Gestational Diabetes Mellitus

Gestational Diabetes Mellitus: Problem when she Elise Bloustein, always slender and healthy, was 38
became pregnant with her first child in 1990. Her joy was tempered by the results of tests that revealed two problems: anemia and gestational diabetes, which Ms. Bloustein believes may have been caused by stress associated with the deaths of her parents.

Frequent sonograms were done to monitor the babys growth and prevent a stillbirth, a risk of gestational diabetes. Ultimately, the baby was born normal and healthy, weighing seven pounds. But Ms. Bloustein was cautioned that gestational diabetes could recur in a future pregnancy (it didnt) and that she was at high risk of later developing mature-onset (now called Type 2) diabetes.

Gestational Diabetes Mellitus: Affected Countries/ Statistics

Gestationaldiabetes mellitusoccurs in 3 to 5% in all the expecting mothers during pregnancy. It is on the rise in developing countries like India. Gestational diabetes, which affects about 4 percent of pregnant women, usually occurs midpregnancy, by the 28th week of gestation.

Risk of Gestational Diabetes Overweight

Older than 25 Have a strong family history of diabetes Have had gestational diabetes during a prior pregnancy Have previously given birth to a baby weighing nine or more pounds Prediabetic with blood sugar levels higher than normal Risk is greater in African-American, Asian and Hispanic women than in Caucasians.

Gestational Diabetes Mellitus: Causes

Though its causes are unclear, there are some clues, namely placental hormones that suppress the action of insulin in the mother. This can result in insulin resistance: the mothers pancreas continues to spew out insulin but her bodys cells fail to use it properly to process blood sugar, causing sugar levels to rise in the mothers blood.

Gestational Diabetes Mellitus: Results

This extra sugar, though not the mothers insulin, crosses the placenta and raises the babys blood sugar level, giving the baby more energy than it needs to grow normally. The result is macrosomia, a fat baby often too big to be born naturally without injury to the baby, mother or both.

Gestational Diabetes Mellitus: Solutions The treatment goal, as Ms. Bloustein was told, is
to maintain a normal blood sugar level, and to keep the level as even as possible throughout the day. Sensible meal plan consisting of three small, well-spaced meals and up to three snacks each day, and limit sweets and refined starches. She must know when and how much carbohydraterich food to consume, and her diet should include fiber-rich vegetables, fruits, dried beans and peas, and whole grains.

Gestational Diabetes Mellitus: Solutions

Regular physical exercise is also important. Daily walking and swimming are especially good in pregnancy. If such self-help measures do not normalize blood sugar, the woman may also require insulin, which she can inject herself. In some cases, an oral medication, metformin, may be prescribed with or without insulin.

 To be sure blood sugar levels stay on target, a woman should test herself via a finger prick and blood glucose monitor at regular times: when she wakes up, before meals, and an hour or two after meals. Desirable blood sugar targets are 95 or less upon awakening, 140 or less an hour after meals, and 120 or less two hours after meals.

Gestational Diabetes Mellitus: Solutions

Gestational Diabetes Mellitus: Solutions

In 6 to 12 weeks after giving birth, a woman who has had gestational diabetes should be retested. And she should keep her own and her childs weight down and be tested periodically for signs of diabetes as she ages.