Gestational diabetes is a form of diabetes induced by pregnancy. There is no specific known cause, but it is believed that pregnancy hormones reduce the body’s ability to use and respond to insulin. The result is a high blood glucose level (hyperglycemia). Besides its role in the exchange of nutrients between the mother and the fetus, the placenta also has an endocrine function due to the release of steroids, which have a hyperglycemic effect by blocking the function of insulin in organs.
Another hormone that supports fetal nutrition is placental lactogen, which carries out a gluconeogenesis process to maintain basal blood glucose levels, which are essential for fetal development. These two factors—steroid production and placental lactogen—are what cause a woman to develop diabetes during pregnancy, typically in the second trimester, when the placenta becomes fully functional.
Symptoms
The symptoms that may occur 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
Risk Factors
Risk factors for developing gestational diabetes (GDM) include:
- Family history of type 2 diabetes
- Older maternal age — risk increases with age. Pregnancies after age 30 are more at risk
- Race — African American, Native American, and Hispanic women are more prone
- Obesity
- Gestational diabetes in a previous pregnancy
- Having previously given birth to a baby over 4 kg (8.8 lbs)
- Smoking doubles the risk of gestational diabetes
Diagnosis
To detect a possible risk of gestational diabetes, several methods can be used: fasting or postprandial blood glucose, oral glucose tolerance test (OGTT), O'Sullivan screening, etc.
Treatment
The treatment for GDM, as with other types of diabetes mellitus, focuses on keeping blood sugar levels within normal ranges. Treatment may include the following:
Special diet
- Exercise
- Daily monitoring of blood sugar levels
- Insulin injections
- Often, gestational diabetes can be treated with diet and exercise. If this is not effective, insulin therapy will be started.
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