GESTATIONAL DIABETESE
Gestational diabetes (or gestational diabetes mellitus, GDM) is a type of diabetes which affects pregnant women who were not known to have diabetes before. It affects 5-10% of pregnancies, depending on the ethnic background. There is no known specific cause, but it's believed that the hormones produced during pregnancy reduce a woman's receptivity to insulin resulting in high blood sugar.
Gestational diabetes mellitus generally has little symptoms but potentially severe complications for mother and fetus, warranting some form of maternal screening. Diagnostic tests rely on high levels of glucose detected in blood samples.
Babies born to mothers with GDM are at increased risk of complications, mainly growth abnormalities and chemical imbalances such as low blood sugar, whereas the mother is at higher risk of pregnancy complications such as preeclampsia. GDM is a reversible condition, in the way that women who have adequate control of glucose levels can effectively decrease the associated risks and give birth to healthy babies.
Women with GDM are at high risk of developing type 2 diabetes mellitus later in life, while their offspring is prone to develop childhood obesity with type 2 diabetes later in life. Most women require treatment only by diet modifications and moderate exercise but some will need anti-diabetic drugs (including therapy with insulin).
RISK FACTORS
Classical risk factors for developing gestational diabetes are the following:
* a previous diagnosis of gestational diabetes or prediabetes, impaired glucose tolerance, or impaired fasting glycaemia
* a family history revealing a first degree relative with type 2 diabetes
* maternal age - a woman's risk factor increases the older she is (especially if older than 35 years of age)
* ethnic background (those with higher risk factors include African-Americans, North American native peoples and Hispanics)
* being overweight, obese or severely obese increases the risk by a factor 2.1, 3.6 and 8.6, respectively
* a previous pregnancy which resulted in a child with a high birth weight (>90th centile, or >4000 g)
* previous poor obstetric history
In addition to this, smoking doubles the risk of gestational diabetes[6] Polycystic ovarian syndrome is also a risk factor.
SYMPTOMS
Frequently women with gestational diabetes exhibit no symptoms (which is an arguement in favour of screening during pregnancy). However, possible symptoms include increased thirst, increased urination, fatigue, nausea and vomiting, bladder infection, yeast infections and blurred vision.
