Understanding Gestational Diabetes, Implications In Pregnancy
Gestational diabetes is a condition in which your blood sugar levels become high during pregnancy. It affects pregnant people who have never been diagnosed with diabetes.
Gestational diabetes occurs when the body cannot produce the insulin it needs during pregnancy. People with this condition develop high blood sugar levels during pregnancy. People with this condition develop high blood sugar levels during pregnancy.
During pregnancy, some people may 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.
Symptoms Of Gestational Diabetes
It is rare for gestational diabetes to cause symptoms. A doctor may test for gestational diabetes if you have certain risk factors.
If you do experience symptoms, they’ll likely be mild. Diabetes symptoms may include; fatigue, blurred vision, excessive thirst, excessive need to urinate, and yeast infections.
Gestational diabetes occurs when your body cannot produce the insulin it needs during pregnancy. During pregnancy, your body produces larger amounts of some hormones, including, human placental lactogen (hPL) and other 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 more glucose is available in your bloodstream 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.
You should see your doctor if you develop symptoms of high blood sugar, such as increased thirst, needing to urinate more often than usual, and a dry mouth – do not wait until your next test. You should have the tests even if you feel well, as many people with diabetes do not have any symptoms.
Preconception testing
Every woman of childbearing age with diabetes should be counseled about the importance of tight glycemic control prior to conception. studies show an increased risk of diabetic embryopathy, especially anencephaly, microcephaly, congenital heart disease, and caudal regression directly proportional to elevations in A1C during the first 10 weeks of pregnancy.
Hemoglobin A1C is a blood test that represents the average blood glucose level over the previous two to three months. This test may be done once per trimester during pregnancy or more frequently as recommended by the health care provider.
There are opportunities to educate all women and adolescents of reproductive age with diabetes about the risks of unplanned pregnancies and the opportunities for improved maternal and fetal outcomes with pregnancy planning. Effective preconception counseling could avert substantial health and associated cost burden in offspring. Family planning should be discussed, and effective contraception should be prescribed and used until a woman is prepared and ready to become pregnant.
To minimise the occurrence of complications, beginning at the onset of puberty or at diagnosis, all women with diabetes of childbearing potential should receive education about first, the risks of malformations associated with unplanned pregnancies and poor metabolic control.
The second is the use of effective contraception at all times when preventing pregnancy. Preconception counseling using developmentally appropriate educational tools enables adolescent girls to make well-informed decisions. Preconception counseling resources tailored for adolescents should be available at no cost during antenatal care sessions.
Preconception testing
Preconception counseling visits should include rubella, syphilis, hepatitis B virus, and HIV testing, as well as Pap smear, cervical cultures, blood typing, prescription of prenatal and vitamins (with at least 400 μg of folic acid).
Diabetes-specific testing should include A1C, thyroid-stimulating hormone, creatinine, and urinary albumin-to-creatinine ratio; review of the medication list for potentially teratogenic drugs, that is, ACE inhibitors, angiotensin receptor blockers, and statins; and referral for a comprehensive eye exam. Angiotensin-converting enzyme (ACE) inhibitors are medications that help relax the veins and arteries to lower blood pressure. ACE inhibitors are used to treat high blood pressure and diabetes, both of which are more common in people with obesity. High blood pressure, diabetes, and obesity increase a woman’s chance of having a miscarriage.
Women with pre-existing diabetic retinopathy would need close monitoring during pregnancy to ensure that retinopathy does not progress.
If you develop gestational diabetes, it doesn’t mean you had diabetes before your pregnancy or will have it afterward. But developing it does raise your risk of developing type 2 diabetes in the future.
If poorly managed, gestational diabetes can also raise your child’s chance of developing diabetes. It can increase the possibility of complications for you and your baby during pregnancy and delivery.
Diabetes that is not well controlled causes the baby’s blood sugar to be high. The baby is “overfed” and grows extra-large. Besides causing discomfort to the woman during the last few months of pregnancy, an extra-large baby can lead to problems during delivery for both the mother and the baby.