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.
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.
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.
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.
American Diabetes Association Professional Practice Committee. (2021). 15. Management of Diabetes in Pregnancy: Standards of Medical Care in Diabetes—2022. Diabetes Care, 45(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 Wochenschrift, 131(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