Gestational Diabetes

Gestational diabetes is characterized as the onset of abnormal blood glucose levels in conjunction with insulin irregularities in pregnant women. Gestational diabetes is generally diagnosed in pregnant women during their third trimester of pregnancy, and the disease accounts for approximately less than 5% of all pregnancies in the United States.

Causes of Gestational Diabetes

Hormonal fluctuations during pregnancy in women are altogether common; however these hormonal changes have potentially unhealthy implications for a pregnant mother. An increase in the production of certain hormones allows for the transfer of nutrients from a mother to the baby in the placenta and helps prevent the pregnant mother from developing low blood sugar – which would be harmful to the health of the baby. These very hormonal changes contribute to insulin resistance.

Insulin resistance is when the breakdown of glucose in the blood by insulin is impaired due to the presence of other hormones produced during pregnancy. In response to the natural insulin resistance that occurs in all pregnancies, the pancreas (the organ primarily responsible for the production of insulin) increases its production of the hormone by up to three times the normal amount. However, in the event that insulin resistance progresses and the pancreas is unable to produce an ample quantity of insulin, glucose levels rise to unhealthy levels and a diagnosis of gestational diabetes results.

Diagnosing Gestational Diabetes

The diagnosis of gestational diabetes usually occurs between the 24^th and 28^th week of pregnancy in women that are at risk. The primary means of testing for the disease is the Oral Glucose Tolerance Test (OGTT). The test consists of fasting for a period of about 8 hours prior to the test, consuming a liquid compound containing glucose, and subsequently testing a sample of blood approximately an hour after ingesting the glucose. Depending on the amount of glucose ingested and the amount of time the blood sample was drawn after the ingestion of the glucose compound, a blood glucose level that is considered high will result in a diagnosis of gestational diabetes.

Who is Most at Risk?

There are numerous factors that increase the risk of developing gestational diabetes. As with Type 1 and Type 2 diabetes, there are certain ethnic groups which are considered to be at a higher risk for developing gestational diabetes. These ethnic groups include African American, Asian American, Hispanic/Latino, American Indian, or Pacific Islander.

Obesity or having been considered overweight prior to the pregnancy are metabolic factors that also increase risk. In addition, older age can contribute to its onset. Other factors that influence the development of gestational diabetes in expecting mothers are previously having been diagnosed with either pre-diabetes, or having given birth to a baby weighing over 9 pounds. Furthermore, conditions that also influence the onset of gestational diabetes include having been previously diagnosed with gestational diabetes as a result of unmanaged blood sugar levels in another pregnancy or having too much amniotic fluid. A family history of diabetes or already having impaired glucose digestion also contributes to increasing the risk of developing the disease as well.

What Effect will Gestational Diabetes have on my Baby?

Gestational diabetes potentially can affect a pregnant mother and her baby adversely if it is left untreated and unmanaged. There are several negative health implications for the baby in particular if blood sugar levels remain uncontrolled throughout the pregnancy. Primarily the baby can suffer from several metabolic health complications. A condition known as macrosomia is common as a result of unmanaged blood sugar levels among newly born children. Macrosomia means the baby is born with an unusually high birth weight and it may cause complications during delivery. Due to the large birth weight, a caesarian section may be necessary for delivery in order to avoid physical damage, especially to the shoulders, that may occur during traditional child birth.

Another common problem newborns may suffer from is low blood sugar, which is also known as hypoglycemia. Low blood sugar can cause several health complications for the baby and is usually treated in the hospital with either a high glucose drink or injection. ‘Respiratory Distress Syndrome’ or other respiratory problems occur frequently in a child whose mother was diagnosed with gestational diabetes as well. A minor complication known as jaundice, which is characterized by the slight discoloration of the baby’s eyes and skin, is also not unusual.

Gestational Diabetes after Child Birth

After child birth, the endocrine system generally regulates the hormone fluctuations resulting from the pregnancy and the hormones return to pre-pregnancy regularity. Therefore, the insulin resistance that was created as a result of the hormones produced in the placenta diminishes. Subsequently, blood glucose levels stabilize over time and generally return to a safe level approximately six to eight weeks after childbirth. Testing blood glucose levels during this time is recommended in order to screen for the development of type 2 diabetes. Despite the usual outcome of normal blood sugar levels after the delivery, women that were diagnosed with gestational diabetes have an increased risk of up to 60% in developing type 2 diabetes. Moreover, those women also face an increased risk of developing gestational diabetes again in a future pregnancy.

Managing Gestational Diabetes

Type 1, type 2, and gestational diabetes all require strict and comprehensive management in order to decrease the risk of developing their associated complications. Controlling and monitoring blood glucose levels should be the cornerstone of any diabetes management regiment for women diagnosed with gestational diabetes. Women should use a blood glucose testing meter and test their blood sugar regularly, several times a day. Maintaining a healthy range of blood glucose is essential in maintaining good health. In conjunction with frequent blood glucose testing, a healthy diet and regular exercise are essential in combating the detrimental health problems of gestational diabetes.

Managing blood glucose levels through a change in diet is an effective way to not only offset the chances of developing gestational diabetes complications, but also to ensure the baby obtains a sufficient amount of healthy nutrients. Reducing the intake of high calorie, high sugar snacks and replacing them with foods containing natural sugar such as fruits will help keep blood sugar at a healthy level. Also, maintain a healthy weight and avoid foods that are high in fat. Frequent exercise will control weight gain and also keep blood glucose in check. Even though gestational diabetes may have serious health implications, a mother has several methods to manage and overcome the adverse effects of unregulated gestational diabetes.

Please keep in mind that this article on Gestational Diabetes is intended solely as an informational document; consult a licensed physician before making any decisions regarding the management of individual cases of diabetes.


Sources:

WebMD Gestational Diabetes
http://diabetes.webmd.com/guide/gestational_diabetes?page=2

American Diabetes Association
http://www.diabetes.org/gestational-diabetes.jsp

National Diabetes Information Clearinghouse
http://diabetes.niddk.nih.gov/dm/pubs/gestational/#6

National Institute of Health
http://www.nichd.nih.gov/health/topics/Gestational_Diabetes.cfm

Diabetic Seniors Team

Related Articles

Insulin Dependent Diabetes - Insulin dependent diabetes, also known as Type 1 diabetes, is the type of diabetes that results when the body's immune system attacks the beta cells of the pancreas. Consequently, the pancreas is no longer able to produce insulin. People usually find out that they have insulin dependent diabetes mellitus before reaching the age of 30, although it can be diagnosed at any age. Type 1 diabetes is treated with either oral or injected insulin.

Insulin Resistant Diabetes - The most common form of diabetes in America is Type 2 or insulin resistant diabetes mellitus, which is described by the American diabetes Association as a form of diabetes in which the body cannot absorb the insulin produced by the body. It is more common in adults over the age of 40, but is not uncommon (especially in minority groups) to be diagnosed as early as age 10. In many instances, insulin resistant diabetes can be controlled by diet and exercise; however, insulin resistant diabetes mellitus may ultimately lead to needing oral medications or daily insulin injections.

An Understanding of Juvenile Diabetes - Type 1, Type 2, adult onset diabetes, juvenile diabetes--what is it all about? For the non-diabetic these words are confusing and often misunderstood. However, if you have been a diabetic for any length of time, then you know the differences.

Type 1 Diabetes - Type 1 Diabetes, often referred to as juvenile onset diabetes or childhood diabetes, accounts for roughly 5% to 10% of all diagnosed cases of diabetes. Type 1 Diabetes is characterized as the inability for hormone producing pancreatic cells to produce any insulin. The hormone insulin is used to regulate levels of glucose in the blood stream; glucose is a form of energy used by cells throughout the body. However, with the absence of insulin in the blood stream, cells are unable to convert the glucose into energy. Despite that the majority of diagnosed cases of type 1 diabetes occur in children, it can develop at any time during adulthood.