Gestational Diabetes Mellitus (GDM)

What is gestational diabetes mellitus?

Gestational diabetes mellitus ( GDM ) is a condition in which a hormone made by the placenta prevents the body from using insulin efficaciously. Glucose builds up in the blood alternatively of being absorbed by the cells. Unlike type 1 diabetes, gestational diabetes is not caused by a miss of insulin, but by other hormones produced during pregnancy that can make insulin less effective, a condition referred to as insulin resistance. Gestational diabetic symptoms disappear following manner of speaking. approximately 3 to 8 percentage of all pregnant women in the United States are diagnosed with gestational diabetes .

What causes gestational diabetes mellitus?

Although the cause of GDM is not known, there are some theories as to why the condition occurs.

The placenta supplies a growing fetus with nutrients and water, and besides produces a assortment of hormones to maintain the pregnancy. Some of these hormones ( estrogen, hydrocortisone, and human placental lactogen ) can have a obstruct effect on insulin. This is called contra-insulin effect, which normally begins about 20 to 24 weeks into the pregnancy. As the placenta grows, more of these hormones are produced, and the risk of insulin resistance becomes greater. normally, the pancreas is able to make extra insulin to overcome insulin resistor, but when the production of insulin is not adequate to overcome the consequence of the placental hormones, gestational diabetes results .

What are the risks factors associated with gestational diabetes mellitus?

Although any woman can develop GDM during pregnancy, some of the factors that may increase the risk include the follow :

  • Overweight or fleshiness
  • syndicate history of diabetes
  • Having given parturition previously to an baby weighing greater than 9 pounds
  • Age ( women who are older than 25 are at a greater risk for developing gestational diabetes than younger women )
  • Race ( women who are african-american, American Indian, asian American, Hispanic or Latino, or Pacific Islander have a higher risk )
  • Prediabetes, besides known as impaired glucose tolerance

Although increased glucose in the urine is frequently included in the list of risk factors, it is not believed to be a authentic indicator for GDM .

How is gestational diabetes mellitus diagnosed?

The American Diabetes Association recommends screening for undiagnosed type 2 diabetes at the first gear prenatal visit in women with diabetes risk factors. In meaning women not known to have diabetes, GDM testing should be performed at 24 to 28 weeks of gestation. In addition, women with diagnose GDM should be screened for persistent diabetes 6 to 12 weeks postnatal. It is besides recommended that women with a history of GDM undergo lifelong screen for the development of diabetes or prediabetes at least every three years .

What is the treatment for gestational diabetes mellitus?

particular treatment for gestational diabetes will be determined by your doctor based on :

  • Your senesce, overall health, and checkup history
  • extent of the disease
  • Your permissiveness for specific medications, procedures, or therapies
  • Expectations for the course of the disease
  • Your opinion or predilection

discussion for gestational diabetes focuses on keeping blood glucose levels in the normal range. treatment may include :

  • special diet
  • drill
  • daily blood glucose monitor
  • Insulin injections

Possible complications for the baby

Unlike type 1 diabetes, gestational diabetes by and large occurs besides late to cause parturition defects. Birth defects normally originate sometime during the first gear clean-cut ( before the 13th workweek ) of pregnancy. The insulin resistance from the contra-insulin hormones produced by the placenta does not normally occur until approximately the twenty-fourth workweek. Women with gestational diabetes mellitus generally have normal blood boodle levels during the critical first shipshape. The complications of GDM are normally accomplishable and preventable. The winder to prevention is careful control condition of blood sugar levels merely arsenic soon as the diagnosis of diabetes is made. Infants of mothers with gestational diabetes are vulnerable to respective chemical imbalances, such as low serum calcium and low serum magnesium levels, but, in general, there are two major problems of gestational diabetes : macrosomia and hypoglycemia :

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  • Macrosomia. Macrosomia refers to a baby who is well larger than normal. All of the nutrients the fetus receives come directly from the mother ‘s blood. If the parental blood has excessively much glucose, the pancreas of the fetus senses the high glucose levels and produces more insulin in an attack to use this glucose. The fetus converts the extra glucose to fat. even when the mother has gestational diabetes, the fetus is able to produce all the insulin it needs. The combination of high blood glucose levels from the mother and high insulin levels in the fetus results in large deposits of fatness which causes the fetus to grow excessively big .
  • Hypoglycemia. Hypoglycemia refers to low rake sugar in the baby immediately after manner of speaking. This problem occurs if the mother ‘s blood sugar levels have been systematically high, causing the fetus to have a gamey level of insulin in its circulation. After delivery, the baby continues to have a high insulin grade, but it no longer has the high gear level of carbohydrate from its mother, resulting in the newborn ‘s rake sugar level becoming very low. The child ‘s rake carbohydrate level is checked after birth, and if the flat is excessively first gear, it may be necessity to give the child glucose intravenously .

Blood glucose is monitored very close during tug. Insulin may be given to keep the mother ‘s rake sugar in a normal range to prevent the baby ‘s blood boodle from dropping excessively after manner of speaking .

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