Gestational Diabetes
Diabetes can occur temporarily
during pregnancy. This condition is commonly known as gestational
diabetes. Significant hormonal changes during pregnancy can lead
to blood sugar elevation in genetically predisposed individuals.
Blood sugar elevation during pregnancy is called gestational diabetes.
Pregnant women who have never had diabetes before but who have high
blood sugar (glucose) levels during pregnancy are said to have gestational
diabetes. Gestational diabetes affects about 4 percent of all pregnant
women - about 135,000 cases of gestational diabetes in the United
States each year.
What causes gestational diabetes?
No one knows for sure what causes gestational diabetes. The placenta
supports the baby as it grows. Hormones from the placenta help the
baby develop. But these hormones also block the action of the mother's
insulin in her body. This problem is called insulin resistance.
Insulin resistance makes it hard for the mother's body to use insulin.
She may need up to three times as much insulin. Gestational diabetes
starts when your body is not able to make and use all of the insulin
it needs for pregnancy. Without enough insulin, glucose cannot leave
the blood and be changed to energy.
How is gestational diabetes determined?
For many years, pregnant women
took an oral glucose resistance test at the 28-week mark of their
pregnancy. Doctors now believe it is important to test for gestational
diabetes earlier in pregnancy - at 16 weeks - to manage the symptoms
should gestational diabetes be discovered.
How does gestational diabetes affect the baby?
Gestational diabetes affects the mother after the baby's body has
been formed, but while the baby is busy growing. Because of this,
gestational diabetes does not cause the birth defects often seen
in babies whose mothers were diabetic before pregnancy.
Untreated or poorly controlled gestational diabetes can harm the
baby, because while the excess insulin present during gestational
diabetes does not cross the placenta, the excess glucose in the
bloodstream does. The baby's pancreas is faced with the challenge
of producing extra insulin to deal with the extra blood glucose.
Because of the extra insulin made by the baby's pancreas, newborns
may have very low blood glucose levels at birth and are also at
higher risk for breathing problems. Babies with excess insulin become
children who are at risk for obesity and adults who are at risk
for type 2 diabetes.
The excess glucose also can cause the baby to get fatter than it
needs to be, since it has more energy that it needs to grow and
develop.
Treating gestational diabetes
Because gestational diabetes can hurt both mom and baby, treatment
is generally recommended. Treatment for gestational diabetes aims
to keep blood glucose levels equal to those of pregnant women who
don't have gestational diabetes. Treatment for gestational diabetes
includes special meal plans and scheduled physical activity. It
may also include daily blood glucose testing and insulin injections.
Gestational diabetes: after the baby is born
The good news is that gestational diabetes usually resolves once
the baby is born. The bad news, however, is that 25 to 50 percent
of women with gestational diabetes will eventually develop type
2 diabetes later in life, especially in those who require insulin
during pregnancy and those who remain overweight after their delivery.
Patients with gestational diabetes usually undergo an oral glucose
tolerance test about six weeks after giving birth to determine if
their diabetes has persisted beyond the pregnancy, and to assess
the woman's future risk for developing diabetes.
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