Pregnancy with Gestational Diabetes

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Topic Pregnancy with Gestational Diabetes
Gestational diabetes is a condition characterized by high blood sugar (glucose) levels that is first recognized during pregnancy. The condition occurs in approximately 4% of all pregnancies. What Causes Gestational Diabetes in Pregnancy

Almost all women have some degree of impaired glucose intolerance as a result of hormonal changes that occur during pregnancy. That means that their blood sugar may be 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 resisting the actions of insulin. Over the course of the pregnancy, these hormones lead to progressive impaired glucose intolerance (higher blood sugar levels). To try to decrease blood sugar levels, the body makes more insulin to get glucose into cells to be used for energy. 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 blood sugar levels. If, however, the pancreas cannot produce enough insulin to overcome the effect of the increased hormones during pregnancy, blood sugar levels will rise, resulting in gestational diabetes. Complications of Gestational Diabetes

Diabetes can affect the developing fetus throughout the pregnancy. In early pregnancy, a mother's 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, a mother's 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 he or she 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 sugar can drop very low after birth, since it won't be receiving the high blood sugar from the mother. However, with proper treatment, you can deliver a healthy baby despite having diabetes. Risks for Gestational Diabetes:

The following factors increase the risk of developing gestational diabetes during pregnancy Being overweight prior to becoming pregnant (if you are 20% or more over your ideal body weight) Being a member of a high risk ethnic group (Hispanic, Black, Native American, or Asian) Having sugar in your urine

Impaired glucose tolerance or impaired fasting glucose (blood sugar levels are high, but not high enough to be diabetes) Family history of diabetes (if your parents or siblings have diabetes Previously giving birth to a baby over 9 pounds

Previously giving birth to a stillborn baby
Having gestational diabetes with a previous pregnancy
Having too much amniotic fluid (a condition called polyhydramnios) Many women who develop gestational diabetes have no known risk factors. Gestational Diabetes Diagnosed:
High risk women should be screened for gestational diabetes as early as possible during their pregnancies. All other women will be screened between the 24th and 28th week of pregnancy. To screen for gestational diabetes, you will take a test called the oral glucose tolerance test. This test involves quickly drinking a sweetened liquid, which contains 50g of sugar. The body absorbs this sugar rapidly, causing blood sugar levels to rise within 30-60 minutes. A blood sample will be taken from a vein in your arm 1 hour after drinking the solution. The blood test measures how the sugar solution was...
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