As a Catholic couple, open and generous to new life, pregnancy is a condition which it would do well to become informed about. In this issue, I will discuss a few of the more normal conditions, complications and issues surrounding pregnancy, and give links for further research. The first I will examine is Gestational Diabetes.
Now known as Glucose Intolerance of Pregnancy, Type III Diabetes Mellitus. This is a condition that usually develops during the 2nd or 3rd trimester of pregnancy.
Diabetes is caused by the inability of the body to either make insulin or to use it effectively. During pregnancy, the fetus relies on maternal glucose as a primary fuel source. Pregnancy triggers protective mechanisms that have anti-insulin effects: increased hormone production, which antagonizes the effects of insulin: degradation of insulin by the placenta: and prolonged elevation of stress hormones, which raise the blood glucose levels.
In a normal pregnancy, an increase in anti-insulin factors is counter balanced by an increase in insulin production to maintain normal blood glucose levels. However, women who are pre-diabetic or diabetic are unable to produce sufficient insulin to overcome the insulin antagonist mechanisms of pregnancy, or their tissues are insulin-resistant. As insulin requirements rise toward term, the patient who is pre-diabetic may develop gestational diabetes, necessitating dietary management and possibly insulin injections to achieve optimum blood glucose levels.
Signs and symptoms:
Indications for screening for gestational diabetes include obesity, excessive weight gain, excessive hunger or thirst, polyuria (frequent urination), sugar in the urine, repeated yeast infections, previous delivery of a large baby (over 9lb), high blood pressure and a family history of diabetes.
Uncontrolled diabetes during pregnancy can cause still-birth, fetal anomalies, premature delivery,and birth of an infant who is small or large for gestational age. Such infants are at risk for severe episodes of hypoglycemia shortly after birth, and are prone to other metabolic imbalances.
Regular pre-natal visits are all that is required to detect gestational diabetes, since doctors test for diabetes at least three times during a woman's pregnancy to prevent the complications that would pose a risk to the baby and themselves. It can be detected with a simple blood test.
In most cases gestational diabetes can be controlled by diet and exercise. Insulin injections may be necessary for some. After birth, the need for insulin will return to normal and the woman will no longer be diabetic. She will need to be tested on a yearly basis as some women go on to develop diabetes later in life.
Overall, the woman who develops gestational diabetes has no greater risk for complications than does a woman with a normal pregnancy if it is well controlled. Maintaining the optimum blood sugar levels is much easier today than it was in the past because with home glucose testing it is much simpler to keep the sugar levels in the proper range. 2-4% of pregnant women will develop gestational diabetes so it is important for all to be tested throughout the 9 months of pregnancy.
If you have any questions, please ask your doctor or nurse.
I will be happy to answer any general questions. Please write to me c/o The Editor.
Below is a link to an exhaustively complete site with answers for every question you could possibly ask about gestational diabetes. The image and the illustration at the beg article are from the Mediconsult site.
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