Diabetes Woes During Pregnancy

WOMEN'S HEALTH

Contrary to type 1 diabetes, gestational diabetes is not brought on by a deficiency in insulin, but rather by other hormones produced throughout pregnancy that may reduce the effectiveness of insulin – a condition known as insulin resistance

Gestational diabetes mellitus is a condition when a woman who did not have diabetes before pregnancy, develops the condition during pregnancy. In gestational diabetes mellitus (GDM), a hormone produced by the placenta interferes with the body's ability to use insulin properly. As opposed to being taken in by the cells, glucose accumulates in the blood.

Contrary to type 1 diabetes, gestational diabetes is not brought on by a deficiency in insulin, but rather by other hormones produced throughout pregnancy that may reduce the effectiveness of insulin – a condition known as insulin resistance. After childbirth, gestational diabetes symptoms go away.

Approximately five per cent of pregnancies result in GDM, though statistics can vary greatly depending on the criteria utilised and the demographics of the population. The symptoms of gestational diabetes in women are typically non-existent or mistaken for those of pregnancy. Most people learn that they have it when they go for a routine examination.

Cause of GDM

Although the causes of GDM are not known, there are some theories which suggest as to why this condition occurs. When you eat, your pancreas releases the hormone, insulin, which aids in the transfer of the blood glucose to your cells, where it is used by them as an energy source. The placenta produces hormones throughout pregnancy that cause the blood glucose levels to rise. The pancreas can typically produce enough insulin to deal with it. However, GDM develops if your body is unable to produce enough insulin or stops utilising it as it should.

Risk Factors of GDM

Although any woman can develop GDM during pregnancy, the following are some factors that may raise the risk:

• Obesity or overweight

• Family history of diabetes

• Having given birth previously to an infant weighing greater than nine pounds

• Age (women who are older than 25 are at a greater risk for developing GDM than younger women)

• Race (women who are African-American, American Indian, Asian American, Hispanic or Latino, or Pacific Islander have a higher risk)

• Prediabetes, also known as impaired glucose tolerance

Although elevated urine glucose is frequently included as a risk factor, it is not thought to be a reliable sign of GDM.

Diagnosis of GDM

Typically, gestational diabetes develops in the second trimester. Women with diabetes risk factors should be screened for undetected type 2 diabetes at their initial prenatal appointment.

At 24 to 28 weeks of gestation, GDM testing should be done on pregnant women who are not known to have diabetes. Six to twelve weeks after giving birth, women with diagnosed GDM should be checked for persistent diabetes. Additionally, it is advised that women with a history of GDM receive lifelong screenings for the onset of diabetes or prediabetes, at least once every three years.

Treatment of GDM

The doctor will choose a specific GDM plan according to the following factors:

• age, overall health, and medical history

• extent of the disease

• tolerance for specific medications, procedures or therapies

• expectations for the course of the disease

• opinion or preference of the patient

The goal of GDM treatment is to maintain normal blood glucose levels. Treatment may include special diet, exercise, daily blood glucose monitoring and insulin injections. The risk for gestational diabetes can be lowered by eating a healthy diet, staying active and losing extra weight before pregnancy.

Effects on the baby

Most GDM complications can be controlled and avoided. Controlling blood sugar levels carefully as soon as diabetes is diagnosed is essential for prevention. If you and your doctor keep your blood sugar under control while you have GDM, your baby will probably be healthy. During labour, blood glucose is routinely checked. In order to avoid the baby's blood sugar from dropping too low after delivery, insulin may be administered to the mother to maintain her blood sugar in a normal range. Doctors will check the blood sugar level of your new-born immediately after delivery. Until it returns to normal, they might need to receive glucose through intravenous therapy if it is low. But there are some risk factors too. Your baby might be at risk of excessive birth weight, early pre-term birth, serious breathing difficulties, low blood sugar, obesity and type 2 diabetes in later life, and still birth. The mother also stands a risk of high blood pressure and future diabetes.

Maintaining a healthy diet and lifestyle lowers the risk of GDM. Ask your doctors and plan your treatment accordingly.

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