Diabetes: Gestational Diabetes
What is Gestational Diabetes?
Gestational diabetes is a condition characterized by high blood glucose
(sugar) levels that is first recognized during pregnancy. About
7% of all pregnant women in the U.S. are diagnosed with gestational
diabetes.
What Causes Gestational Diabetes?
Almost all women have some degree of impaired glucose intolerance during
pregnancy as a result of hormonal changes that occur during pregnancy. That
means that their blood sugar is higher than normal, but not high enough to have
diabetes. During the later part of pregnancy (the third trimester), these
hormonal changes place pregnant woman at risk for gestational diabetes.
During pregnancy, increased levels of certain hormones made in the placenta
(the organ that connects the baby by the umbilical cord to the uterus) help
shift nutrients from the mother to the developing fetus. Other hormones are
produced by the placenta to help prevent the mother from developing low blood
sugar. They work by stopping the actions of insulin.
Over the course of the pregnancy, these hormones lead to progressive impaired
glucose intolerance (higher blood glucose levels). To try to decrease the
glucose levels, the body makes more insulin to shuttle glucose into cells.
Usually the mother's pancreas is able to produce more insulin (about three
times the normal amount) to overcome the effect of the pregnancy hormones on
glucose levels. If, however, the pancreas cannot produce enough insulin to
overcome the effect of the increased hormones during pregnancy, glucose levels
will rise, resulting in gestational diabetes.
What Are the Complications of Gestational Diabetes?
Diabetes in a pregnant woman can affect the developing baby throughout the
pregnancy. In early pregnancy, maternal diabetes can result in birth defects and
an increased rate of miscarriage. Many of the
birth defects that occur affect
major organs such as the brain and heart.
During the second and third trimester, maternal diabetes can lead to
over-nutrition and excess growth of the baby. Having a large baby increases
risks during labor and delivery. For example, large babies often require
caesarean deliveries and if a large baby is delivered vaginally, they are at
increased risk for trauma to their shoulder.
In addition, when fetal over-nutrition occurs and hyperinsulinemia results,
the baby's blood glucose can drop very low after birth, since it won't be
receiving the high blood glucose from the mother.
However, with proper treatment, you can deliver a healthy baby despite having
gestational diabetes.
Next: Who is at risk for gestational diabetes? »
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