Risks of gestational diabetes, Causes, prevent
Abstract : Risks of gestational diabetes
While discussing the relevant topic ‘lifelong risks of gestational diabetes’, it is essential to focus on some related issues, such as,
- What is gestational diabetes?
- What causes gestational diabetes?
- And what are the risk factors for gestational diabetes?
- What are the complications and lifelong risks (for both the mother and the baby)?
- How to prevent gestational diabetes?
- How to manage gestational diabetes?
- What needs to be done for the woman with gestational diabetes after childbirth?
Veritably, lifelong risks in any malignancy need lifelong care and caution to ensure long-term safety.
Conclusively, as a part of care and caution, the woman (having gestational diabetes) needs to regularly monitor blood sugar level regardless of whether any symptoms of diabetes are observed or not even after childbirth.
1. What is gestational diabetes?
Gestational diabetes is a condition of glucose intolerance that occurs during pregnancy (when blood sugar level rises to a high level without having any diabetes). Gestational diabetes can occur at any stage during pregnancy. However, it usually develops during the last half of pregnancy (sometimes as early as the 20th week of pregnancy period).
Gestational diabetes normally disappears after giving birth to the baby. But if it persists even after the delivery of the baby, the woman is at higher risk to develop type-2 diabetes later in life.
Like other types of diabetes, gestational diabetes affects how the body cells use sugar (glucose). As gestational diabetes also leads to high blood sugar, it can affect both the pregnant mother as well as the unborn baby.
2. What causes gestational diabetes
Researchers are still not sure about the genuine causes behind gestational diabetes during pregnancy. To understand how gestational diabetes occurs, one needs to understand at first how pregnancy affects the body's glucose level.
One digests the foods he eats which produce sugar (glucose) that initially enters into the bloodstream. In response, the pancreas (it is a large gland behind the stomach) produces insulin. And insulin is a hormone that helps glucose to shift from the bloodstream into body cells where it is used as energy.
During pregnancy, the placenta produces a high level of various other hormones. Almost all of the hormones produced impair the actions of insulin in the body cells and raises blood sugar levels. However, modestly elevated blood sugar level during pregnancy is considered normal (Placenta is an organ that develops during pregnancy. It is attached to the wall of the uterus lying usually at the top. The umbilical cord connects the placenta to the baby. Blood from the pregnant mother passé through the placenta filtering necessary oxygen/ glucose/ other nutrients to the baby via the umbilical cord).
As the baby grows, the placenta produces more and more insulin countering hormones. In the case of gestational diabetes, the placental hormones provoke a rise in blood sugar to a level that can adversely affect the growth and development of the unborn baby.
3. What are the risks of gestational diabetes?
Any pregnant woman can develop gestational diabetes. But still, some women during pregnancy are at higher risk which includes:
3.1) Age: Women older than age 25 are at higher risks to develop gestational diabetes.
3.2) Family or personal history: If the pregnant woman is pre-diabetic (blood sugar level is marginally elevated than normal), or if she had gestational diabetes in her previous pregnancy, then it can be a precursor for type-2 diabetes. Again, if any family member (particularly parent) has diabetes, the risk of gestational diabetes is greater.
3.3) Obesity: If the pregnant woman has excessive weight, then the risk of gestational diabetes is higher.
3.4) Race: Women of black or Asian race are at higher risk to develop gestational diabetes.
4. What are the complications and lifelong risks for both the mother and the baby?
4.1) Complication and long term risk for mother
4.1.1) For pregnant mother, gestational diabetes may invite high blood pressure as well as preeclampsia (it is a life-threatening condition and a serious disorder that can occur during pregnancy or after childbirth. In such conditions, high blood pressure and other signs of organ injuries crop up that include: the abnormal amount of protein in urine/ abnormal kidney or liver function/pain in the lungs/severe headache).
4.1.2) If the woman had gestational diabetes before, then there is every risk of the return of gestational diabetes in the next pregnancy. Over and above, as the woman (with gestational diabetes) gets older, she may face life long risk of getting type-2 diabetes.
4.1.3) The woman with gestational diabetes and obese child during birth can invite sustaining birth injuries requiring cesarean delivery.
4.2) Complication and long term risk for the baby
4.2.1) Because of gestational diabetes of the pregnant mother, the baby may be at increased risk of excessive weight during birth. Extra glucose in the bloodstream of the pregnant mother crosses the placenta which triggers the baby’s pancreas to make extra insulin. This can cause the baby to grow too large (The condition is known as macro-soma in which the baby at birth weighs more than 9 pounds).
4.2.2) Sometimes babies develop hypoglycemia (low blood sugar) shortly after birth. Because their insulin production gets high. Severe hypoglycemia affecting the newborn baby may provoke seizure of the baby (in which case prompt feeding and intravenous glucose solution may be needed to bring blood sugar to a normal level).
4.2.3) Again in some cases, the pregnant mother (with gestational diabetes) may develop high blood pressure. This may increase the risk of early labor. Moreover, the doctor may recommend early delivery as the baby is getting too large. As such, the babies born early may experience respiratory trouble syndrome- a condition that makes breathing difficult (Babies born with this syndrome may need additional help for breathing until their lungs mature and become stronger).
Even if the babies are not born early, still they may experience respiratory trouble if their mother has gestational diabetes.
Conclusively, the US health information on gestational diabetes casts a gloomy picture that triggers concerns among pregnant women all over the world. According to the sources, gestational diabetes affects about 7% of all US pregnancies annually resulting in approximately 200000 cases every year. After pregnancy, 10% of women (who had gestational diabetes before) continue to develop type-2 diabetes. Additionally, their children also are at higher risk to develop obesity and type-2 diabetes in the future.
5. How to prevent gestational diabetes
Prevention is better than cure. But when neither prevention nor cure is possible,
In that case, delaying the symptoms of the disease with suitable methods is the best option. Although there is no guarantee to prevent gestational diabetes, it can at least be delayed by following a healthy lifestyle (well before pregnancy) that include:
- To choose foods that are rich in fiber but poor in calories and focus on fruits/ vegetables/whole grain.
- To stay active and regularly take physical exercise before and during pregnancy. Daily 30 minutes exercise of moderate intensity can help achieve the goal.
- And to lose excess weight before pregnancy. Doctors usually don’t recommend losing weight during pregnancy. However, in the case of obesity, losing extra weight is good to ensure a healthy and safe pregnancy.
6. How to manage gestational diabetes.
The pregnant woman (with gestational diabetes) needs more prenatal care and frequent visits to the doctor to monitor overall health in general and fetus health in particular. What matters most is to keep blood sugar level within safe limits by taking healthy foods/ fruits/ drinks in addition to physical activity (preferably 30 minutes walk every morning). Additionally, medication (insulin injection/ oral medication) may be needed in the case of some patients. Whatsoever, everything should be done only under the doctor’s advice.
If gestational diabetes is detected, a regular visit to the doctor at least during the last 3 months of pregnancy is essential. If necessary, the pregnant woman must consult different health specialists (such as gynecologist/ endocrinologist/ dietitian or nutritionist). When one is pregnant, the different health specialists will check for diabetes as well as various related problems as part of prenatal care.
Conclusively, after the baby is born, the blood sugar level needs to be checked again within 6 weeks to diagnose and treat the disease and other related problems by the healthcare team (consisting of different health specialists). Once gestational diabetes is confirmed, it is essential to test blood sugar regularly. However, the frequency of blood sugar tests will depend on the result of the blood sugar test soon after the baby is born.
8. What needs to be done for the woman with gestational diabetes after childbirth
As lifelong risks of gestational diabetes, it may return in the next pregnancy even though the symptoms of gestational diabetes usually vanishes right after the childbirth. Over and above, with aging, the woman (having gestational diabetes) faces the lifelong risk to develop type-2 diabetes. Even if blood sugar is found normal right after childbirth, blood sugar tests need to be done every 1-3 years.
Conclusively, one having gestational diabetes still faces the long-term risk of developing diabetes in the future even after crossing the age when there is no possibility to get pregnant anymore.