1. Gestational Diabetes
Gestational diabetes affects pregnant women. According to recent surveys, eleven per cent of pregnant women, around the world, suffer from gestational diabetes; and this is more prevalent in women of Asian descent.
Cause of Gestational Diabetes and Who Are at Risk
In normal situations, the baby resolves this as it receives the excess glucose. However, if the baby is also insulin resistant, it will not receive enough glucose for it’s needs. The excess glucose the baby cannot absorb returns to the mother, causing her blood glucose levels to rise.
Women with the following characteristics have a higher risk of developing gestational diabetes:
- Between the age of twenty-five and forty-five years old
- A normal weight before pregnancy
- Parents that have a history of diabetes
- Did not eat an excess of sugary food, prior to pregnancy
- Previously gave birth to a baby weighing more than eight pounds
- If they were born with the disorder, macrosomia.
Those who are between twenty-five to forty-five years old
A woman under thirty years of age, but over twenty-five, has a higher chance of her diabetes being gestational diabetes, unless a problem with her pancreas is discovered.
Type 1 diabetic patients are normally diagnosed before the age of twenty. So, unless the pregnant woman has developed a disease in her pancreas, there is no reason she would produce less or no amount of insulin.
Type 2 diabetic patients experience symptoms at age thirty and over. So, if the pregnant woman is below that age, her diabetes may only be gestational diabetes.
However, if a pregnant woman develops high blood sugar, when she was over thirty years, her diabetes will not be declared gestational, unless it is properly investigated.
A normal weight before pregnancy
Pregnancy can cause sudden hormonal imbalances in women. The hormones may trigger an increase in appetite and weight gain, which could even be borderline obesity. The body automatically defends itself from this sudden imbalance, by making the cells resistant to insulin.
Parents that have a history of diabetes
Diabetes is hereditary. A person who has at least one diabetic parent has a higher risk of acquiring the disease. If the pregnant woman is over thirty years old and her parent or parents have diabetes, she should be investigated thoroughly, before ruling out chronic diabetes.
If she is below thirty and one or both of her parents have a history of diabetes, there is a higher chance the diabetes is temporary.
A pregnant woman is at a higher risk of having type 2 diabetes, once she is older than thirty years old.
Does not eat an excess of sugary food, prior to pregnancy
Type 2 diabetes develops because of high carbohydrate or high sugar diet. If a pregnant woman has been observing this type of diet before pregnancy and has a high level of glucose in her blood; she may not be suffering from gestational diabetes, but type 2 diabetes. This is more likely if she is age thirty or older
Previously gave birth to a baby weighing more than eight pounds
Women who have given birth to a baby weighing eight pounds or more, have a higher risk of developing gestational diabetes, unless the size of the baby is offset by the genetics of the parents.
Studies show that as a baby receives the same nutrients as the mother, it also acquires the high glucose level in the mother’s blood, while in the womb. The increase in the glucose level may cause them to grow abnormally.
Was born with macrosomia.
Women who are born with the condition – macrosomia (i.e. she weighed more than eight pounds when born), are prone to gestational diabetes and type 2 diabetes.
Symptoms of Gestational Diabetes
Gestational diabetes has no symptoms, apart from the presence of sugar in your urine. If there are, they can be overshadowed by the changes in the body, during pregnancy. Therefore, it can be difficult to suspect you have the condition.
However, if you fit any of the characteristics described above, you should consider checking your blood sugar every month, during pregnancy. A fasting blood sugar (FBS) is more accurate than a routine blood sugar test. If you need an FBS test, you should fast for at least five hours, but no more than eight. If you have a routine blood test, it should be taken at least an hour after your meal.
You should inform your obstetrician, if your FBS test is higher than 7mmol/L. If you had a routine blood test, a level of 11mmol/L result could be a sign of gestational diabetes.
Complications of Gestational Diabetes
Untreated gestational diabetes may be temporary and reversible, but it can be dangerous to both the mother and child.
Possible complications of unmonitored gestational diabetes are:
• High blood pressure
Pregnant women should have normal blood pressure, especially when nearing childbirth. Gestational diabetes can affect the blood pressure of pregnant women and cause it to fluctuate to critical levels. This could lead to an aneurysm or pre-eclampsia during child birth.
Gestational diabetes lowers the level of albumin (protein) in the blood. Albumin stops water or fluids escaping from blood vessels. If the level of albumin is low, fluid may escape and get trapped in other organs of the body. This fluid usually settles on the feet, making them swell. However, in some cases, fluid may settle in the brain and the lungs, which is dangerous and may be life threatening.
This rarely happens to women with gestational diabetes. However, when it does, it can be more dangerous to the baby than the mother. One study showed, that ketoacidosis during the first trimester of pregnancy may cause unintentional abortion; and malnutrition to both the mother and baby.
The fetus grows abnormally large in the uterus. It causes the baby to weigh significantly more than the average. About ninety per cent more than expected for gestational age. Depending on the mother’s health and size of her uterus, macrosomia may result in premature birth and/or a caesarian section.
• Type 2 diabetes
This usually occurs if a woman, diagnosed with gestational diabetes, maintains a high carbohydrate and high-fat diet after the birth.
• Difficulty breathing (for the babies)
Gestational diabetes may cause the baby to have underdeveloped lungs. This can cause respiratory distress syndrome in babies, which makes it difficult for them to breathe. This condition is life-threatening, for babies under twelve months of age.
Babies born to a mother with unmonitored gestational diabetes may experience hypoglycemia during the first few weeks after their birth. This is due to the normal defense mechanism of the baby’s body. They produce more insulin to balance the blood glucose level.
Some Guidelines for Women with Gestational Diabetes
A woman diagnosed with gestational diabetes can do the following, to help reverse or control it.
• Avoid food with simple sugars
Cake frosting, soda, powdered juice and candies are high in simple sugars. Eating them will drastically increase the sugar level in your blood.
Obstetricians, do not recommend lowering the carbohydrate and fat intake of a pregnant woman, as they are important during pregnancy. They recommend the woman gets her carbohydrate and fat from healthier sources.
• Always monitor your blood sugar
Some women wait until they feel the symptoms of high blood sugar, before they get their blood sugar checked. If a pregnant woman waits, until they feel extreme hunger, thirst or drowsiness before their blood sugar is checked, complications may have already arisen in their body and their baby.
It is important that women ensure they regularly monitor their blood sugar levels. Make sure you for further investigation at the first sign of a problem.
Doctors often give a mother a schedule for prenatal checkups and mothers often only visit on that day. However, any abnormal symptoms should always be checked by her doctor.
Delaying treatment of gestational diabetes may result in health problems for the baby and mother.
Exercise may help increase the sensitivity of the body to insulin. Pregnant women are limited to certain types of physical activity, but there are exercises specifically aimed at pregnant women. If the pregnant woman does not have time to take these classes, a twenty-minute walk before 8:00 am can help balance the level of glucose in both the baby and mother. Walking may also help lower the risk of preeclampsia.
Treatment for Gestational Diabetes
Oral medication may be prescribed to pregnant women. Doctors can also prescribe insulin injections, as a treatment for gestational diabetes, if levels fluctuate a lot.
Since these treatments can affect the growth of the baby, they must be given with care. The insulin injections used for mothers, will be pure human insulin, so it does not affect the development of the baby.
The condition when your blood glucose level is higher than normal; but lower than the level for a Type 2 diabetic, is known as prediabetes.
When a person has a fasting blood sugar level of 5.6mmol/L to 6.4mmol/L, they may be considered prediabetic. A routine blood sugar level, with a result above 11.1mmol/L may also be considered prediabetic.
People with prediabetes are at higher risk of developing type 2 diabetes. However, this type of diabetes is reversible. Reversing it will help you prevent type 2 diabetes.
Who may become Prediabetic?
Prediabetes may happen to anyone, regardless of age. But, the following people have a higher risk of developing pre diabetes:
- Those who are overweight or obese
- Those who rarely exercise; or do any physical activity
- Those who were overweight or obese when they were younger Women who had gestational diabetes;
- Those with a family history of type 2 diabetes;
- People who don’t eat healthily.
Symptoms of Prediabetes
Research has shown that the following symptoms of type 2 diabetes, start during the pre-diabetic stage:
- Acanthosis Nigricans or dark patches: Doctors suggest a blood sugar test should be taken at the first sign of darkness around the neck, or abnormal darkness in the knee and elbow region, regardless of the age of the person.
- Hair thinning or hair loss: This is a tricky symptom, as many conditions may result in hair thinning and hair loss. But, if the person is obese, passive and eats a lot of sugary food, this could be a symptom of prediabetes or a start of type 2 diabetes.
Complication of Prediabetes
Prediabetes does not result in any health complication but may lead to type 2 diabetes; or gestational diabetes for pregnant women.
Treatment for Prediabetes
Treatment is not prescribed for people who are prediabetic. Experts recommend a healthy lifestyle to reverse it. If a pre diabetic continues to follow the lifestyle that reversed their prediabetes, they may not necessarily go on to develop type 2 diabetes.