Gestational Diabetes: Symptoms, Causes and Treatment

Gestational Diabetes: Definition

Gestational diabetes is a condition that refers to high blood glucose levels observed during pregnancy. The to-be-mother may or may not have a previous medical history of diabetes. The condition is also clinically referred to as gestational diabetes mellitus or GDM. Gestational diabetes arises from glucose intolerance during a pregnancy and is diagnosed during routine screening. The high level of glucose in the tested blood samples is known to affect around 10% of pregnancies.

Causes of Gestational Diabetes

There is no specific cause yet identified for the onslaught of gestational diabetes. However, research reveals that the possible trigger is the hormonal imbalance caused during pregnancy. This is believed to increase the pregnant woman's resistance to insulin and finally results in a glucose tolerance that is impaired. Insulin is known to bind to its receptor on the cell membrane and this causes protein activation. The resultant plasma membrane translocation of the Glut-4 transporter and the influx of glucose via glycogen synthesis and that of fatty acids causes increased insulin resistance.

Hormones produced during pregnancy interfere with insulin action and the entry of glucose into cells. The result is that glucose remains within the bloodstream and the levels rise, generating the need for more insulin. Research reveals that women with GDM display insulin resistance that cannot be taken care of by the increased hormone production within the β-cells of the pancreas. The increase in fat deposits due to placental hormones mediate insulin resistance, increasing the action of cortisol, progesterone, human placental lactogen, estradiol and prolactin. Autoimmunity, obesity and single gene mutations are also observed as triggers for gestational diabetes.

Gestational Diabetes: Signs and Symptoms

The risk factors observed in the development of gestational diabetes include:

• Prediabetes or impaired fasting glycaemia.
• Family history of type 2 diabetes.
• Maternal age over 35 years.
• African-American, Native American or Hispanic ethnic origin. The condition is also observed among Pacific Islanders and natives of the Indian subcontinent.
• Obesity.
• Poor previous obstetric clinical analysis.
• Smoking during pregnancy.
• Polycystic ovarian syndrome.

The signs and symptoms commonly observed in women with gestational diabetes include increased thirst and hence increased urination, nausea and vomiting, fatigue, bladder infection, blurred vision and yeast infection. There are a number of screening and diagnostic gestational diabetes tests that are clinically conducted to record high levels of plasma or serum glucose.

Treatment Options

GDM treatment options include the administration of folic acid supplements and antidiabetic drugs as part of insulin therapy. The implementation of a dedicated diabetic diet to exclude simple carbohydrates and spread the daily carbohydrate consumption throughout the course of the day and moderate physical exercise are very necessary.

Controlling Gestational Diabetes

The screening glucose challenge test, oral glucose tolerance test or OGTT and urinary glucose testing helps to monitor gestational diabetes. Dedicated diet modifications, antidiabetic drugs, exercise and at times insulin help to control the condition.

Effects of Diabetes During Pregnancy

Women who are diagnosed with gestational diabetes are at an increased risk of producing offspring prone to childhood obesity and juvenile diabetes. The mother herself is at a risk of developing type 2 diabetes post-pregnancy. The fetus is exposed to increased levels of glucose since glucose travels to the embryo via the placenta. The increased insulin level within the fetus exposes the unborn to growth-stimulating effects like the development of a large body or macrosomia and an ongoing high insulin production level, after birth. The condition could also be the reverse, creating a low blood glucose level or hypoglycemia, in the new born.

Complications of Gestational Diabetes

The babies born to women who suffer gestational diabetes are exposed to an increased risk of prolonged gestational age, delivery complications, jaundice and low blood sugar levels. GDM imposes growth abnormalities and chemical imbalances on the baby. Gestational diabetes is treatable.