A CAUSE FOR CONCERN IN PREGNANCY
By Cydne Kaelin
Gestational diabetes is a unique type of diabetes that occurs when a woman is pregnant. Approximately four percent of all pregnant women are affected by gestational diabetes. The disease is caused when the body is unable to properly process insulin, causing high levels of blood sugar, very similar to type 2 diabetes. It usually occurs during the second trimester, and often disappears after the child is born. Left untreated, gestational diabetes can cause harm to the fetus as well as to the mother.
If you are diagnosed, treatment includes special meal plans and regularly scheduled physical activity, which helps lower blood sugars. It may also include daily blood glucose testing and, if necessary, insulin injections. Work with your doctor, nurse practitioner, and other members of your health care team so that your gestational diabetes treatment can be adjusted as needed.
Following the prescribed treatment for gestational diabetes will help ensure a healthy pregnancy and birth, and a healthy baby. While gestational diabetes usually goes away after several weeks, it is important to remember that you have a higher risk of gestational diabetes with your next pregnancy and a greater chance of becoming diabetic later in life. One or two months post-pregnancy, get a blood glucose test to ensure that your gestational diabetes is in fact gone. It is important to exercise, minimize weight gain, and maintain a healthy diet full of vegetables, fruits and minimal fats to ensure that you remain in good health.
What Triggers Gestational Diabetes?
Gestational diabetes starts when a woman’s body is not able to make and use all the insulin it needs for pregnancy due to hormonal changes caused by pregnancy. During pregnancy, hormones from the placenta help the baby grow and develop. But thesesame hormones make it tougher for the woman’s body to use insulin, creating insulin resistance. In most cases, this isn’t a problem: as the need for insulin increases, the pancreas steps up its production. But when a pregnant woman’s pancreas can’t keep up with the insulin demand and blood glucose levels get too high, the result is gestational diabetes.
Babies Are Affected by Gestational Diabetes
High levels of blood glucose circulating to the fetus can cause unusually large, fat babies. This is a condition known as macrosomia. Extra blood glucose goes through the placenta, giving the baby high blood sugar levels. The baby’s pancreas in turn must make extra insulin to get rid of the blood glucose. Since the baby is getting more energy from the mother’s high glucose level than it needs to grow and develop, this excess energy is stored as fat. Babies with macrosomia face health problems of their own, including shoulder damage at birth (shoulder dystocia) because they are too large to fit through the birth canal. Because of the extra insulin made by the baby’s pancreas, newborns may develop very low blood glucose levels (hypoglycemia) at birth and are also at higher risk for breathing problems and jaundice. These babies also have an increased risk for obesity and type 2 diabetes as adults. Gestational diabetes has not generally been associated with birth defects.
How Does Gestational Diabetes Affect The Mother-To-Be?
Besides suffering symptoms of diabetes, women may need a cesarean section delivery to be performed if the baby is macrosomic. Expectant mothers are also at increased risk for preeclampsia, a serious condition characterized by significant increases in blood pressure. Women with gestational diabetes are at greater risk of developing Type 2 diabetes and high blood pressure later in life.
An Accurate Diagnosis Requires Testing
Pregnant women at risk for developing gestational diabetes should be tested between weeks 24 and 28; earlier if there are risk factors present, and especially if the condition was present during a previous pregnancy.
Who Is At Risk For Gestational Diabetes?
- Women over 25 years of age
- Has a family history of type
- Experienced gestational
diabetes during a previous
- Is overweight
- Had a previous pregnancy
resulting in unexplained
stillbirth or an infant with a
birth weight over 9 pounds
Expectant mothers who have gestational diabetes may experience increased thirst, tiredness, excessive urination and other symptoms similar to diabetes mellitus. Unfortunately, those same symptoms are normal for any pregnancy. As in prediabetes, gestational diabetes often has no symptoms at all. The woman’s blood sugar should be tested regularly by the prenatal medical team and at home, especially if she is considered at risk.