Gestational (pregnancy) diabetes
It is a disorder of glucose metabolism that develops during pregnancy, caused by insufficient or ineffective insulin production. Prolonged elevation of blood sugar (glucose) can harm both the mother and the fetus.
Table of Contents
Placental hormones – Gestational diabetes develops during pregnancy due to placental hormones that reduce the mother's insulin sensitivity. As a result, blood glucose levels rise and the body is unable to metabolize it effectively.
Insulin resistance – Almost all women develop some degree of insulin resistance during the second half of pregnancy.
Overweight or obesity – Obesity before pregnancy increases the risk of insulin resistance
Family history of diabetes – Genetic factors play an important role
Gestational diabetes from a previous pregnancy – If a woman has already had this condition, the risk of recurrence is high
Polycystic ovary syndrome (PCOS) – Hormonal disorders increase the likelihood of developing gestational diabetes
Excessive weight gain during pregnancy – is also one of the important risk factors
Gestational diabetes symptoms and risk factors
Gestational diabetes is mostly asymptomatic, but it is characterized by certain manifestations:
- Increased thirst
- Frequent urination
- Severe weakness and lack of energy
- Decreased visual acuity
Gestational diabetes is not usually associated with excessive consumption of simple carbohydrate-containing foods by the pregnant woman, as is often the case with type 2 diabetes in non-pregnant women. Obesity during pregnancy, metabolic syndrome, and a family history of diabetes contribute to the development of insulin resistance and an increased risk of diabetes during pregnancy.
Other risk factors worth noting include:
- Sedentary lifestyle
- Pre-diabetes (persistent blood glucose level 110–125 mg/dl)
- Cardiovascular diseases
- Gestational diabetes during a previous pregnancy
- Polycystic ovary syndrome
- Previous birth with a newborn weighing more than 5 kg
- Pregnant woman over 40 years old
Healthy nutrition and physical activity adapted to the age and health status of the pregnant woman are sometimes not enough to manage gestational diabetes, and timely treatment is required to prevent further complications.
Complications
Developing gestational diabetes increases the risk of complications such as:
- Preeclampsia – a life-threatening condition characterized by high blood pressure and impaired kidney function
- Hypertension – high blood pressure during pregnancy
- Need for cesarean section – due to large fetus
- Developing type 2 diabetes – high risk of developing chronic diabetes after pregnancy
- The likelihood of gestational diabetes recurring
Untreated gestational diabetes also causes complications in the fetus:
- Fetal macrosomia – birth weight greater than 4 kg, which complicates labor and increases the risk of premature birth
- Hypoglycemia (low blood glucose levels at birth) – Severe hypoglycemic episodes can cause neonatal seizures. Prompt feeding or sometimes intravenous glucose restores normal blood glucose levels.
- Long-term neurodevelopmental disorders – problems with attention, memory, or cognitive functions
- The risk of obesity and type 2 diabetes is higher in children whose mothers developed diabetes during pregnancy.
- Neonatal respiratory distress syndrome (NRDS) – a condition that makes breathing difficult due to incomplete lung development
- Late fetal death – stillbirth or death of a newborn soon after birth
Diagnosis of gestational diabetes
It is essential for all pregnant women to undergo screening for gestational diabetes, which is based on measuring blood glucose levels during pregnancy.
The glucose test is performed in the second trimester of pregnancy, usually at 24–28 weeks, although in women at high risk (e.g., obesity, family history of diabetes, gestational diabetes in a previous pregnancy) the test may be performed earlier, sometimes as early as early pregnancy.
Glucose tolerance testIt is an important test for detecting insulin resistance and gestational diabetes. The initial test is performed on an empty stomach (at least 8 hours after the last meal), after which the patient is given a concentrated glucose solution to drink, and a repeat test is performed 2 hours after the sample is taken.
Gestational diabetes is diagnosed if at least one of the results obtained during a glucose tolerance test is above normal.
GestationalDiabetesTreatmentPregnancyAt the time
The main goal of treatment is to maintain normal blood sugar levels. It is important to:
- Lifestyle change
- Blood sugar monitoring
- Medical treatment if necessary
Lifestyle changes include both diet and physical activity.
Weight loss during pregnancy is not usually recommended, unless it is essential for the health of the mother and fetus and is done under the supervision of a doctor.A healthy diet includes a balanced diet rich in fiber and nutrients.
physical activity
Regular exercise is important both before, during and after pregnancy.Exercise lowers blood sugar levels and alleviates common pregnancy discomforts: back pain, muscle cramps, swelling, constipation, and insomnia.Walking and swimming are good choices.
Blood sugar monitoring
If necessary, it is necessary to check blood sugar levels several times a day - in the morning on an empty stomach and after meals.This ensures that blood sugar levels remain within the normal range.
Medical treatment
If diet and exercise are not enough, oral antidiabetic medications or insulin injections may be necessary.The goal is to effectively control blood sugar levels.
Fetal monitoring
Assessment of fetal development is part of the treatment plan, in parallel with antidiabetic treatment.
After childbirth
Blood glucose levels are also monitored regularly after delivery. Although in most cases of gestational diabetes, blood glucose levels return to normal after delivery, it is still necessary to check glucose levels periodically to avoid missing any significant blood sugar spikes.
Source:
https://www.synevo.ro/diabet-gestational-cum-influenteaza-sarcina/
https://www.thediabetescouncil.com/20-things-you-should-know-about-gestational-diabetes/
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