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Gestational Diabetes

by Dr. Frank Varon

What is gestational diabetes mellitus?

Pregnancy has typically been viewed as a statement of health, as it should be. In the midst of morning sickness, heartburn, exhaustion, and the excitement of pregnancy, women might be oblivious to other changes in their bodies that lead to developing gestational diabetes mellitus (GDM). Gestational diabetes is defined as the development of glucose intolerance with the onset or first recognition during pregnancy. This is not to be confused with previously diagnosed diabetes. Gestational diabetes is diagnosed as the result of routine glucose tolerance screening on an otherwise healthy population of women. In women who are diagnosed with gestational diabetes, beta cells in the pancreas that produce insulin are unable to produce enough insulin to meet the body's needs. The beta cell defects in gestational diabetes result from the same causes as hyperglycemia in general, and includes autoimmune disease, genetic, and insulin resistance causes. Gestational diabetes is now viewed as diabetes in evolution. Women with a history of gestational diabetes will more than likely develop diabetes during their lifetimes.

 

Is gestational diabetes common?

It is estimated that nearly 135,000 women every year develop gestational diabetes in the United States. The numbers are increasing especially in minority women. Recent studies have shown that the GDM prevalence has increased by 10 percent to as much as 100 percent in several racial and ethnic groups over the past 20 years. There is a true increase in gestational diabetes, and this probably reflects or contributes to the current trends in diabetes and obesity.

 

Am I at risk for gestational diabetes?

The risk factors for gestational diabetes are:

  • Obesity
  • Maternal age
  • Family history of diabetes
  • Race/ethnicity
  • Low birth weight history (mother)

 

How does it affect my pregnancy?

Congenital birth defects increase as the maternal blood sugar rises during the first 6 to 8 weeks of pregnancy. This is the primary demise for infants of pregnancies complicated by either type 1 or 2 diabetes. However, rates of birth defects higher than the norm in non-diabetic pregnancies (1-2%) appear to associated with first-trimester A1c values >2 standard deviations above the normal average of a normal pregnant population. Babies born to mothers with gestational diabetes tend to have higher birth weights. There is research that indicates that those higher-birth-weight babies are at increased risk for being overweight in adolescence.

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