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Gestational Diabetes (diabetes in pregnancy) : Symptoms, Causes, Diagnosis and Treatment

What is Gestational Diabetes?

During pregnancy, some women develop high blood sugar levels. This condition is known as gestational diabetes mellitus (GDM) or gestational diabetes. Gestational diabetes typically develops between the 24th and 28th weeks of pregnancy.

According to the Centers for Disease Control and Prevention, it?s estimated to occur in 2 to 10 percent of pregnancies in the United States.

If you develop gestational diabetes while you?re pregnant, it doesn?t mean that you had diabetes before your pregnancy or will have it afterward. But gestational diabetes does raise your risk of developing type 2 diabetes in the future.

If poorly managed, it can also raise your child?s risk of developing diabetes and increase the risk of complications for you and your baby during pregnancy and delivery.

Gestational diabetes is diabetes diagnosed for the first time during pregnancy (gestation). Like other types of diabetes, gestational diabetes affects how your cells use sugar (glucose). Gestational diabetes causes high blood sugar that can affect your pregnancy and your baby's health.

While any pregnancy complication is concerning, there's good news. Expectant mothers can help control gestational diabetes by eating healthy foods, exercising and, if necessary, taking medication. Controlling blood sugar can keep you and your baby healthy and prevent a difficult delivery.

In women with gestational diabetes, blood sugar usually returns to normal soon after delivery. But if you've had gestational diabetes, you have a higher risk of getting type 2 diabetes. You'll need to be tested for changes in blood sugar more often.

Gestational Diabetes is also known as diabetes in pregnancy. Gestational Diabetes belongs under the category of Pregnancy disease. Generally Female are the victim of the Gestational Diabetes. Seriousness of this disease is Medium.

Symptoms of Gestational Diabetes are :

  • Fatigue/weakness
  • Weakness

    Weakness is when strength is decreased and extra effort is needed to move a certain part of the body or the entire body. Weakness is due to loss of muscle strength. Weakness can be a big part of why cancer patients feel fatigue.

    Fatigue

    Fatigue is an extreme feeling of tiredness or lack of energy, often described as being exhausted. Fatigue is something that lasts even when a person seems to be getting enough sleep. It can have many causes, including working too much, having disturbed sleep, stress and worry, not having enough physical activity, and going through an illness and its treatment.

  • Extreme thirst
  • Frequent urination
  • Dry mouth
  • Causes

    Gestational Diabetes can be caused due to:

    The exact cause of gestational diabetes is unknown, but hormones likely play a role. When you?re pregnant, your body produces larger amounts of some hormones, including:

    • human placental lactogen (hPL)
    • hormones that increase insulin resistance

    These hormones affect your placenta and help sustain your pregnancy. Over time, the amount of these hormones in your body increases. They may start to make your body resistant to insulin, the hormone that regulates your blood sugar.

    Insulin helps move glucose out of your blood into your cells, where it?s used for energy. In pregnancy, your body naturally becomes slightly insulin resistant, so that more glucose is available in your blood stream to be passed to the baby. If the insulin resistance becomes too strong, your blood glucose levels may rise abnormally. This can cause gestational diabetes.

    What kind of precaution should be taken in Gestational Diabetes?

    It?s not possible to prevent gestational diabetes entirely. However, adopting healthy habits can reduce your chances of developing the condition.

    If you?re pregnant and have one of the risk factors for gestational diabetes, try to eat a healthy diet and get regular exercise. Even light activity, such as walking, may be beneficial.

    If you?re planning to become pregnant in the near future and you?re overweight, one of the best things you can do is work with your doctor to lose weight. Even losing a small amount of weight can help you reduce your risk of gestational diabetes.

    Treatment for the Gestational Diabetes

    Diagnosis

    If you're at average risk of gestational diabetes, you'll likely have a screening test during your second trimester ? between 24 and 28 weeks of pregnancy.

    If you're at high risk of diabetes ? for example, if you're overweight or obese before pregnancy or you have a mother, father, sibling or child with diabetes ? your doctor may test for diabetes early in pregnancy, likely at your first prenatal visit.

    Routine screening for gestational diabetes

    Screening tests may vary slightly depending on your health care provider, but generally include:

    • Initial glucose challenge test. You'll drink a syrupy glucose solution. One hour later, you'll have a blood test to measure your blood sugar level. A blood sugar level of 190 milligrams per deciliter (mg/dL), or 10.6 millimoles per liter (mmol/L) indicates gestational diabetes.

    A blood sugar below 140 mg/dL (7.8 mmol/L) is usually considered normal on a glucose challenge test, although this may vary by clinic or lab. If your blood sugar level is higher than normal, you'll need another glucose tolerance test to determine if you have the condition.

    • Follow-up glucose tolerance testing. This test is similar to the initial test ? except the sweet solution will have even more sugar and your blood sugar will be checked every hour for three hours. If at least two of the blood sugar readings are higher than expected, you'll be diagnosed with gestational diabetes.

    Some of the sugar tests are:

    Treatment

    Treatment for gestational diabetes includes:

    • Lifestyle changes
    • Blood sugar monitoring
    • Medication, if necessary

    Managing your blood sugar levels helps keep you and your baby healthy. Close management can also help you avoid complications during pregnancy and delivery.

    Lifestyle changes

    Your lifestyle ? how you eat and move ? is an important part of keeping your blood sugar levels in a healthy range. Doctors don't advise losing weight during pregnancy ? your body is working hard to support your growing baby. But your doctor can help you set weight gain goals based on your weight before pregnancy.

    Healthy diet

    A healthy diet focuses on fruits, vegetables, whole grains and lean protein ? foods that are high in nutrition and fiber and low in fat and calories ? and limits highly refined carbohydrates, including sweets. A registered dietitian or a diabetes educator can help you create a meal plan based on your current weight, pregnancy weight gain goals, blood sugar level, exercise habits, food preferences and budget.

    Stay active

    Regular physical activity plays a key role in every woman's wellness plan before, during and after pregnancy. Exercise lowers your blood sugar, and as an added bonus, regular exercise can help relieve some common discomforts of pregnancy, including back pain, muscle cramps, swelling, constipation and trouble sleeping.

    With your doctor's OK, aim for 30 minutes of moderate exercise on most days of the week. If you haven't been active for a while, start slowly and build up gradually. Walking, cycling and swimming are good choices during pregnancy. Everyday activities such as housework and gardening also count.

    Monitor your blood sugar

    While you're pregnant, your health care team may ask you to check your blood sugar four or more times a day ? first thing in the morning and after meals ? to make sure your level stays within a healthy range.

    Medication

    If diet and exercise aren't enough, you may need insulin injections to lower your blood sugar. Between 10% and 20% of women with gestational diabetes need insulin to reach their blood sugar goals. Some doctors prescribe an oral medication to control blood sugar, while others believe more research is needed to confirm that oral drugs are as safe and as effective as injectable insulin to control gestational diabetes.

    Close monitoring of your baby

    An important part of your treatment plan is close observation of your baby. Your doctor may check your baby's growth and development with repeated ultrasounds or other tests. If you don't go into labor by your due date ? or sometimes earlier ? your doctor may induce labor. Delivering after your due date may increase the risk of complications for you and your baby.

    Follow-up after delivery

    Your doctor will check your blood sugar after delivery and again in six to 12 weeks to make sure that your level has returned to normal. If your tests are normal ? and most are ? you'll need to have your diabetes risk assessed at least every three years.

    If future tests indicate type 2 diabetes or prediabetes, talk with your doctor about increasing your prevention efforts or starting a diabetes management plan.

    Possible complication with Gestational Diabetes

    Gestational diabetes that's not carefully managed can lead to high blood sugar levels. High blood sugar can cause problems for you and your baby, including an increased likelihood of needing a C-section to deliver.

    Complications that may affect your baby

    If you have gestational diabetes, your baby may be at increased risk of:

    • Excessive birth weight. Higher than normal blood sugar in mothers can cause their babies to grow too large. Very large babies ? those who weigh 9 pounds or more ? are more likely to become wedged in the birth canal, have birth injuries or need a C-section birth.
    • Early (preterm) birth. High blood sugar may increase women's risk of early labor and delivery before the due date. Or early delivery may be recommended because the baby is large.
    • Serious breathing difficulties. Babies born early to mothers with gestational diabetes may experience respiratory distress syndrome ? a condition that makes breathing difficult.
    • Low blood sugar (hypoglycemia). Sometimes babies of mothers with gestational diabetes have low blood sugar (hypoglycemia) shortly after birth. Severe episodes of hypoglycemia may cause seizures in the baby. Prompt feedings and sometimes an intravenous glucose solution can return the baby's blood sugar level to normal.
    • Obesity and type 2 diabetes later in life. Babies of mothers who have gestational diabetes have a higher risk of developing obesity and type 2 diabetes later in life.
    • Stillbirth. Untreated gestational diabetes can result in a baby's death either before or shortly after birth.

    References:

    1. https://www.bcbs.com/the-health-of-america/reports/trends-in-pregnancy-and-childbirth-complications-in-the-us
    2. https://www.mayoclinic.org/diseases-conditions/gestational-diabetes/symptoms-causes/syc-20355339
    3. https://www.cdc.gov/pregnancy/diabetes-gestational.html
    4. https://www.healthline.com/health/gestational-diabetes#prevention
    5. https://www.nhs.uk/conditions/gestational-diabetes/
    6. https://www.medicinenet.com/gestational_diabetes/article.htm
    7. https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/gestational
    8. https://www.endocrineweb.com/conditions/gestational-diabetes/gestational-diabetes

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