Pregnancy presents an enormous burden on the woman's body. Even though it is a completely natural process, not every body can tolerate well all the changes. Gestational diabetes mellitus or gestational diabetes most often occurs in predisposed women at the beginning of the third trimester, when there are significant changes of the levels of many hormones. In such a situation there is an increased amount of sugar, glucose, in the blood, similar to other types of diabetes. Increased blood sugar is not good for several organs, in the case of pregnancy, however, not only for the organs of the mother, but also of the developing child.
Causes of gestational diabetes
Gestational diabetes in most cases corresponds to type 2 diabetes, which nowadays more and more elderly people suffer from. Typical is often sufficient production of insulin, a pancreatic hormone. It is formed in the islets of Langerhans of the pancreas and through pancreatic ducts it is released into the duodenum. The function of insulin is to reduce the amount of glucose in the blood. The problem is in insulin resistance, i.e. the tissues are insensitive to insulin. For this reason glucose does not get into the tissues and thus remains in the blood.
Risk factors of gestational diabetes
Gestational diabetes occurs in about 5% of pregnant women and postpartum typically disappears. Risk factors for diabetes include especially age over 30 years, the incidence of diabetes in first-degree relatives, overweight, smoking, previous birth of a child with weight over 4000 g. In women who have experienced gestational diabetes, the disease significantly increases the risk of type 2 diabetes in the following years.
Symptoms of gestational diabetes
Due to the fact that blood glucose is usually not dramatically increased during gestational diabetes, most women do not notice any difficulties. Therefore it is necessary to monitor blood glucose during pregnancy when visiting a doctor. Nevertheless, the intolerance of glucose is not usually too serious, it is very important to carefully monitor the disease in the interest of developing a healthy fetus. Gestational diabetes is manifested only during prolonged untreated diabetes; the symptoms are increased urination, fatigue, thirst, frequent infections and impaired wound healing.
Symptoms of untreated gestational diabetes
If gestational diabetes is untreated or inadequately treated, it can develop consequences for both the mother and the fetus.
Consequences of gestational diabetes on the fetus
Mother's increased blood sugar gets through the placenta into the bloodstream of the fetus. It responds by increased production of insulin. For a fetus it is also a growth hormone, due to which a child grows rapidly, increasing its supply of fat, also muscles and bones grow. The birth of such a child presents a risk for the baby, who can be injured in the birth canal, as well as for the mother, whose perineum can be injured. Therefore, the delivery of the baby is done by Caesarean section. If the mother's diabetes is untreated the development of fetal organs is delayed and the child after birth can have breathing problems, worse neonatal jaundice, but also heart rhythm disorders. In the first days after birth, the newborn also has risk of hypoglycemia, which can lead to disorders of consciousness. The most serious consequence of untreated gestational diabetes is intrauterine fetal death. When these children are older they are at risk of attention disorders, brain dysfunction, hyperactivity, childhood obesity and in adulthood a higher incidence of type 2 diabetes.
Consequences of gestational diabetes on the mother
If the gestational diabetes is not treated properly, complications can develop such as the occurrence of high blood pressure, increased incidence of infections, birth injuries, or preeclampsia, a high blood pressure linked to pregnancy. Also there is a risk that the diabetes will continue after childbirth.
Treatment of gestational diabetes
Women diagnosed with gestational diabetes are usually forced to follow a diet with a prescribed amount of sugars per day and pregnancy exercise is considerably emphasized. Unfortunately, these measures are not sufficient for all patients, and therefore in such cases insulin injections must be applied. The physician decides the treatment method according to the value of blood sugar on an empty stomach, which ideally should not exceed 5.5 mmol / l.
Prognosis of gestational diabetes
The discovery of gestational diabetes is certainly quite unpleasant due to the increasing risks for both mother and child. On the other hand, treatment of all types of diabetes has nowadays progressed and with sufficient commitment, careful following of the regime and advices of doctors such a condition can be well managed. The good news for these patients is undoubtedly the fact that in most cases postpartum the blood sugar levels again spontaneously normalize thus ends the need to follow a diet or insulin application. Nevertheless, it is important to keep in mind that after gestational diabetes there is a lifelong increased risk of developing diabetes type 2, and therefore it is wise to regularly check your blood glucose levels with your general physician.