Gestational Diabetes
Gestational diabetes is a chemical diabetes that develops during pregnancy, usually after the third month of pregnancy. Pregnancy can produce temporary changes in the way the pregnant woman's blood sugar is regulated. Towards the end of the second trimester, at six months, the baby begins dramatic growth. To give the baby enough nourishment, the placenta and the pregnant woman's body produce hormones. These hormones raise the pregnant woman's blood sugar level. Normally, the pregnant woman's pancreas makes extra insulin to cover the raised blood sugar level. This helps keep the pregnant woman's blood sugar level normal. In some pregnant women though, the pancreas can't make enough extra insulin. Thus, too much sugar builds up in the pregnant woman's blood and gestational diabetes occurs.
Gestational diabetes is usually not permanent. It usually goes away after the baby is delivered because those things that increase the need for insulin disappear after delivery. However, more than half of all women that get gestational diabetes will develop permanent diabetes within ten years after delivery of their baby. Women who are overweight during these ten years are at a particularly high risk.
Factors which may make a woman more prone to developing gestational diabetes include:
1. Being overweight – excess fat causes cells to resist the action of insulin, resulting in the cells having difficulty using blood glucose for energy. This causes sugar to build up in the blood and thus raise blood sugar levels.
2. A family history of diabetes – any woman who has a parent, brother, or sister with diabetes has an increased risk of developing diabetes in pregnancy.
3. A prior history of gestational diabetes, delivery of a baby weighing more than ten pounds, or an unexplained stillbirth or miscarriage.
4. Stress – severe emotional or physical stress will not cause diabetes but may trigger it in someone who is prone to the disease. Stress causes an increase in hormones and this raises blood sugar levels.
Dangers of Gestational Diabetes
Though gestational diabetes may go away after delivery, it can cause problems for the baby and the pregnant woman. As in any diabetic pregnancy, the primary danger is uncontrolled blood sugar. Today, sugar levels can be controlled and almost all pregnant women with gestational diabetes do very well.
Gestational diabetes can cause the pregnant woman to develop toxemia with swelling and increasing blood pressure. Some women with gestational diabetes may have classic symptoms of diabetes such as increased thirst, hunger, frequent urination and weakness, but others may have no symptoms and feel healthy.
For the baby, the major risks include:
1. High birth weight – when the pregnant woman's blood sugar levels are high, the baby is overfed from excess sugar. The baby then becomes fat and large which can be dangerous for the baby and the pregnant woman during a vaginal delivery. Very large babies are therefore generally delivered by C-section.
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2. Low blood sugar – odd as it may seem, the baby of a pregnant woman with high blood sugar may develop low blood sugar after delivery. During pregnancy, the pregnant woman's insulin isn't shared with the baby. The baby makes and uses its own insulin. When the baby is fed increased sugar, the baby's pancreas gets used to producing an increased amount of insulin, but after birth, the baby is no longer getting sugar from the pregnant woman but may continue to produce too much insulin.
As a result, its blood sugar level may fall too low, which if prolonged, may cause brain damage. Fortunately this is rare and easily avoidable if medical personnel are used to caring for babies of pregnant women with gestational diabetes
3. Respiratory distress syndrome (difficulty breathing) – an infant's ability to breathe normally depends on having sufficiently developed lungs. In some pregnancies complicated by diabetes, a baby's lungs lack what is known as surfactant, a film that coats the lungs and makes breathing possible.