What is Gestational Diabetes?
Gestational diabetes develops during pregnancy (gestation) - usually around the 24th week. About 2 and 10 percent of expectant mothers develop this condition, making it one of the most common health problems of pregnancy. Like other types of diabetes, gestational diabetes affects how your cells use sugar (glucose) in your body's main fuel.
What causes Gestational Diabetes in Pregnancy?
When you eat, your digestive system breaks most of your food down into a type of sugar called glucose. The glucose enters your bloodstream and then, with the help of insulin (a hormone made by your pancreas), your cells use the glucose as fuel. However, if your body doesn't produce enough insulin too much glucose remains in your blood instead of moving into the cells and getting converted to energy.
We don't know what causes gestational diabetes, but we have some clues. 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. When insulin is not much sufficient to produce, the blood glucose levels rise too high, resulting in gestational diabetes.
Most women with gestational diabetes don't remain diabetic after the baby is born. Once you've had gestational diabetes, though, you're at higher risk for getting it again during a future pregnancy and for developing diabetes later in life.
How Gestational Diabetes can Affect your Baby?
Gestational diabetes affects the mother in late pregnancy, after the baby's body has been formed, but while the baby is busy growing. Because of this, gestational diabetes does not cause the kinds of birth defects sometimes seen in babies whose mothers had diabetes before pregnancy.
However, untreated or poorly controlled gestational diabetes can hurt your baby. When you have gestational diabetes, your pancreas works overtime to produce insulin, but the insulin does not lower your blood glucose levels. Although insulin does not cross the placenta, glucose and other nutrients do. So extra blood glucose goes through the placenta, giving the baby high blood glucose levels. This causes 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 grow and develop, the extra energy is stored as fat.
This can lead to macrosomia, or a "fat" baby. Babies with macrosomia face health problems of their own, including damage to their shoulders during birth. 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.
Chances of Getting Gestational Diabetes
According to the American Diabetes Association your chances of getting gestational diabetes are higher if you...
- you're over 35 years old
- you're overweight
- have had gestational diabetes before
- have given birth to a baby weighing more than 9 pounds
- have a strongly family member with history of diabetes
- have high blood pressure
- have sugar in your urine.
- have too much amniotic fluid
- have had an unexplained miscarriage or stillbirth
A small number of women might be considered at such low risk that they might not have to get tested. You're part of this group if you meet all of the following criteria:
- You're younger than 25.
- Your weight is in a healthy range.
- You're not a member of any racial or ethnic group with a high prevalence of diabetes, including people of Hispanic, African, Native American, South or East Asian, Pacific Island, and indigenous Australian ancestry.
- None of your close relatives have diabetes.
- You've never had a high result on a blood sugar test.
- You've never had an overly large baby or any other pregnancy complication usually associated with gestational diabetes.
Symptoms of Gestational Diabetes
Usually there are no symptoms, or the symptoms are mild and not life threatening to the pregnant woman. The blood sugar (glucose) level usually returns to normal after delivery.
Symptoms may include:
- Blurred vision
- Fatigue
- Frequent infections, including those of the bladder, vagina, and skin
- Increased thirst
- Increased urination
- Nausea and vomiting
- Weight loss despite increased appetite
How will I Know if I have Gestational Diabetes?
Gestational diabetes usually has no symptoms. That's why almost all pregnant women have a glucose-screening test between 24 and 28 weeks.
However, if you're at high risk for diabetes or are showing signs of it (such as having sugar in your urine), your caregiver will recommend this screening test at your first prenatal visit and then repeat the test again at 24 to 28 weeks if the initial result is negative.
By the way, if you get a positive result on a glucose-screening test, it doesn't necessarily mean that you have gestational diabetes. It does mean that you'll need to take a longer follow-up test (a glucose tolerance test, or GTT) to find out.
References
- Diabetes Basics Retrieved February 15, 2013
- Gestational diabetes. Retrieved February 16, 2013
- Gestational diabetes. Retrieved February 18, 2013
