Diabetic Pregnant Women - Gestational Diabetes
Gestational diabetes affects approximately 3 to 5 percent of all pregnant women in the United States. This article addresses issues such as diet, exercise, blood sugar level and general medical care of women with gestational diabetes.
Diabetes is a disease where the body uses food improperly. The body gets its main energy source from glucose or from a breakdown of complex carbohydrates such as starches. Once sugar and starches are digested, they enter the blood stream in the form of glucose. Insulin assists the body in getting the glucose from the blood stream to the muscles and other body tissues. The pancreas is where insulin is manufactured. Glucose cannot get into the body cells without insulin. Instead, glucose accumulates in the blood and is excreted into the urine through the kidneys.
Women with gestational diabetes have plenty of insulin. The problem is that the insulin is partly blocked by hormones made in the placenta. This is called insulin resistance. In women without gestational diabetes, the pancreas makes enough insulin to overcome the insulin resistance. But when the pancreas makes all the insulin it can and it still cannot overcome the effect of the placenta's hormones, that woman has gestational diabetes.
Factors associated with an increased risk of gestational diabetes are obesity, diabetes in the family, a stillbirth, or a child with a birth defect. Studies have shown that women older than 25 are also at greater risk. The Council on Diabetes in Pregnancy recommends that all pregnant women be screened for this disease. One of the most common screening methods is the 50-gram glucose screening test.
The key to preventing complications is control of blood sugar levels immediately after the diagnosis of gestational diabetes. A comforting fact is that
gestational diabetes does not cause birth defects. But many babies are born much larger than average. The baby can grow too large for a vaginal birth and a cesarean section delivery is necessary. In some cases, the baby is born with hypoglycemia. In this case, the baby will be given glucose intravenously. These two examples are manageable and preventable.
The key is careful control of blood sugar levels in the mother immediately after the diagnosis of gestational diabetes.
An important component in caring for gestational diabetes is a strict diet. There is a wide assortment of literature that details dietary guidelines for women with gestational diabetes. Her health care practitioner will teach her how to measure her blood glucose level at home. Additionally, she may have to check her urine for ketones (these are by-products of the breakdown of fat). Ketones may be found in the blood and urine as a result of inadequate insulin.
It is very unlikely that the baby will have diabetes. However, the child may be at risk for Type II diabetes. Other problems such as hypoglycemia and jaundice may also occur.
More than likely, gestational diabetes goes away immediately after delivery. But these women are at risk of developing it in future pregnancies. Make sure to have screening tests during subsequent pregnancies in the first trimester. By Michael Russell
