Diabetes is a condition in which blood glucose (sugar) levels are too high. Gestational means during pregnancy, so gestational diabetes (GD) occurs when diabetes is first found during pregnancy. GD usually goes away after the birth of the child. However, some women develop diabetes or prediabetes (impaired glucose tolerance) after delivery.
GD is common. About 7% of pregnant women have it. It can cause problems in babies such as a higher birth weight (leading to a cesarean, or C-section, delivery), damage during birth (e.g., to shoulders), breathing problems, low blood sugar levels after birth, and higher risk of obesity and diabetes in later life. For women, GD increases the chance of getting preeclampsia late in pregnancy.
Insulin is a hormone that helps the body to break down sugar for energy. Without enough insulin, blood sugar levels rise and diabetes occurs. Certain hormones produced by women during pregnancy block insulin’s effect. The cells become “resistant” to insulin and it becomes more difficult for the glucose in blood to be transported into the cells where it is needed for energy, so more insulin than normal is needed.
GD has no clear symptoms. Some women with GD may have increased thirst or hunger or may need to urinate more often. Pregnant women without GD may also have these same symptoms.
Women at greatest risk include those with diabetic family members, who are overweight or older than 35, or who already gave birth to a large baby, a baby born with an abnormality, or a stillbirth (dead baby). Also, women who had GD in another pregnancy or are Hispanic, African American, Native American, or Pacific Islander have a greater risk.
It’s hard to rely on symptoms to diagnose GD, so blood sugar levels should be tested during pregnancy, especially in high-risk women. If tests show high levels, the health care provider will do frequent blood sugar tests for the rest of the pregnancy. Also, testing blood sugar levels at home will help monitor the condition.
Treatment is aimed at keeping blood sugar in the normal range. Special meal plans, moderate exercise, regular (e.g., daily) blood sugar testing, and insulin injections will do this.
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Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.
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