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Gestational Diabetes: Symptoms, Causes, Diagnosis, treatment

Gestational diabetes is diabetes diagnosed during a pregnancy. It is also known as secondary diabetes because the usual cause of diabetes (a reduced ability to make or process insulin) is sometimes present but someone has already developed gestational diabetes.

 

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Gestational diabetes usually only lasts for the duration of a pregnancy and rarely leads to complications — it is not necessary to take medication or take glucose home from the hospital. However, since there may be extra risk for developing complications such as high blood pressure and preeclampsia, it's important for women with gestational diabetes to follow their health care provider's instructions carefully.

Women without a family history of diabetes may be more likely to develop gestational diabetes. Women who have had gestational diabetes in a prior pregnancy may have a higher risk of developing it again.

Symptoms:

The general symptoms are associated with high blood sugar such as increased urination, increased thirst and increased hunger. Some women may have nausea which is a symptom of uncontrolled blood sugar. Other symptoms are drowsiness, blurred vision, headache and fatigue.

When to see a doctor

If you have these symptoms, be sure to see your physician.

Why is it necessary to visit the doctor?

The first thing the doctor will do is take a blood sugar level. This is a test done in the morning while fasting, if you eat or drink anything before the test, your blood sugar level will be higher than normal and may be misleading as to why you are visiting the doctor. If you have gestational diabetes, your blood sugar may be too high at that time. The same goes for after giving birth. You will want to make sure that this unexpected high does not contribute to harming either baby or mother.

Causes:

There are many things that can cause gestational diabetes. Some of these include:

1. Ethnicity

2. Weight gain while pregnant, especially if it exceeds what is considered normal by your physician

3. Family history of diabetes

4. Other health complications such as high blood pressure or heart disease, if any in the family

5. Obesity

6. Age - gestational diabetes generally does not occur until 30 to 35 years of age due to the influence of age on insulin resistance, but this is becoming less significant as more women are living into their 70's and 80's and longer life spans are becoming more common

7. Medications - these include over the counter and prescription medications such as birth control pills, antihistamines and antibiotics

8. Stress

9. Insulin resistance - most cases of gestational diabetes are due to insulin resistance, which is when a body's tissues become resistant to insulin.

10. Diet - more and more research has shown that the type of food we eat can have an influence on the development of gestational diabetes

11. Iodine deficiency

Complications:

Women with gestational diabetes are at an increased risk of developing diabetes later in life. If a woman has gestational diabetes, it is recommended that she be tested for gestational diabetes in subsequent pregnancies to screen for any problems the child may have later in life. Gestational diabetes can also increase the chances of developing other complications such as high blood pressure and preeclampsia (a condition that can cause seizures and low blood pressure )

Complications in this pregnancy include preeclampsia, which is a potentially serious condition that occurs when levels of certain proteins increase fluid retention in your body and cause a rapid rise in blood pressure. This condition can lead to severe damage to your kidneys or damage to the placenta and impair fetal growth. Another risk is that diabetes may lead to high blood pressure during pregnancy, which can cause miscarriage and preterm birth.

If you have gestational diabetes, your baby's risk of having a birth defect is increased slightly, but not significantly.

Diagnosis:

A diagnosis of gestational diabetes usually involves taking a fasting glucose test between weeks 24 and 28 of the pregnancy. If this test reveals that your glucose level is greater than or equal to 120 mg/dl or if it remains greater than or equal to 100 mg/dl at the 1 hour mark, you will need to be retested within 48 hours. If both tests are positive, you will then be tested every 3 days until delivery.

If your fasting glucose level is below 100 mg/dl, you must be tested more frequently after delivery to make sure that your blood sugar levels have remained normal.

Treatment:

If you are diagnosed with gestational diabetes, it's important to follow your doctor's instructions closely so that you don't develop complications. Your doctor will monitor your blood sugar level and blood pressure during the pregnancy, as well as after delivery. If necessary, her treatment plan may include:

1. Approving the use of insulin or a form of insulin to help the body's cells respond to insulin better and keep blood sugar levels controlled at a healthy level

2. Changing your diet to lower your blood sugar levels

3. Taking a drug called metformin to help normalize your blood sugar levels when needed

4. Drinking milk or eating special carbohydrate-free snacks instead of high carbohydrate foods such as pretzels and crackers, which may increase the amount of insulin you need

If you are diagnosed with gestational diabetes, it is often advisable for you to check your blood sugar immediately after giving birth. If you have mild symptoms and it appears that your doctor does not need to monitor your blood sugar, you should not be given an infant finger prick test until 1 hour after delivery.

Prevention:

There are several steps you can take to prevent gestational diabetes. These include:

1. Eat a healthy diet. It's especially important for pregnant women to eat the proper amount of protein, carbohydrates and calories during pregnancy, which is about 3500 calories per day when you are pregnant. You should try eating at least 45 grams of protein with each meal to supply your body with the essential amino acids needed for baby's development.

2. Limit your sodium intake if you are on a prescription drug such as diuretic, including high blood pressure medication or heartburn medication used to ease stomach upset and heartburn during pregnancy

3. Limit your intake of sweets and refined sugar.

4. If you are overweight, try to lose weight prior to becoming pregnant to reduce the chance of developing gestational diabetes or other complications during pregnancy.

5. Exercise regularly - this is beneficial for you and your baby, as well as lowering the risk of gestational diabetes and preeclampsia.  Start exercising at least 3 months before getting pregnant so that you do not put undue stress on your body while pregnant. However, if you have never exercised before, it is best to start slowly to prevent any physical side effects such as sore muscles or injury during pregnancy.

6. Avoid smoking during pregnancy. Sucking on cigarettes can make it more difficult to control your blood sugar, while the nicotine in tobacco may interfere with the development of the baby's lungs.

7. If you are diagnosed with gestational diabetes, it is important that you try to maintain a healthy weight throughout your pregnancy and after delivery. If you have gestational diabetes, your doctor or midwife will give you specific instructions for exercising and food intake that are necessary for maintaining a healthy weight throughout your pregnancy and after delivery to help prevent complications from gestational diabetes.

 

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