Despite prenatal care, around five percent of women will develop diabetes during pregnancy. Gestational diabetes is a temporary, but potentially serious problem.
In this edition of Vital Signs, Dr. Brian Casey, an obstetrician with Parkland Hospital, explains gestational diabetes is part of the physiology of pregnancy.
From Dr. Casey’s interview…
What is gestational diabetes? The placenta releases a hormone during pregnancy. Some women respond to those hormones quite well, and some women cannot deal with the increased insulin resistance and produce enough insulin. So their blood sugar go up during the pregnancy.
How serious or dangerous a condition is this?
- For the mother: "...the risks are associated with the delivery and are isolated to the pregnancy. With the higher blood sugar levels in the mother, the fetus sees those blood sugar levels and releases insulin to respond to that. And the insulin release can increase the size of the baby. And that translates into difficulties Mom would have with the delivery and could result in an overgrown baby and increased risk for caesarian delivery."
- For the baby: "..the risks are immediate. You can very low blood sugars in the baby after the cord is cut. The high blood sugar of the mother is cut off, and the baby’s pancreas is still producing insulin and that drives the blood sugar of the baby down, so the pediatricians need to be very aware of that as well."
Who’s at high risk for gestational diabetes? "Asian women, from a ethnicity standpoint, are at the highest risk, followed by African American and Hispanic women, with Caucasian women being at the lowest risk. (Do we know why women of color are prone to this?) No, we just know when you look at the demographics these segments of the population are at increased risk. And teasing out the individual risk factors like obesity can be a bit difficult, but when you adjust for that there seems to be an ethnic propensity."
There are no symptoms: "We routinely test women during the pregnancy and that’s the only way a woman would know during the course of pregnancy that she had gestational diabetes."
Treatment: "We generally treat women with diet and we give them a glucose meter and ask them to check their blood sugar four times a day. And we spend a great deal of time educating our patients on what the diagnosis means, foods to avoid, portion control – all in an effort to keep their blood sugar down so that we can avoid the byproduct of the diagnosis."
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