Insulin resistance, a term that has been widely used in the field of diabetes, has also received more and more attention in pregnant women in recent years. So, what exactly does insulin resistance have on pregnancy?
1. What is insulin resistance?
Insulin resistance, also known as decreased insulin sensitivity, refers to the weakening of insulin's role in regulating blood sugar, which is a compensatory response of the body to excess energy.
2. Why does insulin resistance occur?
Obesity is the most common cause of insulin resistance, along with other causes such as glucocorticoids, antipsychotic drugs, etc.
3. What are the effects of insulin resistance on pregnancy?
1. Cause excessive androgens in women and follicular development disorders
The hyperinsulinemic state stimulates the ovaries and adrenal glands to secrete androgens, which act directly on oocytes.
2. Affect endometrial receptivity
Endometrial decidualization is essential for the establishment and maintenance of pregnancy, and the process of endometrial decidualization requires increased glucose intake, impaired glucose utilization
3. Cause immune coagulation abnormalities
When insulin resistance occurs, blood sugar is too high and overloaded, which can easily lead to obesity. as well as various metabolic problems, causing various inflammations, and at the same time,
4. Increased risk of complications during pregnancy
Patients with insulin resistance are prone to endocrine changes during pregnancy, and are prone to complications such as gestational diabetes and hypertension.
5. Affect the health of future generations
Insulin resistance occurs before and during pregnancy, neonates have increased complications, and are at increased risk of obesity, insulin resistance, and diabetes in adulthood.
4. How is insulin resistance diagnosed?
At present, there are four commonly used laboratory diagnostic methods (cut-off values):
1.空腹胰岛素≥15mlU/L；
2.空腹血糖(FPG)（mmol/L）/空腹胰岛素(FINS)（uIU/L）≤0.25
oral glucose tolerance test (OGTT) and insulin release test (INS):
①空腹胰岛素升高，≥15mlU/L；
(2) The insulin secretion curve was elevated, with a peak value of more than 10 times that of fasting;
3. Delayed insulin secretion, with a peak at the 120th or 180th minute; 180 minutes of insulin does not return to fasting value.
4. 胰岛素抵抗指数（HOMA-IR）≥2.69。 HOMA-IR=空腹胰岛素×空腹血糖/22.5，胰岛素以U/ml表示，血糖以mmol/L表示。
A result that meets any of these criteria is diagnostic of insulin resistance.
5. How is insulin resistance treated?
1. Lifestyle adjustment: improve dietary habits, increase dietary fiber intake, and reduce high-sugar and high-fat foods; , increase the body's metabolic rate, reduce weight; to maintain a good sleep schedule.
2. Weight control: Insulin resistance is closely related to obesity, and reducing body weight through diet modification and exercise can help improve insulin resistance. Weight loss of 5% to 10% can significantly improve insulin sensitivity.
3. Medications: For patients with insulin resistance, doctors may prescribe medications, such as biguanides (such as metformin), thiazolidinediones, etc., which can. The use of the drug should be done under the guidance of a doctor.
4. Blood glucose monitoring: For patients with insulin resistance, regular blood glucose monitoring is very important.
5. Blood pressure and blood lipid control: When combined with hypertension, hyperlipidemia and other diseases, it is necessary to actively control blood pressure and blood lipid levels to reduce the risk of cardiovascular disease.
6. Regular follow-up: Patients with insulin resistance need to go to the hospital for regular follow-up.
7. Psychological intervention: Maintain a good psychological state, reduce the pressure of life and work, and contribute to the treatment and intervention of insulin resistance.
Insulin resistance, as a common metabolic disorder, can be detected and intervened in time to reduce the adverse effects of insulin resistance on pregnancy.