Gestational Diabetes: Symptoms, Causes, Risks, Complications, Diagnosis, Treatment, Prevention and Outlook

0
37
Pregnant women who have Gestational Diabetes checking her blood glucose

1Overview

Gestational diabetes is characterized by the increase in blood glucose levels during pregnancy and disappears after giving birth. Just like type 1 and type 2 diabetes, gestational diabetes causes the blood glucose levels to soar to high and dangerous levels.

This type of diabetes affects how the cells use sugar or glucose. This condition can both affect the mother’s and baby’s health.

When a person eats, the digestive system works by breaking down the food into glucose, which the cells need to survive and work their functions. With the help of insulin, a hormone produced by the pancreas, glucose is transported to the different cells, fats, and muscles to use as fuel.

However, if there is not enough insulin or the pancreas cannot supply insulin, the cells may have a problem responding to insulin, leading to insulin resistance. However, when a person is pregnant, the body naturally becomes resistant to insulin, so that more sugar or glucose is available to nourish the body. However, in some cases, the pancreas would eventually increase its production of insulin to compensate for the demand.

Early detection and treatment of gestational diabetes are important to manage the disease and prevent its progression to its possible complications.

2Symptoms

Most pregnant mothers won’t feel any sign or symptom of the condition. Most cases are just detected through blood testing or screening for gestational diabetes. For some cases, however, the signs and symptoms typical of diabetes can be observed, including:

  • Sugar in the urine as seen in a urinalysis
  • Polyuria – excessive urination
  • Polydipsia – excessive thirst
  • Polyphagia – excessive hunger
  • Fatigue
  • Nausea
  • Frequent bladder, vaginal and skin infections
  • Blurred vision
  • Dry mouth

About 2 to 5 percent of pregnant women develop gestational diabetes. This number can increase to about 7 to 9 percent of mothers who are more likely to have risk factors. Typically, the obstetrician may recommend testing for gestational diabetes between the 24th and 28th week of pregnancy.

3Causes

Some researchers do not know why some women develop gestational diabetes. However, it is important to understand how pregnancy can affect the processing of blood glucose in the body to understand how gestational diabetes occurs fully.

The body digests the food taken to produce glucose, which is needed by the cells of the body. The pancreas will then produce insulin, a hormone that helps transport glucose to the different cells in the body, where the energy is used as energy.

However, during pregnancy, the placenta secretes high levels of hormones which could weaken the action of insulin. This could lead to increased levels of blood sugar in the body. When the baby develops and grows bigger, the placenta will then produce more and more insulin-counteracting hormones. As a result, gestational diabetes will become worse during the second and third trimester.

All pregnant women may have insulin resistance in late pregnancy. However, most pregnant women can produce enough insulin to address this problem while some cannot, making them prone to developing gestational diabetes.

4Risk Factors

Any woman can develop gestational diabetes during pregnancy. However, some women are more prone than others due to the following risk factors:

Being obese and overweight – Being obese and overweight may increase the risk of having gestational diabetes.

Older than 25 years old – Some pregnant women can develop gestational diabetes if they are more than 25 years old.

Family history or personal health history of GDM – The risk of having gestational diabetes increases if the pregnant mother had prediabetes before becoming pregnant. The risk will also heighten if one family member, a parent or sibling has type 2 diabetes. Also, if you previously delivered a baby who is more than 9 pounds or 4.1 kilograms are at a higher risk of developing gestational diabetes.

Unexplained stillbirth – If you have a maternal history of a stillbirth and the reason is unknown, you are at a higher risk of developing gestational diabetes.

Race – You are at a higher risk of gestational diabetes if your family origins are Chinese, African-Carribean, Middle Eastern and South Asian.

5Complications

Gestational diabetes normally goes away after birth. However, some women may have it even after childbirth. There are also many complications linked to GDM, in both the baby and the mother.

Complications to the mother

Increased tendency to give birth via C-section – Gestational diabetes that is not treated properly or managed carefully may lead to uncontrolled blood sugar levels and this might cause problems in the baby. As a result, these complications may take a toll on the baby’s health and life.

Preeclampsia and high blood pressure – Gestational diabetes may increase the risk of hypertension or high blood pressure. This dangerous blood pressure readings may trigger preeclampsia, a severe complication of pregnancy that could threaten the lives of the baby and the mother.

Diabetes in the future – People with gestational diabetes may develop full-blown diabetes in the future. In some cases, pregnant women who had GDM during their previous pregnancy may also develop the disease on the succeeding pregnancies.

Complications to the baby

Preterm birth – Early birth or preterm birth is a complication of gestational diabetes. When a mother has increased blood glucose levels, this might trigger preterm labor. Sometimes, the doctor can also schedule an earlier birth since the baby is very large.

Excessive weight gain – The baby inside the womb could get very large because of the excessive blood sugar in the bloodstream. The baby can grow very large, called macrosomia. These babies are at a higher risk of having injuries at birth, delivered via C-section and become wedged in the birth canal.

Type 2 diabetes in the future – Babies whose mothers have gestational diabetes may develop type 2 diabetes later in life.

Low blood sugar or hypoglycemia – In some cases, the babies of mothers with gestational diabetes may have hypoglycemia or low blood sugar after birth. This is because the baby’s insulin production is increased. This is a very dangerous condition because it might lead to seizures.

6Diagnosis

The doctor will ask questions about the general health of a pregnant mother. This is done between 8 and 12 weeks. This will help determine if a mother is at a higher risk of having gestational diabetes.

Routine tests for gestational diabetes

Oral glucose tolerance test (OGTT) – Also called the initial glucose challenge test,
the patient will drink a glucose solution and then after one hour, a blood test is done to measure the blood sugar levels. The normal result should be below 130 or 140 mg/dL. If the blood is higher than normal, this means that the pregnant mother has a higher risk of developing gestational diabetes later in the pregnancy.

Follow-up glucose tolerance testing – This test is done with fasting. The mother will fast overnight and a blood glucose test is done the next morning. The mother will drink a glucose solution and the blood sugar level will be checked every hour for about three hours. If two of the readings are high, the mother will then be diagnosed with gestational diabetes.

7Treatment

In women with gestational diabetes, the tendency of having problems with the pregnancy is decreased by the proper control of the sugar levels in the body. For those who are pregnant, many medicines are not allowed. Mostly, the treatment of gestational diabetes is through changes in the lifestyle.

Here are the ways to manage gestational diabetes:

Monitor the blood sugar – This is important, especially for pregnant women. The doctor may request to check your blood for about four to five times a day, particularly early in the morning and after meals. There are many home kits available today.

Watching the food you eat – Eating a healthy diet with the right type of foods is the best way to control the levels of blood sugar in the body. Doctors do not advise on losing weight during pregnancy but the doctor will assist and guide you on setting weight gain goals depending on the present weight and the weight before pregnancy.

Regular exercise – Practicing regular physical activity or exercise is important in maintaining a healthy body. Exercise also lowers the blood sugar levels by triggering the body to transport glucose into the cells.

Monitoring of the baby – It is important for you to monitor your baby, through regular consultations with the doctor. Moreover, you can do ultrasounds and other tests to determine the health of the baby.

8Prevention

There are no guarantees when it comes to preventing gestational diabetes, but practicing healthy habits before pregnancy is important to avoid having these problems.

Here are ways to keep away from gestational diabetes.

  • Eat healthy foods every day, particularly those who are high in fiber and low in calories
  • Keep active and exercise regularly
  • Maintain a healthy lifestyle and for some, lose weight.

9Outlook

If gestational diabetes is not treated properly and immediately, it could lead to serious problems. On the other hand, when you had a previous bout of gestational diabetes in your previous pregnancies, you are at a higher risk of having the same condition