Specialisation: Diabetes Mellitus

Maternal Gestational Diabetes

During pregnancy, a woman can develop numerous conditions that can be fatal to the fetus if not managed. One of those conditions is diabetes which can occur during pregnancy in women who already do not have the disease. In the US, the prevalence of maternal gestational diabetes, or Gestational diabetes mellitus, GDM, has increased. Defining the condition, its signs and symptoms, the pathophysiology, diagnosis, and Treatment will help women understand how to manage the disease.

About the Disease About

GDM occurs during pregnancy when the body cannot produce insulin. In the US, the prevalence of type 1 and 2 diabetes among women in the reproductive brackets and GDM is increasing (American Diabetes Association Professional Practice Committee, ADAPPC, 2021). GDM increases long-term complications in the fetus, such as anomalies, spontaneous abortion, respiratory distress, neonatal hypoglycemia, and sometimes death. According to ADAPPC (2021), GDM can lead to obesity, type 2 diabetes, and hypertension for the child and mother. Regrettably, GDM has no international agreement on its screening and diagnostic criteria (Rani, 2016). Thus, healthcare providers must educate women under the reproductive bracket on attaining and maintaining euglycemia before conception and during pregnancy.

Sign and Symptoms

Any pregnant woman can develop diabetes. However, GDM has no known symptoms; it can only be detected if one visits a clinic during prenatal care. In most cases, healthcare practitioners should test for GDM between weeks twenty-four and eight of pregnancy. GDM can be discovered if the woman’s blood sugar level is screened. According to ADAPPC (2022), pregnant women with no GDM have lower blood glucose levels as their fetus and placenta take in insulin-independent glucose. In this case, the doctor can advise you on the changes you need to make to protect your and your baby’s health.

Pathophysiology

As ascertained, GDM can lead to long-term complications for the child and mother. Therefore, physicians should find a safe, quality, proficient, and easy-to-administer treatments to help GDM victims. Healthcare providers should understand the GDM pathophysiology to develop such treatments. According to Rani (2016), GDM is due to β-cell dysfunction. If there are beta cell dysfunctions during pregnancy that do not respond to glucose, it leads to reduced insulin production and sensitivity resulting in GDM. Insulin resistance can exist before conception; if it progresses, the woman can risk type 2 diabetes post-pregnancy. According to Rani (2016), as pregnancy advances, insulin resistance is facilitated by placental hormones increasing GDM. It affects the liver, placenta, brain, and adipose tissue if it progresses.

The Diagnostic Test

GDM is fatal to the mother and child if not treated or managed. According to Rani (2016), women with a history of this disease are at risk of two generations of risk as they are at risk of adverse perinatal and maternal type 2 diabetes. Therefore, early diagnosis is fundamental as it helps prevent or manage complications. Diagnosis would involve an oral glucose tolerance test to determine the glucose levels. During the test, the blood is drawn after 8-14 hours of fasting, and after drinking glucose, a doctor will draw another blood after two hours (Kautzky-Willer et al. (2019). According to Kautzky-Willer et al. (2019), during neonatal care, blood glucose monitoring is necessary to screen for GDM.

The Treatment

Women with GDM should be encouraged to manage their diet and start physical exercises to control their blood sugar levels. Kautzky-Willer et al. (2019) advocate that women with GDM must be motivated to undergo nutritional counseling and monitor their glucose levels. However, this will not be enough as one would need an insulin injection to lower their body glucose. ADAPPC (2014) alludes that insulin is the ideal hyperglycemia treatment in GDM. According to Kautzky-Willer et al. (2019), fetal and maternal monitoring is vital to minimize the child’s and mother’s morbidity and mortality.

Conclusion

Diabetes during pregnancy is known as Maternal Gestational Diabetes and has no know symptoms. Thus, pregnant women should be screened during the 24-28 weeks of conception to monitor their blood glucose levels. If one has GDM, they need to watch their diet, ensure they do physical exercises and get insulin injections as instructed by a physician.

References

American Diabetes Association Professional Practice Committee. (2021). 15. Management of Diabetes in Pregnancy: Standards of Medical Care in Diabetes—2022. Diabetes Care45(Supplement_1), S232-S243. https://doi.org/10.2337/dc22-s015

Kautzky-Willer, A., Harreiter, J., Winhofer-Stöckl, Y., Bancher-Todesca, D., Berger, A., & Repa, A. et al. (2019). Gestationsdiabetes (GDM) (Update 2019). Wiener Klinische Wochenschrift131(S1), 91-102. https://doi.org/10.1007/s00508-018-1419-8

Rani, P. (2016). Screening and Diagnosis of Gestational Diabetes Mellitus, Where Do We Stand. JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH. https://doi.org/10.7860/jcdr/2016/17588.7689

Three Forms of Diabetes Mellitus

Diabetes is among the chronic conditions that contribute to millions of deaths globally. Diabetes Mellitus is a disease caused by low production of insulin by the pancreatic cells or the body does not use of insulin in the control of blood sugar levels (NIDDK, para. 1-3). A hormone called insulin controls blood sugar and is released from the pancreas when the level of blood glucose rises, such as after eating. Diabetes can contribute to hyperglycemia, which can affect the functioning of various body organs such as the kidney and liver (NIDDK, para. 1-2). Circulation sugar levels return to normal due to insulin’s stimulation of the liver’s metabolization of glucose and the removal of glucose in the body by muscle and fat cells. Diabetes can occur in three forms, namely, Diabetes Type 1 (T1DM), gestational diabetes, and type 2 diabetes (T2DM) (Nall, para.1). Therefore, this paper seeks to assess the causes of the three forms of diabetes mellitus.

Causes of Type 1 Diabetes

T1DM is caused by a reaction involving the destruction of the pancreatic beta cells responsible for producing insulin. Genetic traits passed from parents to their offspring can cause type 1 diabetes. Environmental factors such as viral infection can create room for type 1 diabetes. Research proves that viral infections such as the Human Enteroviruses (HEVs) associated with polio, can expose the beta-cells that produce insulin to attack the body’s immune system. This type of diabetes affects children more than adults (Nall, para. 2-4).

Causes of Type 2 Diabetes

T2DM is caused by risk factors such as unhealthy lifestyles, which contribute to being overweight or obese in most adults. Some unhealthy lifestyles include consuming processed foods with high sugar content that contribute to an increase in weight (Higuera & Lawler, para. 2-4). The failure to adhere to dietary recommendations is also a contributing factor to the development of diabetes in most adults. The high sugar, salt, and fat contents in most of the diets that adults consume contribute to obesity, and in expectant mothers, the probability of delivering obese children is high. Age can also be a causing factor of this type of disease since most older adults above 50 years engage in unhealthy lifestyles, especially after retiring (Higuera, V., & Lawler, para. 1).

Causes of Gestational Diabetes

Previous gestational diabetes during pregnancy can cause gestational diabetes in the future. Some causes of T2DM, such as obesity, can contribute to gestational diabetes, especially if an expectant mother is overweight. Age is another cause since older expectant mothers are likely to experience gestational diabetes due to unhealthy lifestyles that can cause the accumulation of fat deposits in the body and high blood pressure (Welch & Bennington-Castro, para. 3-4). Placental hormones such as growth hormones can also prevent pancreatic cells from producing sufficient insulin. Prediabetes can also contribute to the development of gestational diabetes since the body has signs of developing the health condition (Welch & Bennington-Castro, para. 2).

Conclusion

The general causes of the three forms of diabetes generally include unhealthy lifestyles such as consuming processed diets with high sugar and fat content, which contribute to hyperglycemia and are a health risk to many children and adults, including expectant mothers. This topic is essential to educate the general public on how to live healthy lifestyles through regular exercise and adhering to the recommended nutritional diets with low sugar, salt, and fat contents that can contribute to obesity.

Works Cited

NIDDK. (2019, March). Symptoms & Causes of Diabetes | NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/symptoms-causes

Higuera, V., & Lawler, M. (2019, May 2). Type 2 Diabetes Complications: Heart Disease, Diabetic Retinopathy, Neuropathy, and More | Everyday Health. EverydayHealth.com. https://www.everydayhealth.com/type-2-diabetes/treatment/type-2-diabetes-complications-heart-disease-diabetic-retinopathy-neuropathy-more/

Welch, A., & Bennington-Castro, J. (2020, December 3). What is gestational diabetes? Symptoms, causes, diagnosis, treatment, and prevention | everyday health. EverydayHealth.com. https://www.everydayhealth.com/gestational-diabetes/guide/

Nall, R. (2021, November 30). Diabetes: Symptoms, treatment, prevention, and early diagnosis. Www.medicalnewstoday.com. https://www.medicalnewstoday.com/articles/323627#type-1-diabetes