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Gestational Diabetes during pregnancy

Gestational Diabetes during pregnancy

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Sometimes you develop diabetes during pregnancy even if you have had no history of it. This type of diabetes is called gestational diabetes. Nothing to worry about though. It is only of temporary nature that usually develops in the second trimester and subsides with the end of pregnancy (i.e. post delivery). Only about 4% of pregnant women suffer from gestational diabetes  

Thursday, August 31st, 2017

What is diabetes?

Normally, the stomach and intestines digest the carbohydrate in our food into a sugar called glucose. Glucose is the main source of our body’s energy. After digestion, the glucose moves into our blood to produce energy in our body. Insulin, the hormone secreted by pancreas, is needed to get the glucose out of our blood and into the body cells to provide energy. If you have diabetes, it means either your body doesn’t make enough insulin, or your cells can’t use it the way they should. As a result , the glucose since it is not being utilized, builds up inside your blood, which then causes diabetes or high blood sugar.

How does gestational diabetes happen?

Hormonal changes. Due to the hormonal changes that occur during pregnancy, most mothers go through some degree of impaired glucose tolerance. This means that their blood sugar may be higher than normal, but not high enough to have diabetes.

The actions of insulin are stopped. During pregnancy, increased levels of hormones secreted in the placenta helps in shifting the nutrients from the mother to the developing foetus. Other hormones produced by the placenta help in preventing the mother from developing low blood sugar. They work by inhibiting the actions of insulin.

Insulin production may be insufficient. Usually the mother's pancreas is able to produce more insulin (about three times of the normal amount) to overcome the effect of the pregnancy hormones on blood sugar levels. If, however, for some reason the pancreas cannot produce enough insulin to overcome the effect of the increased hormones during pregnancy, blood sugar levels rise, resulting in gestational diabetes.

What causes Gestational Diabetes?

Obesity and family history. This can happen due to number of reasons. For instance, if you're obese (your body mass index is over 30 kg/m2) the chances of gestational diabetes increase. It may also happen if you have had gestational diabetes in a previous pregnancy. Strong family history of diabetes can be another reason. You may still develop gestational diabetes even if none of these apply to you.

How does one find out? Clickable option highlighted part

Oral glucose tolerance test. To find out if you have gestational diabetes or not, consult your doctor who can advice you to undergo a oral glucose tolerance test (OGTT) which is just like any other test that measures the amount of glucose in your blood. You are required to provide your fasting blood sample for checking the fasting blood sugar levels which is used to screen for and diagnose diabetes. After that, you are asked to drink glucose solution 100 gm and provide blood samples at 1 hrly. Interval till 3hrs. post glucose load. It is then tested for post-prandial levels of sugar in your blood.

Random glucose testing. Or else, you can provide your blood sample for testing the random blood glucose level. The normal range of fasting blood glucose level is <120 mg/100 ml of blood, the post-prandial blood glucose level is <180 mg/100 ml of blood and the random blood sugar level is 160-200 mg/100 ml of blood.

Test for HbA1c. Your blood sample can also be tested for HbA1c, which is a type of haemoglobin circulating in your body. Glucose gets bound to this very type of hemoglobin, and is referred to as glycosylated haemoglobin. HbA1c levels depend upon the blood glucose concentration in the last 3 months. That is, higher the glucose concentration in blood, higher the level of HbA1c. If the level of your HbA1c is higher than 7% of the total hemoglobin, you are likely to have diabetes. Hence it is used to check the control of sugar over past 2-3 months.

Why one must not overlook it?

Potential risks of diabetes for you., If untreated, high blood sugar levels can be unhealthy for both you and your baby. .

Preeclampsia and other issues. Women with gestational diabetes are at a higher risk of developing preeclampsia, particularly those who have been overweight or  obese before pregnancy or whose blood sugar levels are not well controlled. Diabetes can affect your kidneys, eyes and heart. It may increase the tendency to develop infections. In uncontrolled diabetes your doctor may have to take you up for early delivery. Chances of operative delivery / C-Section increase in diabetes mothers.

What are the risks for your baby?

Overweight. If your blood sugar levels are high, too much glucose ends up in your baby's blood., The baby's pancreas then needs to produce more insulin to process the extra glucose. All this excess blood sugar and insulin can cause your baby to put on extra weight, particularly in the upper body. The baby can also be unusually large, (a condition called macrosomia). A large baby may need to be delivered by a surgical procedure called cesarean section, instead of the normal process.

Low blood sugar. After the birth, due to excessive insulin in the blood, the baby’s blood sugar may be too low. This is known as hypoglycemia. In that case you may need to breastfeed the baby right away and still need to get glucose through a tube into her blood, if her blood glucose levels drop

Respiratory Distress Syndrome. The baby may develop Respiratory Distress Syndrome, which means she may have trouble breathing and may need oxygen or other help.

Low mineral levels. The baby may have low mineral levels specially calcium in the blood. This problem can cause muscle twitching or cramping, but can be treated by giving the baby extra minerals.

What is the cure or how can you prevent it ?

Keep a check on your diet and physical activities. Eat a healthy and balanced diet that is low in simple carbohydrates like sugar. Usually controlling carbohydrates is an important part of a healthy diet for mothers with gestational diabetes. Get regular, moderate physical activity after consulting with your doctor.. Maintain a healthy weight. Note that the amount of weight gain that is healthy for you depends on how much you weighed before pregnancy.

Check your blood sugar often. Some mothers with gestational diabetes also need to take insulin to help manage their diabetes. The extra insulin can help lower their blood sugar level.

Gestational diabetes

In most cases it remits after child birth, however few women may become frank diabetic.Most mothers who have gestational diabetes can give birth to perfectly healthy babies if it  is treated and controlled early. All you need to do is to  follow some simple, general rules like controlling your blood sugar, maintaining a healthy diet, maintaining a healthy weight, and getting into an exercise regime. 

Remember, to always consult your doctor.

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