What is Gestational Diabetes and What is its Cause?
By Nina Nazor
Have you or someone you love been recently diagnosed
with gestational diabetes? You must be worried, but relax; it can be controlled with a healthy diet, exercise and insulin
Gestational diabetes is the type of diabetes mellitus that is
first detected during pregnancy, usually between week 24 and 28 of gestation. If you have gestational diabetes, your baby
does not have diabetes, however, you must keep your blood glucose levels under control to avoid health problems for you or
your baby. Gestational diabetes affects about 4% of all pregnant women in the United States each year.
What are the causes of gestational diabetes?
The causes of gestational diabetes are not understood in detail, but it seems like the placenta produces a hormone
called placental lactogen, which is thought to inactivate up to 50% of insulin action in your body. This makes it more difficult
for your cells to use insulin and glucose cannot enter the cells of your body to be stored or converted into energy and it
then can build up in your blood to very high levels.
When the baby is born
and the placenta is out of your body, it is very likely that your blood glucose levels return to normal, but once you've
had gestational diabetes, your chance of developing gestational diabetes in future pregnancies is increased, as it is the
risk of having type 2 diabetes.
In the case your blood glucose levels don't
get back to normal after having your baby, then you must have had diabetes before the pregnancy or developed type 1 or type
2 during the pregnancy. Then you would need to have diabetes treatment for good.
You should have a glucose test 6 weeks after delivery to make sure your glucose levels are in normal levels.
How does gestational diabetes affect you and your baby?
Your baby does not have diabetes. He is healthy and comfortable in your womb, but if you don't control glucose
levels, the baby can get hurt.
When your blood glucose levels are high,
the baby receives that excess glucose and produces more and more insulin to use it or store it as fat. This can make your
baby very big, what is called macrosomia.
If the baby is too big there
be problems like damaged shoulders or another trauma related with a difficult birth.
Also, the baby can develop dangerous low glucose levels after he is separated from you. Since he is used to get high
levels of glucose through the umbilical cord, his little body is used to release too much insulin, and that causes hypoglycemia
Another problem the baby might have could be breathing difficulty
because his lungs may not develop completely due to high glucose levels in your blood.
You can be at greater risk for hypertension, preclampsia and C-section, but remember, if you keep glucose under control
and follow a healthy diet, exercise regularly and do what your Diabetes Care Team tells you to do, you will have a successful
pregnancy and your baby will be healthy.
How is gestational diabetes
The test for diagnose has two components. First, the
people at the lab would give you a drink containing 50g of glucose. Then, after 1 hour, they would take another sample of
your blood and test it. If you have above 140 mg/dL they will ask you to come back other day to have a glucose tolerance test
In this test, they will take a fasting blood sample, give you a drink with 100g of glucose
and take samples again at 30 minutes, 1 hour, 2 hours and 3 hours.
is positive for gestational diabetes if you have any two of the following values: a fasting plasma glucose above 105 mg/dl,
a 1-hour glucose above than 190 mg/dl, a 2-hour glucose level above 165 mg/dl, or a 3-hour glucose concentration of more than
Treating gestational diabetes
Treatment has to be started immediately. Your health team might even ask you to stay at the
hospital to be monitored. For sure you will need to have a meal plan designed for you, an exercise plan, daily blood glucose
monitoring and insulin shots if your blood glucose levels don't respond well to diet and exercise.
The use of diabetes pills during pregnancy is not recommended since they cross the placenta
reaching the baby. Insulin works only in your body helping keep your blood glucose levels under control but without crossing
the placenta and thus, not affecting the baby.
Following the treatment correctly
will allow you to have a healthy pregnancy and birth, protecting your baby.
You have an increased risk for developing
diabetes in the future, so you should try to follow a healthy lifestyle, lose weight, exercise regularly, eat a well balanced
diet and stay fit.
Adapted from the American Diabetes Association: Gestational