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Gestational diabetes
Gestational diabetes is a form
of diabetes which affects pregnant women. It is believed that the hormones
produced during pregnancy reduce a woman's receptivity to insulin, leading
to high blood sugar levels. Gestational diabetes affects about 4% of all
pregnant women. It is estimated that about 135,000 cases of gestational
diabetes arise in the United States each year.
Hormones involved in development of placenta, which helps the baby to
develop also blocks, the action of the mother's insulin in her body. This
problem is called insulin resistance. During pregnancy a mother may need
up to three times more insulin for glucose to leave the blood and
transform to energy. When body is not able to use insulin due to insulin
resistance it develops into Gestational Diabetes. Glucose builds up in the
blood to high level, it is called hyperglycemia.
Gestational diabetes affects the mother in late pregnancy and the baby
too. Insulin does not cross the placenta, as glucose and other nutrients
do. Extra blood glucose passes through the placenta that gives the baby a
high blood glucose level. It results the baby's pancreas to make extra
insulin to get rid of the blood glucose. Since the baby is getting more
energy than it needs to develop and grow, the extra energy is stored as
fat. It can lead to Macrosomia i.e. “Fat” baby. At birth this fat baby
develops problem in breathing or may develop hypoglycemia due to over
production of insulin.
Why there is a need to take care of gestational diabetes
Gestational diabetes can harm you and your baby, so you
need to consider about it seriously and start caring at once. The main aim
of gestational diabetes treatment is to keep blood glucose levels equal to
those of normal pregnant women. It needs a planned meal and scheduled
physical activity, even blood glucose testing and insulin injections if
required. If gestational diabetes is taken care off properly, reduces the
risk of a cesarean section birth that high weight babies may require.
Symptoms of Gestational Diabetes
Often women with gestational diabetes exhibit no
symptoms. Screening glucose challenge test is a preliminary screening test
performed between 26-28 weeks. However, symptoms of gestational diabetes
are similar as Type II diabetes. It includes increased thirst, increased
urination, fatigue, nausea and vomiting, bladder and yeast infection, and
blurred vision.
Gestational Diabetes – Risk of diabetes in Future:
Gestational diabetes is only a temporary phase, it
disappears after pregnancy. But once you are diagnosed with gestational
diabetes, your chances are 2 in 3 that it will return in future. It is
hard to tell whether the particular woman has diabetes due to gestational
diabetes or type 2 diabetes. There seems to be a link between the tendency
to get gestational diabetes and type 2 diabetes. Gestational diabetes and
type 2 diabetes both involve insulin resistance.
Risk factors for gestational diabetes include :
* Strong family history of type 2 diabetes
* Mother’s age - a woman is at higher risk if she is aged at the time of
pregnancy
* Obesity
* Fallen prey to gestational diabetes in previous pregnancy
* A previous pregnancy that resulted in a child with a birth weight of 9
pounds or more
* If you are diagnosed with prediabetes, impaired glucose tolerance, or
impaired fasting glucose.
Gestational Diabetes Test :
Depending on risk factors, the doctor will decide when
you need to be checked for diabetes. If you are at higher risk, the blood
glucose level may be checked at your first prenatal visit. If your test
results are normal, you will be checked again sometime between weeks 24
and 28 of your pregnancy.
Depending on the risk and your test results, you may have one or more of
the following tests:
Fasting blood glucose or random blood glucose test: When plasma glucose
level is >126 mg/dl or when random plasma glucose >200 mg/dl is confirmed
on a subsequent day then the woman is at risk to develop GDM. Hence, you
will be suggested by your doctor to go for some confirmatory tests.
Screening glucose challenge test: It is a preliminary screening test,
which is performed between 26-28 weeks. This test will diagnose whether
diabetes exists or not by indicating whether or not the body is using
glucose. The Glucose Challenge Screening is now considered to be a
standard test performed during the second trimester of pregnancy.
Oral glucose tolerance test (OGTT): Women who are considered at risk for
gestational diabetes are being asked to go for this test. The glucose
challenge is performed by giving 1.76 oz of glucose drink and then drawing
a blood sample an hour later and measuring the level of blood glucose
present. Women with a blood sugar level greater than 140 mg/dl may have
gestational diabetes, and require a follow up test called a 3-hour oral
glucose tolerance test (OGTT).
According to ADA following values are considered to be abnormal for the
OGTT:
* Fasting Blood Glucose Level≥95 mg/dl
* 1 Hour Blood Glucose Level≥180 mg/dl
* 2 Hour Blood Glucose Level≥155 mg/dl
* 3 Hour Blood Glucose Level≥140 mg/dl
Treatment for Gestational Diabetes :
Women with gestational diabetes have healthy
pregnancies and healthy babies if, they follow a treatment plan from their
health care provider. It is required to keep your blood glucose levels in
a target range. Each woman should have a specific plan designed just for
her needs, so one can follow these general tips to stay healthy with
gestational diabetes:
* Know your blood sugar and keep it under control
* Eat a healthy diet
* Get regular, moderate physical activity
* Keep a healthy weight
Women with gestational diabetes should note down their blood sugar level,
physical activity and everything she eats and drinks, in a daily record
book. This can help track how well the treatment is working and what is to
be done further to maintain the normal blood sugar level. Some women with
gestational diabetes will also need to take insulin, to help manage their
diabetes if blood sugar is shooting up, in spite of all this. The extra
insulin can help them lower their blood sugar level.
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