Attention, chocolate lovers: You may not be able to help yourselves. Swiss and British scientists have linked the widespread love of chocolate to a chemical "signature" that may be programmed into our metabolic systems.
Read more health news
Diabetes of Pregnancy - Gestational Diabetes
- Overview, Causes, & Risk Factors
- Symptoms & Signs
- Diagnosis & Tests
- Prevention & Expectations
- Treatment & Monitoring
- Attribution
Overview, Causes, & Risk Factors
Gestational diabetes is an intolerance to glucose that first occurs, or is first detected, during pregnancy. Glucose is the main form of sugar in the body. Gestational diabetes occurs in 4% of all pregnancies.
What is going on in the body?
Glucose is an important source of energy used by the body's cells. When a person eats, the pancreas normally makes extra insulin. The insulin causes the glucose in the blood to move inside the body's cells. In a woman with gestational diabetes, the hormones produced in pregnancy block the effects of insulin. Glucose then builds up in the blood and the cells are left without a main source of energy. The result is a high level of glucose in the blood, a condition known as hyperglycemia. High blood sugar levels can damage the growth of the fetus. This may cause complications for both the mother and baby.
What are the causes and risks of the disease?
The following conditions may increase a woman's chance of developing gestational diabetes:
Symptoms & Signs
What are the signs and symptoms of the disease?
Usually there are no symptoms of gestational diabetes. If symptoms develop, they are often mild and may include:
Diagnosis & Tests
How is the disease diagnosed?
The American Diabetes Association (ADA) recommends glucose testing of women with any of the risk factors listed above as soon as feasible during pregnancy. If gestational diabetes is not diagnosed during the initial screening of high risk women, they should be retested between 24 and 28 weeks of pregnancy. Similarly, women of average risk should be tested between 24 and 28 weeks of pregnancy.
The ADA describes 2 approaches to evaluation of gestational diabetes in pregnant women:
If the blood glucose level is elevated in either of the approaches, a diagnosis of gestational diabetes is made.
Prevention & Expectations
What can be done to prevent the disease?
Gestational diabetes can sometimes be prevented by regular exercise and a balanced diet to maintain a healthy weight before conceiving and during pregnancy. It is important to let the healthcare provider know if there is a family history of diabetes.
What are the long-term effects of the disease?
Complications for the mother include:
What are the risks to others?
Complications for the baby include:
Treatment & Monitoring
What are the treatments for the disease?
The goal of treatment is to bring blood glucose levels to normal, and to keep them there throughout the pregnancy. This will prevent complications for both mother and child. The diet should provide enough calories and nutrients to allow appropriate weight gain in both mother and fetus. A dietician will provide counseling and education. If changing the diet does not control glucose levels, insulin injections may be needed.
Until recently, oral medications were not recommended for gestational diabetes. However, a recent study indicated that glyburide is safe and effective to take in the last 6 months of pregnancy.
What are the side effects of the treatments?
Hypoglycemia, or low blood sugar, may result if too much insulin is given, or if meals are skipped. Hypoglycemia should be avoided, because the fetus will also experience low blood sugar levels.
What happens after treatment for the disease?
Pregnancy hormones drop dramatically after delivery, and a woman may no longer need insulin. High blood glucose levels usually go away after pregnancy. But 30% to 40% of women with gestational diabetes may develop type 2 diabetes at some time in their lives. Obesity or a family history of diabetes may increase this risk. A balanced diet and exercise after delivery will help with weight loss and will lower the risk of diabetes in the future. At the exam 6 weeks after delivery, a oral glucose tolerance test can help determine if further treatment is needed.
How is the disease monitored?
Women with gestational diabetes run a high risk of having it in future pregnancies. Women who previously had gestational diabetes but are not pregnant should have fasting blood sugar tests each year to detect diabetes.
Attribution
Author:Eva Martin, MD
Date Written:
Editor:Ballenberg, Sally, BS
Edit Date:12/31/00
Reviewer:Eileen McLaughlin, RN, BSN
Date Reviewed:07/03/01