Gestational Diabetes

gestational diabetesWhat is gestational diabetes? It is a type of diabetes that can occur only in pregnant women. The condition only occurs in women who have never previously had a diabetes diagnosis.

There are approximately 135,000 cases in the United States each year, or roughly 4% of all pregnancies (some estimates, however, suggest the occurrence is up to 8% of all pregnancies).

How does it happen? Scientists do not know what exactly causes this type of diabetes. Nonetheless, doctors believe the hormones produced during pregnancy seem to increase a woman’s resistance to insulin. Insulin is a hormone that helps transfer glucose, or blood sugar, from your blood into your cells where it is used as energy to keep your body running properly.

When you have insulin resistance, your cells have difficulty using the insulin to complete this necessary function. Eventually, the unused glucose builds up in your blood, resulting in a diagnosis of gestational diabetes.

Interestingly enough, most women have some insulin resistance near the end of their pregnancy. However, gestational diabetes is when this process occurs earlier in the pregnancy.

Risk Factors And Symptoms

There are very few signs or symptoms of gestational diabetes. Instead, most woman are diagnosed through a routine pregnancy blood test screening which typically occurs between weeks 24 and 28.

The National Institute of Health has put together a checklist of Risk Factors worth reviewing.

  •  You have a parent, brother or sister with diabetes.
  • You are African American, American Indian, Asian American, Hispanic/Latino, or Pacific Islander.
  • You are 25 years old or older.
  • You are overweight.
  • You have had the condition before, or have given birth to at least one baby weighing more than 9 pounds.
  • You have pre-diabetes.

If you checked any of these risk factors, talk to your doctor about taking a screening test. A Diagnosis is done through a variety of specialized blood test, we discuss in this article.

While there are typically no symptoms or signs, occasionally a woman may experience some of the more common diabetes symptoms, including but not limited to increased hunger, thirst, urination or excessive weight gain.

Controlling and  treatment

gestational-diabetesControlling gestational diabetes is critical component to your natal care. The condition can adversely affect both the mother and the child.

Fortunately, treatment is typically straight forward and involves meal planning and exercise. Losing excess weight either before pregnancy or during, can help reduce the risk of developing the condition or help manage it if you already have it.

Exercise is also very important. Even daily walking and swimming can go a long way to help control your blood sugar.

Meal Planning and nutrition is also very important. A dietician should be consulted to formulate meals that work for the mother and accomplish the goal of properly controlling the mother’s blood sugar.

Generally, a meal plan will be created around the following guidelines:

  • Three small meals a day, with one to three snacks
  • Limit sugar intake (i.e., very few sweets!)
  • Carbohydrate Monitoring (when and how much you can eat)
  • Plenty of Fiber (fruits, vegetables, whole grain crackers, cereals, and breads.)

You can read more about meal planning here.

Some women may also need to conduct daily blood glucose testing and take insulin to control their diabetes.

Possible Complications

The good news is that gestational diabetes complications can typically be avoided if the disease is caught early and a proper control plan is followed. Nonetheless, it is important to be educated as much as possible regarding the risks associated with the condition.

Gestational diabetes primarily affects the baby in the latter pregnancy stages. While insulin does not travel from the mother to the baby, glucose does. Thus, if the mother is not managing her blood glucose levels properly, the extra glucose she is carrying can pass to the baby.

This causes a number of different complications.

The baby now has to produce additional insulin to get rid of the extra glucose passed from the mother. The extra glucose energy is not needed by the baby, thus it is stored as fat.

The baby can develop a condition called Macrosomia (“fat baby”) due to the increased weight. Macrosomia affects both the mother and child.

The mother may now have to have a cesarean section, as the baby is too large to travel through the birthing canal.

Alternatively, she may experience an aggravated labor due to the baby’s increased size if no caesarean is performed.

The baby may suffer a shoulder injury during the birth because of its increased size. Macrosomia babies also have additional risk of low blood sugar and breathing problems at birth.

Beyond the birth, babies also have a higher risk of childhood obesity. Regardless of weight, the baby of a mother with gestational diabetes has a higher risk of type 2 diabetes later in life.

Conclusion

After birth, the condition usually goes away. However, once a woman has had the disease, her chances are 2 in 3 that she will have it again during her next pregnancy. Moreover, she has a much greater risk of developing type 2 diabetes later in life.

Thus, losing weight, healthy food choices and getting regular exercise should be a priority. Even slight changes in these three areas can significantly reduce or eliminate a woman’s chance of developing diabetes later in life.

SOURCES:

NIH Publication No. 12-5129, July 2012 (accessed February 2013)
American Diabetes Association, What is Gestational Diabetes (accessed February 2013).
By Erich Schultz – Last Reviewed January 2013.