1 or type 2 diabetes, a pregnant woman needs to pre-select a medical institution that has a specialized maternity hospital. While in such an institution, a pregnant woman is under the close supervision of an endocrinologist; if necessary, the woman is assisted by other medical specialists.

Anyone who has given birth with diabetes knows that both before and after the birth of a child, it is necessary to regularly monitor the level of sugar in the body.

What is the danger of diabetes for fetal development?

Diabetes mellitus and pregnancy are dangerous because as the disease develops, the likelihood of various defects in the fetus increases. This is a consequence of the fact that the developing fetus receives carbohydrate nutrition from the mother and, at the same time as the glucose consumed, the fetus does not receive the required amount of the hormone insulin, despite the fact that the developing child’s own pancreas is undeveloped and unable to produce insulin.

In type 1 and type 2 diabetes, a constant state of hyperglycemia provokes a lack of energy, resulting in improper development of the child’s body.

The fetus's own pancreas begins to develop and function in the second trimester. If there is an excess of sugar in the mother’s body, the pancreas of the fetus, after formation, begins to experience increased stress, as it produces a hormone that should not only utilize glucose in its own body, but also normalize the mother’s blood sugar level.

Increased insulin production provokes the development of hyperinsulinemia. Increased insulin production leads to hypoglycemia in the fetus; in addition, the fetus experiences respiratory distress and asphyxia.

A very low sugar content in the fetus can lead to death.

Sugar level

Pregnant women have a tendency to increase the amount of sugar in their blood plasma after eating. This situation is due to the acceleration of the absorption of sugars and an increase in the time of absorption of consumed food. This is due to a decrease in gastrointestinal activity. If there are disturbances in the functioning of the pancreas during pregnancy, a woman may develop gestational diabetes.

To identify a predisposition to this type of disease, a glucose tolerance test is performed during the first dose. If the test results in a negative result, the test should be repeated between 24 and 28 weeks of pregnancy.

If there is a positive test result, the doctor is obliged to monitor the pregnant woman throughout the entire pregnancy, taking into account the development of any type of diabetes mellitus in the body. The tolerance test should be carried out after an 8-14 hour fast, during which only water is allowed. The best time to test is in the morning.

At the same time as the glucose tolerance test, blood is taken from a vein for laboratory testing. After taking venous blood, the amount of sugar in the plasma is immediately determined using a laboratory method.

If the analysis determines blood sugar to be more than 11.1 mmol/l, then the woman is diagnosed with gestational diabetes.

Treatment of pregnant women and childbirth with type 1 diabetes mellitus

To compensate for gestational diabetes, a special diet is used. If it is necessary to introduce dietary nutrition, it should be remembered that the energy value of foods consumed by a pregnant woman cannot be reduced sharply. Canceling the intake of high-energy foods containing large amounts of carbohydrates should be carried out gradually.

Proper nutrition for a pregnant woman involves consuming small amounts of food at one time. It is better if food consumption becomes fractional - five to six times a day. Light carbohydrates should be excluded from the diet and the consumption of fatty foods should be reduced.

This is due to the fact that light carbohydrates can sharply increase blood sugar, and fats with a lack of insulin lead to the formation of ketone bodies, which provoke poisoning. A pregnant woman's diet must include fresh fruits and vegetables, as well as herbs.

A woman must constantly monitor sugar in her body and adjust the dose of insulin depending on this indicator. If following a diet does not reduce blood sugar levels, the doctor monitoring the pregnancy will prescribe therapy with insulin.

Tablets to lower blood sugar are not recommended during this period, as they can harm the fetus. To correctly select the dose of insulin during therapy, the pregnant woman should be hospitalized in the endocrinology department of the medical institution.

If a woman is diagnosed with gestational diabetes, then the best option is a natural birth at a period not exceeding 38 weeks. Induction of labor should take place under the constant supervision of a doctor over the pregnant woman’s body. It is necessary to stimulate labor after examining the woman’s body and the fetus.

A child born at this stage tolerates the process of physiological childbirth well.

If insulin is used to treat gestational diabetes, the endocrinologist after childbirth determines the need for further use of insulin therapy.

Those women who gave birth with diabetes know that a cesarean section, which replaces childbirth, is performed only in cases where there are obstetric indications for this.

Such indications may be the likelihood of hypoxia, developmental delay or other complications.

If you have diabetes, both childbirth and the entire pregnancy process should take place under the strict supervision of an endocrinologist.

The question of what time to choose for delivery is decided by the doctor individually and depends on several factors, the main ones being:

• severity of the disease;
• the degree of compensation used;
• condition of the developing child;
• presence of identified obstetric complications.

Most often, due to an increase in the number of various disorders, delivery is carried out at 37-38 weeks.

The optimal option is the method of delivery in which the child is born through the mother’s natural birth canal. During the birth process, the mother's blood glucose level is measured every two hours. This is required in order to adequately decompensate diabetes mellitus using insulin therapy.

The question of spontaneous birth is accepted if the fetus is cephalad and the woman has a pelvis of normal size, as well as in the absence of complications in the fetus and mother caused by the presence of diabetes mellitus. A caesarean section is performed if the pregnant woman is carrying her first child and the fetus is large in size and the woman has a small pelvis.

When giving birth with type 1 diabetes, glycemic control is mandatory; the purpose of this procedure is to reduce the likelihood of a hypoglycemic state, up to. During labor, active muscle work occurs, which leads to a sharp decrease in the amount of sugar in the blood plasma without the use of drugs containing insulin.

Carrying out resuscitation measures for a newborn

The basic principle of resuscitation for a newborn depends on its condition, degree of maturity and methods used during delivery. In newborns who were born from mothers with diabetes, very often there are signs of diabetic fetopathy, which can occur with varying frequency in various combinations.

Children born with signs of diabetic fetopathy require special care. During the first time after birth, such newborns require special monitoring of breathing, glycemia, acidosis and possible damage to the central nervous system.

The basic principles of resuscitation measures are:

1. Prevention of the development of hypoglycemia.
2. Carrying out dynamic monitoring of the child’s condition.
3. Carrying out syndromic therapy.

In the initial neonatal period, newborns who have a very difficult time adapting to the world around them. Severe adaptation is often accompanied by the development of disorders such as conjugation jaundice, toxic erythrema, significant loss of body weight and its slow restoration to normal parameters. The video in this article will help you understand the rules of sugar.

Indication for caesarean section in a pregnant woman with diabetes mellitus are: severe gestosis, polyhydramnios, abnormal position of the fetus, any vascular complications of the expectant mother, progressive fetal hypoxia, labile course of diabetes mellitus, deterioration of the general condition of the mother. Caesarean section can be either planned (sometimes the woman knows about it from the first months of pregnancy) or emergency.

TO elective surgery prepared in advance and carried out at the optimal gestational time. Usually a woman gives birth at 38 weeks, but according to indications, doctors may insist on surgery even at 32 weeks. Sometimes, despite all the measures taken, complications cannot be avoided. Approximately 60% of all births due to diabetes mellitus end in caesarean section. But today’s medical advances make it possible, therefore, to preserve the life and health of the child himself and to preserve the mother’s potential to raise the baby and give him another brother or sister.

Indication for emergency Carrying out a cesarean section is usually a complication during childbirth. This includes weakness of contractions, disproportion in the size of the pelvis of the mother and fetus, increasing hypoxia, and deterioration of the mother’s condition. During the operation, doctors continuously monitor glucose levels and maintain them within limits, conducting constant insulin therapy.

Anesthesia It can be epidural and general. The duration of the operation itself is on average one hour. Blood loss is approximately 800 ml. The operation is not difficult if the doctors are sufficiently qualified. The incision is usually made transversely, this way the vessels are less damaged. A newborn baby, even with sufficient or excess body weight, is considered premature and is under constant medical supervision and special care. In the postoperative period, measures are taken to speed up the healing of the sutures (usually the sutures are removed on the 7th day), and insulin therapy is adjusted. Breastfeeding for a mother with diabetes is not contraindicated and is highly desirable. Since during lactation there may be a significant decrease in the need for insulin, it is necessary to discuss the specifics of the diet with your doctor.

The onset of the next, necessarily planned, pregnancy after a cesarean section, it will be possible no earlier than 2 years, when the suture on the uterus is securely healed. Even in the maternity hospital, doctors will definitely advise the mother on reliable and suitable means of contraception. Sometimes, even on the eve of the operation, doctors, according to indications, can offer the woman sterilization(tubal ligation). As a result, after thinking carefully and consulting with her husband, a woman can reliably protect herself from an unplanned pregnancy and devote herself entirely to the joys of motherhood and marriage. But making any decisions remains with the woman.

In perinatal practice, births with GDM (gestational diabetes mellitus) are rare. This type of disease occurs spontaneously and resolves after delivery. Diabetes can make itself felt at 15-17 weeks of pregnancy. Against the background of hormonal changes, metabolic reactions in a woman’s body are disrupted, which causes the occurrence of sugar disease.

Concept of gestational diabetes

Gestational diabetes occurs during pregnancy and is considered a prediabetic condition. It occurs due to a decrease in the sensitivity of one’s own cells to insulin. At the beginning of the first trimester, a pregnant woman is tested for glucose tolerance. If the result is negative, a repeat test is required at 25-28 weeks. With a second pregnancy, the risk of relapse is 80%.

The breakdown of tolerance tests to determine GDM is presented in the table:

Causes and symptoms

Medicine has not established the exact cause of gestational diabetes, but there are known unfavorable factors that can cause the disease:

• heredity;
• obesity;
• the age of the woman in labor is over 35 years;
• hormonal disorders;
• complications in previous births;
• bad habits (smoking, drinking alcohol);
• bearing a large fetus.

Symptoms are not always an effective method of identifying the disease, since all of the above can be present in an absolutely healthy woman. With gestational diabetes, a pregnant woman experiences increased fatigue, blurred vision, dry mouth, and debilitating thirst even in the cold season. Frequent urge to urinate. In the later stages, frequent urge to go to the toilet is typical for pregnant women, but in the early stages, such a symptom should alert you.

During diabetes mellitus, a pregnant woman should strictly adhere to the doctor's recommendations.

In case of gestational diabetes mellitus, a pregnant woman must strictly follow the doctor’s recommendations, otherwise the consequences for both the child and the mother are inevitable. Gestational diabetes can negatively affect the baby's health. The pancreas adapts to function within the glucose levels produced by the mother's body. When the sugar content is high, an excess amount of insulin is produced, this process is called. After childbirth, there is a risk of a sharp drop in sugar. There is also a high probability of having a large baby, in which case the delivery ends with a caesarean section.

The main danger for the mother is the development of type 2 diabetes after childbirth. During pregnancy, the load on all organs increases, which is complicated by increased sugar. As a result, kidney failure may occur. Also, with diabetes in pregnant women, infection of the genital tract is possible due to disruption of the natural microflora and physiological decrease in immunity, which leads to infection of the fetus and premature birth.

Gestational diabetes is high blood sugar in women who are pregnant. It is rare and usually disappears on its own after childbirth. But a pregnant woman is at risk of developing regular diabetes in the future.

Clinical picture

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What is the danger of pathology?

Gestational diabetes requires strict adherence to all recommendations of the attending physician. Otherwise, the disease will negatively affect both the development of the baby and the health of the mother herself.

The activity of a woman’s pancreas is disrupted, since the organ functions fully only when the required amount of glucose in the blood is produced by the body. If the sugar level increases, excess insulin is produced.

During pregnancy, all of a woman’s internal organs are subject to stress, and with high glucose levels, their work becomes more difficult. This has a particularly negative effect on the functioning of the liver: the disease leads to liver failure.

Diabetes of gestational etiology undermines the immune system of the expectant mother, which is already weakened. This causes the development of infectious pathologies that adversely affect the life of the fetus.

After the baby is born, glucose levels can drop sharply, which also affects the body. The main danger of gestational diabetes after childbirth is the high risk of developing type 2 diabetes.

During pregnancy, any woman can get GDM: tissues become less sensitive to insulin produced by the body. As a result, insulin resistance begins, in which the content of hormones in the blood of the expectant mother increases.

The placenta and baby need a lot of sugar. But its active use adversely affects the process of homeostasis. The pancreas begins to produce excessive insulin to make up for the glucose deficiency.

Due to the high content of the hormone, organ cells fail. Over time, the pancreas stops producing the required level of insulin, and gestational diabetes develops.

After the baby is born, the mother’s blood sugar levels return to normal. But this fact is not a guarantee that the disease will not overtake the woman in the future.

be careful

According to WHO, every year 2 million people die from diabetes and its complications around the world. In the absence of qualified support for the body, diabetes leads to various kinds of complications, gradually destroying the human body.

The most common complications are: diabetic gangrene, nephropathy, retinopathy, trophic ulcers, hypoglycemia, ketoacidosis. Diabetes can also lead to the development of cancer. In almost all cases, a diabetic either dies fighting a painful disease or becomes a real disabled person.

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Risk factors during pregnancy

• Increased glucose levels in urine.
• Failure in carbohydrate metabolism.
• Excess body weight, accompanied by metabolic disorders.
• Age over 30 years.
• Heredity – the presence of type 2 diabetes mellitus in close relatives.
• Preeclampsia, severe toxicosis, observed in previous periods of pregnancy.
• Pathologies of the heart and blood vessels.
• Gestational diabetes in the past.
• Miscarriage, stillbirth of a child or a large baby whose body weight is over 4 kg.
• Congenital malformation of the nervous system, blood vessels, heart in previous children.

If a woman falls into at least one of these categories, then the gynecologist carries out special monitoring of her condition. The patient will need frequent monitoring of her blood sugar levels.

Signs and symptoms

It is not always possible to determine gestational diabetes in a pregnant woman based on symptoms. This is due to the fact that manifestations of pathology can also occur in a healthy woman.

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When the disease occurs, the patient is worried about rapid fatigue, blurred vision, a feeling of dry mouth, and a constant desire to drink in any weather conditions.

Ladies also complain of an increased urge to empty the bladder. Typically, this symptom plagues pregnant women in the later stages, but with diabetes it also occurs in the first trimester.

Diagnostics

To detect gestational diabetes, your doctor will order a laboratory blood test to check your glucose levels. Analysis is carried out every 3 months. Normal blood sugar is no more than 5.1 mmol/l.

If the study shows a value greater than this value, then the doctor prescribes a glucose tolerance test. For this purpose, blood is taken from the patient in the morning on an empty stomach, then given a glass of sweet water to drink, and the test is performed a second time an hour after the first test. This diagnosis is carried out again after 2 weeks.

How is the treatment done?

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If the diagnosis of gestational diabetes mellitus in a pregnant woman is confirmed, then treatment is carried out in a comprehensive manner. Therapy is carried out until the baby is born.

The pathology control plan includes:

• Dietary nutrition is the main method of treatment.
• Moderate physical activity. Doctors consider long walks to be the most suitable option.
• Daily monitoring of blood glucose levels.
• Systematic laboratory testing of urine.
• Monitoring blood pressure.

For most women carrying a child, following a diet is enough to get rid of the disease. If the patient follows the recommendations of the attending physician, then it is possible to do without the use of medications.

If dietary nutrition does not cope with the pathology, then the doctor prescribes insulin therapy. The hormone is administered through injections. Drugs that lower blood sugar levels are not prescribed during pregnancy, as they can harm the fetus.

Diet food

Successful therapy for gestational diabetes is not complete without adherence to a diet - this is the basic rule of treating pregnant patients. Food should be varied and balanced. It is prohibited to sharply reduce the energy value of the menu.

Doctors advise eating 5-6 times a day and in small portions. Most food is taken in the first half of the day. It is necessary to prevent the feeling of hunger.

It is necessary to remove carbohydrates that are easily digestible from the diet. Such foods include pastries, cakes, buns, bananas, and grapes. Eating these foods quickly increases your blood sugar levels. You will also have to give up tasty but unhealthy fast food - fast food.

You will also need to minimize the consumption of butter, mayonnaise and other high-fat foods. The percentage of saturated fat intake should not exceed 10. Sausage, pork, and semi-finished products should be excluded from meat dishes. Instead, it is recommended to use low-fat varieties - beef, poultry, fish.

The daily menu should contain foods containing a large amount of fiber: bread, cereals, green vegetables, herbs. In addition to fiber, they contain many vitamins and microelements necessary for the functioning of the human body.

How does childbirth occur with GDM?

After examining the woman, the doctor determines how childbirth should proceed with gestational diabetes mellitus. There are only two options: natural delivery and caesarean section. The choice of technique depends on the stage of the pathology in the pregnant woman.

If labor began unexpectedly or stimulation was performed, then the birth of a child naturally is possible only in the following cases:

• The size of the baby's head coincides with the parameters of the mother's pelvis.
• The child's body weight does not exceed 4 kg.
• The correct presentation of the fetus is upside down.
• The ability to visually observe the condition of the fetus during birth.
• The baby does not have severe hypoxia or congenital malformations.

Women suffering from gestational diabetes mellitus during pregnancy face several problems: their amniotic fluid breaks prematurely, labor begins prematurely, and during the birth of the child, the mother feels severe weakness in her body, which prevents her from making efforts in the process of pushing.

If a woman suffers from diabetes during pregnancy, she should be in a hospital under the supervision of doctors. Usually, after birth, the baby does not need an insulin injection. But the child should be kept under the supervision of doctors for 1.5 months and his tolerance to sugar should be checked, which will make it possible to find out whether the disease has caused harm to the baby.

Prevention

It is almost impossible to completely protect yourself from the occurrence of gestational diabetes and its complications during pregnancy. Often expectant mothers who are not even at risk suffer from pathology. The most important preventive measure is following the rules of nutrition during pregnancy.

If in the past a woman has already had diabetes while expecting a baby, then the next child must be planned. It is allowed to give birth no earlier than 2 years after the last birth. To prevent a recurrence of gestational disease, it is necessary to start monitoring your body weight 6 months before conception, exercise daily, and regularly undergo laboratory tests for blood glucose levels.

You should not take medications without a doctor's recommendation. Some drugs, when taken arbitrarily, can lead to the development of the pathology in question.

Gestational diabetes mellitus can lead to adverse consequences for a pregnant woman and her baby. Therefore, it is extremely important to plan your pregnancy and follow all doctor’s recommendations.

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More than 400 million people in the world suffer from diabetes. And these numbers are growing steadily. Therefore, the possibility of childbearing with this disease is becoming a global problem of our time.

Childbirth with diabetes

Just a few decades ago, diabetes was a clear contraindication to pregnancy. Now doctors are not so categorical. But it is important to understand that carrying a child with such a disease is a serious burden on the body of the expectant mother. It is necessary to supply enough insulin to yourself and your child. Diabetic women often experience miscarriages and fetal death in the womb.

It is worth preparing for conception 4-6 months in advance:

• get tested;
• maintain normal blood glucose levels for a long time. You need to measure your sugar even at night;
• prevent the development of hypertension;
• engage in moderate physical activity;
• strictly follow the diet, exclude quickly digestible carbohydrates from the diet.

Diabetes mellitus is usually divided into 3 types:

• Type 1 – requires constant supply of insulin.
• Type 2 – often manifests itself in adulthood (after 35 years). Sugar levels are adjusted through diet.
• Type 3 – gestational. Acts as a complication during pregnancy.

Women with type 2 diabetes, for obvious reasons, do not face the problem of bearing a child. The question is more relevant for insulin-dependent people of childbearing age. The gestational type is not dangerous and ends with pregnancy. Despite medical progress, not every woman diagnosed with diabetes is allowed to give birth.

• if both parents suffer from this disease;
• with vascular complications that develop due to diabetes;
• with irregular blood glucose levels;
• people with type 2 diabetes;
• with a negative Rh factor;
• for tuberculosis;
• renal failure;
• for gastrointestinal diseases (the hormone insulin is produced in the pancreas).

The expectant mother usually knows that she has diabetes. But in some cases, the disease first appears only during pregnancy.

Women who have:

• severe heredity (diabetic parents);
• blood sugar has already been detected previously;
• twin brother (sister) suffers from diabetes;
• overweight;
• there were repeated miscarriages;
• there are children born large (weighing more than kg), with polyhydramnios;

Pregnant women always undergo clinical blood tests. Diabetes will be detected in any case. Attention! Don’t hesitate, register with the clinic as early as possible.

The course of pregnancy with diabetes

Successful delivery with such a problem is possible only with total self-control, which should begin even before the formation of the fertilized egg. Now measuring blood sugar has become much easier. Modern portable glucometers are available to everyone.

In the first three months, there is a temporary decrease in the need for insulin, as the body becomes more sensitive to the hormone. This is a relatively calm time, without complications.

In the second trimester, blood sugar rises. Hyperglycemia occurs, which, with insufficient insulin supply, leads to coma.

In the final weeks of pregnancy, sugar levels drop. Insulin therapy is reduced by 20-30%. Diabetes during pregnancy is dangerous due to complications:

1. polyhydramnios;
2. early birth;
3. gestosis;
4. hypoxia;
5. urinary tract infections;
6. pathologies of fetal development;
7. miscarriage.

The doctor’s task is to minimize risks.

Childbirth with type 1 diabetes

With this type of disease, sudden changes in blood sugar levels occur. The doctor is obliged to react in time and adjust the insulin dose. A woman in labor must be admitted to a hospital for preservation at least 3 times, where doctors monitor the condition of the pregnant woman and provide treatment.

Up to 22 weeks – doctors conduct a thorough examination and decide whether to continue/terminate the pregnancy.

At 22-24 weeks - at the stage of increasing need for sugar correction.

At 32-34 weeks, delivery tactics are considered.

A woman is required to have self-discipline and strict adherence to a diet. The longer normaglycemia is maintained before pregnancy, the easier it will be to bear the baby. Complications cannot be 100% avoided, but the risk of their development can be significantly reduced. With high-quality compensation for diabetes, a woman is allowed to give birth on her own at a natural time. In case of insufficient replenishment of sugar, complicated pregnancy, labor is stimulated at a period of 36-38 weeks. Severe complications are an indication for caesarean section.

Physiological birth is possible if:

• the disease is well controlled;
• no obstetric complications (narrow pelvis, uterine scars, etc.);
• the fruit weighs no more than 4 kg;
• Doctors have the technical capabilities to monitor the condition of the mother and child during delivery.

Childbirth with gestational diabetes

Due to hormonal changes, some women develop gestational diabetes at 15-17 weeks after conception. Glucose tolerance is detected in a pregnant woman in the first three months.

The development of the disease is promoted by:

• heredity;
• hormonal imbalances;
• large fetal weight;
• increased weight;
• age.

This type of diabetes often goes away on its own after childbirth. But this does not mean that gestational diabetes is safe. Excessive amounts of insulin cause negative consequences for the fetus. Therefore, it is important to strictly follow the recommendations of your doctor. Childbirth with GDM takes place as planned. After delivery, the mother is at risk of developing type 2 diabetes. Every fourth woman faces this problem.

Every woman dreams of bearing and giving birth to a healthy child. With diabetes, achieving this goal becomes much more difficult. It requires incredible effort, endurance, mental attitude and self-discipline.

The expectant mother should:

• plan your pregnancy in advance;
• act strictly according to the doctor’s instructions, and not on the advice of mommies from the forum;
• maintain a diet;
• Don’t be lazy to measure your blood sugar 10 times a day.

Then the pregnancy will proceed without complications, and childbirth will be easy, without surgical intervention. Today's medicine gives a unique chance to women with diabetes. It shouldn't be missed.

about the author

My name is Andrey, I have been a diabetic for over 35 years. Thank you for visiting my site Diabay about helping people with diabetes.

I write articles about various diseases and personally advise people in Moscow who need help, because over the decades of my life I have seen many things from personal experience, tried many remedies and medicines. In the current 2020, technology is developing very much, people do not know about many things that have been invented at the moment for a comfortable life for diabetics, so I found my goal and help, to the best of my ability, people suffering from diabetes to live easier and happier.