Diabetes mellitus is a serious medical disorder characterized by varying or persistent levels of blood sugar as a result of the defective secretion of the hormone insulin. It is a lifelong condition and has many potential complications.
Many people are unaware that diabetes can also develop during pregnancy. This is known as gestational diabetes, which affects 2 to 3 percent of pregnant women. If not properly controlled, it can lead to problems for the mother or baby.
What exactly is diabetes?
Diabetes is a metabolic disorder, which means a disorder in the process that our bodies use digested food for growth and energy. Most of the food we eat is broken down into glucose, the form of sugar that is present in our blood. This means that glucose is the main fuel for the body. It is used by cells for growth and energy, but cannot enter cells without the presence of insulin – a hormone produced by the pancreas, a large gland behind the stomach. This is a well-coordinated process. When we eat, the pancreas automatically produces the right amount of insulin to move glucose from the blood into cells.
When a person has diabetes, however, the pancreas produces little or no insulin, or the cells do not respond properly to insulin that is produced. The results are clear – glucose accumulates in the blood, overflows into the urine, and passes out of the body.
The incidence of the condition
It is estimated that about 7 percent of the population, have diabetes. Of these, 14.6 million have been diagnosed, and 6.2 million have not been diagnosed. About 1.5 million people aged 20 or older have been diagnosed with diabetes.
About 1 in 200 women of childbearing age has diabetes before pregnancy and other 2 to 5 percent develop diabetes during pregnancy.
Gestational diabetes and possible causes
GDM is a specific type of diabetes that occurs during pregnancy, usually during the second or third quarter. During pregnancy, the body needs more insulin, but what mechanism leads to diabetes is not yet completely clear. During pregnancy, the placenta produces several female hormones such as estrogen, cortisol and human placental lactogen, which prevent insulin from doing its job. These hormones are vital to the preservation of their pregnancy. In some women, this type of diabetes is that the body cannot produce enough insulin to meet the additional needs of pregnancy. Anyway, if diabetes was diagnosed in the first quarter, the most likely condition is that existed before pregnancy.
Diabetes and risks for the baby
Increasing the possibility of birth defects
It has been shown that women with poorly controlled preexisting diabetes in the first weeks of pregnancy are 3 to 4 times more likely to have a baby with a serious birth defect, such as:
- A heart defect
- NTD
- Other birth defects of the brain or spinal cord
They are also at increased risk of miscarriage and stillbirth.
The exact month pregnancy in a woman developed this condition is of great importance. Women with gestational diabetes, which generally develops later in pregnancy, usually have a higher risk of having a baby with a birth defect.
Hypoglycemia
Sometimes babies of mothers with gestational diabetes develop blood sugar (hypoglycemia) shortly after birth.
Macrosomia – very large baby
It has been shown that women with poorly controlled diabetes are at greater risk of having a very large baby. This condition is known as macrosomia. It is proven that these babies grow much due to the extra sugar in the blood of the mother crosses the placenta and enters the fetus. The fetus begins to produce more insulin, which helps process sugar and store it as fat. This excess fat tends to accumulate around the shoulders and trunk, making it difficult vaginal delivery and increases the risk of injury during childbirth.
Baby Death
There is also a slightly increased chance of stillbirth or newborn death, but if diabetes and glucose levels detected are well managed, death is rare.
Other problems
Research has shown that babies of women with poorly controlled diabetes are at greater risk of breathing difficulties, low blood sugar and jaundice. Babies of women with poorly controlled diabetes may also be at increased risk of developing obesity and diabetes as young adults.
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Gestational diabetes and the risks for mother
Gestational diabetes is not an immediate threat to the health of women. This means that most women whose blood sugar levels are kept within the safe range give birth without complications, although some women may result in high blood pressure.
The problem is that women who develop gestational diabetes are more likely to develop gestational diabetes in future pregnancies, and are at greater risk of developing type II diabetes later in life. That’s why early diagnosis and treatment are crucial.
Risk factors for developing gestational diabetes
Although there are no rules, it has been shown that some risk factors may contribute to the development of gestational diabetes. Some of them are:
Years – Is proven that women over 25 are more likely to develop gestational diabetes, although it may actually occur at any age.
Personal or family history – Several studies conducted in the past have shown that the likelihood of developing gestational diabetes increases if a close family member such as a parent or sibling has type 2 diabetes.
Weight – Is it reasonable that overweight before pregnancy makes it more likely that you will develop gestational diabetes. However, weight gain during pregnancy does not cause gestational diabetes.
Race – Some statistics are indicating that women are at greater risk if African American, Hispanic or American Indian.
The diagnosis of gestational diabetes
To detect gestational diabetes, most doctors recommend a test of glucose tolerance. A woman is given a glucose solution to drink, and then blood samples are taken and analyzed at different time intervals to see how the body handles glucose at different times. Experts disagree about whether a pregnant woman is under 25 and has no other risk factors for gestational diabetes have to have this test. Another useful test is a simple urine test. Unfortunately, it is not a reliable indicator of gestational diabetes because the amount of sugar in the urine can vary throughout the day, as a result of what a woman was eating.
Treatment of diabetes in pregnancy – Check the sugar in the body
Diet
A pregnant woman who has been diagnosed with diabetes should follow a diet designed especially for her. The number of calories a pregnant woman with diabetes should eat depending on many factors, including weight, pregnancy and baby’s growth rate. However, there are some rules that must be followed. A pregnant woman with diabetes has an average weight should consume about 2,000 to 2,200 calories a day.
This should help your increase in the recommended amount of 25 to 35 pounds / 10 kilos to 15 during pregnancy.
The dietitian will most likely recommend a diet that includes:
- 10 to 20 percent of calories from protein (meat, poultry, fish, vegetables);
- Approximately 30 percent fat (less than 10 percent of saturated fats);
- Avoid sweets.
Glucose test kits at home are also available. These usually involve taking a small sample of blood with a puncture device. The blood is placed on a strip and is inserted into a measuring device glucose, which gives the blood glucose level.
Regular exercise
Exercise can help control diabetes by asking the body to use insulin more efficiently and is recommended for most women with gestational diabetes and some women with preexisting diabetes. Not only that, but regular exercise can help prevent some of the discomforts of pregnancy, such as:
- Back pain,
- Muscle cramps,
- Swelling,
- Constipation
- Difficulty to sleep
You can also help prepare for childbirth. Women should not practice some hard exercises. She should aim moderate aerobic exercise on most days. For best results, aerobic activity should be combined with stretching and strength training exercises. Exercising at the same time every day, varying your fitness routine and working with other pregnant women can help a woman maintain motivation.
The drugs
Sometimes diet and exercise may not be enough. In that case, a pregnant woman must take daily medication to help reduce your level of blood sugar to safe levels. The most commonly used substance is, of course, insulin. Until recently, insulin was the only option for women with gestational diabetes, because it does not cross the placental barrier. But there is a new diabetes drug, glyburide, which can also be safe and effective in controlling blood sugar in gestational diabetes.