Gestational Diabetes Mellitus: Risk Factors, Symptoms, and Complications
What is Gestational Diabetes Mellitus
It is the condition characterized by hyperglycemia for
the first-time during pregnancy in a woman who was otherwise normal in pre
pregnancy period.
It is basically the same as normal diabetes but the only
difference is that it occurs during pregnancy and the hormonal changes during
pregnancy is the suspected cause of it.
In normal cases of gestational diabetes, the blood
sugar level returns to normal after pregnancy but in some cases, it can persist
as type 2 diabetes mellitus.
Reasons for Gestational Diabetes Mellitus
The actual reasoning behind gestational diabetes is
not known. But in people with excess weight it is found more frequent.
Another suspected more potential cause for GDM is the
insulin-antagonistic activity of progesterone and human placental lactogen
produced during pregnancy.
These hormones inhibit the actions of insulin which
leads to increased blood sugar levels meaning Gestational Diabetes.
Symptoms of Gestational Diabetes Mellitus
There are no visible symptoms found in the case of GDM.
So, there is no way of telling whether a person is suffering from it or not
without any blood sugar screening.
But some suggest that increased urination, thirst, and
hunger can indicate GDM but such symptoms are also seen in normal pregnancy.
So, the best way to identify gestational diabetes is to maintain regular health
checkups.
Risk Factors
Having the following things before pregnancy increases
the likelihood of developing GDM –
a. Over-weight.
b. Leading
a sedentary life.
c. Previous
history of Macro baby.
d. Having
Pre-diabetes (A state where blood sugar is not high enough for Diabetes but
above average value).
e. Family
History of Diabetes.
f.
Previous history of GDM.
g. High
blood pressure or other such medical conditions.
h. Age
more than 25 years.
i.
Certain ethnicity shows more susceptible
to GDM but the reason is not known. Mainly seen in Native American,
African-American, Asian, and Hispanic. But this is not an established belief
and often found wrong.
Complications of Gestational Diabetes Mellitus
Complications for Child -
a. Macrosomia
(Large Baby) – The birth weight of the baby is more than the standard value.
b. Congenital
anomaly of Newborn
c. Increased
Risk of birth trauma in newborns.
d. Stillbirth or Neonatal mortality.
e. May
face Infantile Respiratory Distress Syndrome after birth. Meaning difficulty in
breathing after birth.
f.
Child may go into seizure due to reduced
blood sugar.
Complications for Mother –
a. Develop
future type 2 Diabetes.
b. Develop
High blood pressure.
c. Increases
the likelihood of C-section for the mother’s safety.
d. May
develop Preeclampsia, which is a serious complication for both mother and child
and can endanger their lives.
Prevention
There is no established clinical practice that can
guarantee to prevent Gestational Diabetes. But some lifestyle maintenance can
reduce the possibilities of GDM and can help reduce the complications developed
by it. These are very common practices and everyone can follow without much
hassle. They are –
a. Eat
healthy balanced meal.
b. Workout
daily for some time to stay active and fit.
c. Maintain
weight before pregnancy. It is best to maintain weight at all time as increased
weight does no good.
d. During
pregnancy women gain weight naturally but it should be maintained within the established range. In case of difficulties consult medical professionals.
Blood
sugar of a woman should be regularly checked by her physician during her
ante-natal care. If for some reason it is missed then the patient should mention it and get it done by their own accord as gestational diabetes is a very
important factor for the good health of the mother and baby.
Diagnosis of Gestational Diabetes Mellitus
1. Glucose
screening test by 1-hour 50gm OGTT
a. Irrespective
of food intake, 50gm of glucose is given orally, and at the end of 1-hour blood
glucose is measured.
b. Blood
glucose more than 7.8mmol/L (140 mg%) is suspected of gestational diabetes.
2. Diagnosis
of Gestational Diabetes Mellitus by 75gm OGTT (WHO Criteria)
c. Patient
is advised for overnight fasting and to come on the next morning.
d. Fasting
Blood glucose is measured and then 75gm of glucose is given orally with 300 ml
of water. At the end of 2 hours of glucose load, blood glucose is measured.
e. Gestational
Diabetes Mellitus is diagnosed if any of the following findings are found
positive.
o
Fasting Blood Glucose greater or equal to
7.0 mmol/L (126 mg%).
o
Blood Glucose after 2 hours greater or
equal to 7.8 mmol/L (140 mg%).
Reference –
1.
https://www.mayoclinic.org/diseases-conditions/gestational-diabetes/symptoms-causes/syc-20355339
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