Gestational Diabetes – Part One

What does Diabetes when pregnant really mean?

This is the first of two blog posts about Gestational Diabetes and what it is. Tune in for the second post to talk more about insulin and what it is along with how to diagnose this condition.

Gestational Diabetes is the medical term of acquiring Diabetes while pregnant. This can be a very alarming condition that arises when pregnant. It’s usually a shock when diagnosed but over time, a realization and understanding take over.

This type of condition means that you did not have a problem, related to Diabetes, before your pregnancy and then wham…..your doctor tells you that you have Gestational Diabetes.

Diabetes and Gestational Diabetes means you have a high blood glucose level. Glucose is a sugar molecule that is what normal food is broken down into, as it passes through the blood stream.  Glucose combines with insulin and together, they enter a cell and are used as energy.  Gestational Diabetes usually starts halfway through the pregnancy.

Therefore, Gestational Diabetes is when not enough insulin is produced because you are pregnant.  There are a few problems that should be mentioned.  The first is that often there are relatively few symptoms to begin with. Because of this, almost all women, who are pregnant are screened at some time during their pregnancy.  On average, 5% of all women may have gestational diabetes.

The second big problem is that the babies born to mothers with Gestational Diabetes have their own risks.  They are often larger in size, can have a condition called jaundice, and may actually have low blood sugar after birth.  Another risk is that of newborn death or stillbirth.

Jaundice is when a baby is unable to get rid of certain molecules in the body, such as bilirubin. Though, not all babies with jaundice can point to Gestational Diabetes as the cause.  Jaundice means that baby’s can be yellow in color and have a tendency to cry more often. Treatment is a Bili light for a few weeks after birth. In very small cases, a brain-damaging condition can occur without treatment.


Who is at risk?

1.)     If you’ve had a previous birth with gestational diabetes – this may be a risk.
2.)    If you are overweight – this increases your risk
3.)    As age increases, especially over age 35, so does the risk
4.)    Family history of Diabetes
5.)    Ethnicity – higher risk for Caribbean history, Hispanics, Pacific Islanders, Native Americans, and African-Americans.
6.)    Pregnant – this alone is a risk, and therefore, all women should be screened.


Future Risks and Treatment

For women who become diabetic while pregnant, they risk a future development of Diabetes Mellitus Type 2.  Type 2 is a mostly permanent condition of elevated blood glucose.   Treatment of Type 2 is almost always oral medications and in serious cases, treatment with insulin. But since Gestational Diabetes resolves once the baby is born, the risk of getting Diabetes is therefore for years or months after the birth, when the mother is no longer pregnant.

For women who are pregnant and have Gestational Diabetes, the treatment is often essential to control blood sugar.  In simple cases, monitoring foods and avoiding sugars, especially simple sugars are essential.  Folic acid supplements may help improve and ensure good pregnancy outcomes.  But in some cases, dietary changes are the only thing required.

In many cases, the mother may be required to be treated with insulin.  Insulin is an anti-diabetic drug that replaces the insulin that is typically secreted from the pancreas.  Again, once the baby is delivered, insulin is stopped.  But, if you’ve had Gestational diabetes, and require insulin, there is a 1 out of 2 chance that you’ll develop diabetes within the next five years.

In some more recent research and trials for medications to help with Gestational Diabetes, oral medications may be a helpful solution.  Metformin and Glyburide have been looked at and they show some promise.  But remember, a medication must be safe for the baby as well, not just the mother.  And so far, they are pretty safe.

Today, we’ve talked about what Gestational Diabetes is, Risk Factors, future risks of diabetes, and treatment of this condition. In the next installment, Part II, we will look at How Gestational Diabetes resolves, how to diagnose this condition, and what exactly insulin is.  Tune in for Part II.

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