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PREGNANCY-RELATED CONDITIONS

GESTATIONAL DIABETES

Gestational diabetes mellitus (GDM) is the development if diabetes type II during pregnancy in women who were not previously affected by diabetes. The prevalence is estimated to be between approximately 4% to 11% of all pregnancies (although studies vary on this). However, as with regular (non-gestational) diabetes, prevalence over the last few decades has increased by as much as 30% and is likely still rising due to more sedentary and less active lifestyles. The causes of of GDM are not well understood, but it is believed that increased BMI of the mother prior to conception, genetic factors, and rise in placental hormone levels causing insulin resistance play an important role. If monitored and treated properly it is usually not life threatening for either mother or fetus, and resolves after pregnancy. Symptoms and  treatments are essentially similar to normal (non-gestational) diabetes. If you are pregnant and don't have GDM, it is important to consider preventative measures, which usually don't significantly impact quality of life but can considerably reduce the risk of developing GDM later in the pregnancy.

Risk Factors

  • Insufficient exercise

  • GDM in previous pregnancy

  • Family history of diabetes (gestational or other)

  • Race (risk is higher for racial minorities)

  • Higher BMI (body weight)

Prevention

  • Healthy diet

  • Active lifestyle

  • No excessive pregnancy weight gain

  • Healthy base weight at outset of pregnancy

Risk Factors
Prevention

Symptoms

  • Fatigue

  • More frequent urination

  • ​Increased urine output (polyuria)

  • Sugar in urine (glycosuria, sweet smell)

  • Increased thirst (especially at night)

Complications

Treatments

Symptoms
Treatments
  • Lifestyle changes (diet and exercise)

  • Insulin therapy (medication) - though effects of insulin on placenta and fetus are controversial in the literature

Because of the increased levels of sugar passing through the placenta

and providing nutrition to the fetus, GDM can lead to increased fetal weight and size (macrosomia). This may require either premature delivery or cesarean section

to avoid large fetuses of >10 pounds getting stuck in the birth canal.

 

Furthermore, GDM can lead to hypoglycemia after birth

if the fetus no longer receives the sugar levels it has gotten used to. In extreme cases this can cause seizures. Therefore immediate feeding after birth is important. 

​

Lastly, GDM has been associated with

obesity, diabetes (type II) and cardiovascular disease

of the child during later life.

Complications
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