Gestational diabetes mellitus is a disorder in the metabolism of carbohydrates that occurs in women during pregnancy. Even after birth, the hormonal background is normalized and hyperglycemia, caused by pregnancy, disappears. There are no statistics on the occurrence of this violation in our country yet. According to European studies, prevalence of diabetes mellitus in pregnant women varies from 1 to 15% depending on the region.
And although sugar levels are usually normal after delivery, nonetheless, many endocrinologists consider gestational diabetes as an alarming signal indicating a woman’s tendency to diabetes.
Why is sugar rising?
The exact cause of hyperglycemia in pregnancy is not known yet. To date, it is believed that the fault is the change in the hormonal background, which leads to tolerance of cells to glucose. Approximately 20 weeks pregnant in all pregnant women, the level of insulin in the blood increases.
This is due to the fact that some placental hormones partially block the action of insulin, which leads to a decrease in the sensitivity of cells to the hormone. Contraindicative effect is the placental lactogen, estrogen and cortisol, which are produced by the placenta. Accordingly, in order to meet the body’s insulin requirements, the pancreas of a pregnant woman should produce more hormone, but in some women, the pancreas can not cope with such stresses, which leads to the development of gestational diabetes mellitus.
Risk factors of Gestational Diabetes Mellitus
Heredity is one of the main risk factors for the development of gestational diabetes. If your parents (or relatives) are suffering from diabetes, then the high probability that your pancreas is not able to work at high levels of stress.
Also, the probability of hyperglycemia in pregnancy increases if the woman’s first pregnancy occurs at the age of 35 years and older.
Other factors of gestational diabetes include:
- obesity and overweight, moreover, the more overweight, the greater the likelihood of developing diabetes;
- infectious diseases;
- Gestational diabetes mellitus in the previous pregnancy;
- high blood pressure;
- birth of the previous child weighing more than 4 kg;
How dangerous is diabetes in pregnant women?
If diabetes mellitus (including gestational) during pregnancy does not apply measures to normalize glucose levels in the bloodstream, then the development of fetal malformations is possible. This is due to the fact that the fetus receives from the mother a large amount of glucose, but insufficient amount of insulin, which causes the development of hyperglycemia in the fetus and as a consequence of improper development of some organs and systems.
In the second trimester of pregnancy, the fetus develops its own pancreas, which is forced to produce an increased amount of insulin, since it is necessary to utilize both its own glucose and glucose in the mother’s body. Thus hyperinsulinaemia develops, which leads to a sharp drop in glucose levels in the blood of the fetus, which in turn can lead to impaired breathing functions. Frequent hypoglycemic states violate the nutrition of the brain of the fetus, which ultimately leads to a slowing down of the child’s mental development.
For a mother, uncompensated diabetes is dangerous to possible complications, in which the functions of some organs and systems are violated. Often, in the context of permanent hyperglycemia, an infectious process in the genitourinary tract develops, which in turn may serve as a cause of infection and fetal development.
If diabetes mellitus during pregnancy is poorly compensated, then, as a rule, the fetus develops enough large sizes, which greatly complicates childbirth. Often in such cases, doctors have to resort to a cesarean section. In some cases, the risk is so severe that babies are prescribed at 37 or 38 weeks of pregnancy to protect a woman from complications with a large fetus.
Treatment of Gestational Diabetes Mellitus
If gestational diabetes is well compensated, then pregnancy proceeds normally, and births go through the natural way in normal times.
For normalization of the sugar the doctor prescribes a special diet, which is based on frequent meals (5-6 times a day) in small portions. During pregnancy it is not possible to reduce the energy value of the daily ration, at the same time you need to give up simple, easily digestible carbohydrates (sweets, salmon), which lead to a sharp increase in blood sugar.
It is also necessary to limit the consumption of fats, because at a lowered level of insulin, from them, ketone bodies are formed.
If the diet is not effective in gestational diabetes mellitus, insulin is used.