Disease: Gestational Diabetes

    What is gestational diabetes?

    Gestational diabetes is diabetes, or high blood sugar levels, that develops during pregnancy. It occurs in about 4% of all pregnancies. It is usually diagnosed in the later stages of pregnancy and often occurs in women who have never had diabetes.

    What causes gestational diabetes?

    Gestational diabetes is thought to arise because the many changes, hormonal and otherwise, that occur in the body during pregnancy lead some women to become resistant to insulin. Insulin is a hormone made by specialized cells in the pancreas that allows the body to effectively use glucose for fuel (energy). When levels of insulin are low, or the body cannot effectively use insulin, blood glucose levels rise.

    What are risk factors for gestational diabetes?

    Some degree of insulin resistance and impaired glucose tolerance is normal in late pregnancy. However, in some women, this is enough to produce diabetes of pregnancy, or gestational diabetes. There are several risk factors that can increase your risk of getting gestational diabetes. Risk factors include:

    • Being overweight or obese
    • Having a history of gestational diabetes in a previous pregnancy
    • Having had a baby with a high birth weight (over 9 pounds)
    • Having a parent or sibling with type 2 diabetes
    • Having polycystic ovary syndrome (PCOS)
    • Being of African American, American Indian, Asian American, Hispanic, or Pacific Islander American ethnicity
    • Having pre-diabetes

    What are the symptoms of gestational diabetes?

    Gestational diabetes typically does not cause any noticeable signs or symptoms. This is why screening tests are so important. Rarely, an increase in thirst or increased urination may be noticed.

    How is gestational diabetes diagnosed?

    Gestational diabetes is diagnosed with blood tests. Most pregnant women are tested between the 24th and 28th weeks of pregnancy, but if you have risk factors, your doctor may decide to test earlier in the pregnancy.

    Blood testing confirms the diagnosis. A screening glucose challenge test involves drinking a sugary beverage and having your blood drawn for testing of glucose levels an hour later. If the screening test is not normal, you may need additional testing. Another type of test is an oral glucose challenge test (OGTT). For this test your baseline blood glucose level is checked and then measured at 1, 2, and sometimes 3 hours after consuming a sugary drink.

    Glycated hemoglobin, or hemoglobin A1c, is another test that may be performed. This test is used to monitor long-term blood glucose levels in people with diabetes. The hemoglobin A1c percentage offers a measure of the average blood glucose level over the past few months.

    What are the consequences of gestational diabetes for the baby and mother?

    Women with gestational diabetes who receive proper care typically go on to deliver healthy babies. However, if you have high blood glucose levels, this means the fetus also has high blood glucose levels. The elevation in blood glucose can cause the fetus to be larger than normal, possibly making delivery more complicated. The baby is also at risk for having low blood glucose (hypoglycemia) immediately after birth. Other serious complications of poorly controlled gestational diabetes in the newborn can include an increased risk of jaundice, an increased risk for respiratory distress syndrome, and a higher chance of dying before or following birth. The baby is also at a greater risk of becoming overweight and developing type 2 diabetes later in life.

    If diabetes is present in early pregnancy, there is an increased risk of birth defects and miscarriage compared to that of mothers without diabetes.

    Women with gestational diabetes have a higher chance of needing a Cesarean birth (C-section) due to the large sizes of their babies. Gestational diabetes may increase the risk of preeclampsia in the mother, a condition characterized by high blood pressure and protein in the urine. Women with gestational diabetes are also at increased risk of having type 2 diabetes after the pregnancy.

    What is the treatment for gestational diabetes?

    It is important to receive proper treatment for gestational diabetes, since research studies have shown that the incidence of problems and complications is decreased when treatment plans are followed. Treatment for gestational diabetes involves attention to maintaining a proper diet and exercise as advised by your doctor. Nutritional therapy is the first approach, and many women will achieve adequate glucose control by following a nutritional plan.

    Testing your blood glucose levels at home at specific times or after meals as recommended by your doctor will determine if your glucose levels are within recommended limits. Testing at least four times per day is typical. You may also be asked to test your urine for ketones, substances that are produced when your body metabolizes fat. Ketones are elevated when the body is unable to use glucose for energy.

    If diet and exercise are not sufficient to maintain good control of your blood glucose levels, you may need to take insulin. Insulin is the only approved medication used to treat gestational diabetes in the U.S.; however, some clinicians may choose to use an oral agent to control the blood sugar in some patients. As the pregnancy progresses, your insulin needs may change and insulin doses may have to be adjusted.

    Is there a special diet for a woman with gestational diabetes?

    While there is no one diet that is recommended for women with gestational diabetes, following a meal plan can help keep your blood sugar levels under control and avoid complications.

    • A nutritionist can help you design a meal plan that works for your schedule and preferences.
    • Eating a variety of foods is recommended, and it is better to eat smaller portions throughout the day (such as 3 small to moderate meals and 2-4 snacks) rather than just a few large meals.
    • Many women with gestational diabetes will be advised to eat fewer carbohydrates than in their normal diet and to eat complex carbohydrates that contain fiber. It’s important to limit consumption of foods and drinks with simple sugars like soda, juice, and desserts.
    • High-fiber foods like fresh fruits and vegetables as well as whole-grain products, are not only nutritious but also help keep blood sugar levels stable.
    • Skipping meals is not recommended since this further promotes fluctuations in blood sugar levels.

    What are the symptoms of gestational diabetes?

    Gestational diabetes typically does not cause any noticeable signs or symptoms. This is why screening tests are so important. Rarely, an increase in thirst or increased urination may be noticed.

    How is gestational diabetes diagnosed?

    Gestational diabetes is diagnosed with blood tests. Most pregnant women are tested between the 24th and 28th weeks of pregnancy, but if you have risk factors, your doctor may decide to test earlier in the pregnancy.

    Blood testing confirms the diagnosis. A screening glucose challenge test involves drinking a sugary beverage and having your blood drawn for testing of glucose levels an hour later. If the screening test is not normal, you may need additional testing. Another type of test is an oral glucose challenge test (OGTT). For this test your baseline blood glucose level is checked and then measured at 1, 2, and sometimes 3 hours after consuming a sugary drink.

    Glycated hemoglobin, or hemoglobin A1c, is another test that may be performed. This test is used to monitor long-term blood glucose levels in people with diabetes. The hemoglobin A1c percentage offers a measure of the average blood glucose level over the past few months.

    What are the consequences of gestational diabetes for the baby and mother?

    Women with gestational diabetes who receive proper care typically go on to deliver healthy babies. However, if you have high blood glucose levels, this means the fetus also has high blood glucose levels. The elevation in blood glucose can cause the fetus to be larger than normal, possibly making delivery more complicated. The baby is also at risk for having low blood glucose (hypoglycemia) immediately after birth. Other serious complications of poorly controlled gestational diabetes in the newborn can include an increased risk of jaundice, an increased risk for respiratory distress syndrome, and a higher chance of dying before or following birth. The baby is also at a greater risk of becoming overweight and developing type 2 diabetes later in life.

    If diabetes is present in early pregnancy, there is an increased risk of birth defects and miscarriage compared to that of mothers without diabetes.

    Women with gestational diabetes have a higher chance of needing a Cesarean birth (C-section) due to the large sizes of their babies. Gestational diabetes may increase the risk of preeclampsia in the mother, a condition characterized by high blood pressure and protein in the urine. Women with gestational diabetes are also at increased risk of having type 2 diabetes after the pregnancy.

    What is the treatment for gestational diabetes?

    It is important to receive proper treatment for gestational diabetes, since research studies have shown that the incidence of problems and complications is decreased when treatment plans are followed. Treatment for gestational diabetes involves attention to maintaining a proper diet and exercise as advised by your doctor. Nutritional therapy is the first approach, and many women will achieve adequate glucose control by following a nutritional plan.

    Testing your blood glucose levels at home at specific times or after meals as recommended by your doctor will determine if your glucose levels are within recommended limits. Testing at least four times per day is typical. You may also be asked to test your urine for ketones, substances that are produced when your body metabolizes fat. Ketones are elevated when the body is unable to use glucose for energy.

    If diet and exercise are not sufficient to maintain good control of your blood glucose levels, you may need to take insulin. Insulin is the only approved medication used to treat gestational diabetes in the U.S.; however, some clinicians may choose to use an oral agent to control the blood sugar in some patients. As the pregnancy progresses, your insulin needs may change and insulin doses may have to be adjusted.

    Is there a special diet for a woman with gestational diabetes?

    While there is no one diet that is recommended for women with gestational diabetes, following a meal plan can help keep your blood sugar levels under control and avoid complications.

    • A nutritionist can help you design a meal plan that works for your schedule and preferences.
    • Eating a variety of foods is recommended, and it is better to eat smaller portions throughout the day (such as 3 small to moderate meals and 2-4 snacks) rather than just a few large meals.
    • Many women with gestational diabetes will be advised to eat fewer carbohydrates than in their normal diet and to eat complex carbohydrates that contain fiber. It’s important to limit consumption of foods and drinks with simple sugars like soda, juice, and desserts.
    • High-fiber foods like fresh fruits and vegetables as well as whole-grain products, are not only nutritious but also help keep blood sugar levels stable.
    • Skipping meals is not recommended since this further promotes fluctuations in blood sugar levels.

    Source: http://www.rxlist.com

    It is important to receive proper treatment for gestational diabetes, since research studies have shown that the incidence of problems and complications is decreased when treatment plans are followed. Treatment for gestational diabetes involves attention to maintaining a proper diet and exercise as advised by your doctor. Nutritional therapy is the first approach, and many women will achieve adequate glucose control by following a nutritional plan.

    Testing your blood glucose levels at home at specific times or after meals as recommended by your doctor will determine if your glucose levels are within recommended limits. Testing at least four times per day is typical. You may also be asked to test your urine for ketones, substances that are produced when your body metabolizes fat. Ketones are elevated when the body is unable to use glucose for energy.

    If diet and exercise are not sufficient to maintain good control of your blood glucose levels, you may need to take insulin. Insulin is the only approved medication used to treat gestational diabetes in the U.S.; however, some clinicians may choose to use an oral agent to control the blood sugar in some patients. As the pregnancy progresses, your insulin needs may change and insulin doses may have to be adjusted.

    Source: http://www.rxlist.com

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