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Gestational Diabetes
What is gestational diabetes?
Pregnant women who have never had diabetes
before but who have high blood sugar (glucose) levels during pregnancy
are said to have gestational diabetes. Gestational diabetes affects
about 4% of all pregnant women - about 135,000 cases of gestational
diabetes in the United States each year.
We don't know what causes gestational
diabetes, but we have some clues. The placenta supports the baby as it
grows. Hormones from the placenta help the baby develop. But these
hormones also block the action of the mother's insulin in her body. This
problem is called insulin resistance. Insulin resistance makes it hard
for the mother's body to use insulin. She may need up to three times as
much insulin.
Gestational diabetes starts when your body
is not able to make and use all the insulin it needs for pregnancy.
Without enough insulin, glucose cannot leave the blood and be changed to
energy. Glucose builds up in the blood to high levels. This is called
hyperglycemia.
How gestational diabetes can affect your
baby
Gestational diabetes affects the mother in
late pregnancy, after the baby's body has been formed, but while the
baby is busy growing. Because of this, gestational diabetes does not
cause the kinds of birth defects sometimes seen in babies whose mothers
had diabetes before pregnancy.
However, untreated or poorly controlled
gestational diabetes can hurt your baby. When you have gestational
diabetes, your pancreas works overtime to produce insulin, but the
insulin does not lower your blood glucose levels. Although insulin does
not cross the placenta, glucose and other nutrients do. So extra blood
glucose goes through the placenta, giving the baby high blood glucose
levels.
This causes the baby's pancreas to make extra insulin to get rid of the
blood glucose. Since the baby is getting more energy than it needs to
grow and develop, the extra energy is stored as fat.
This can lead to macrosomia, or a "fat"
baby. Babies with macrosomia face health problems of their own,
including damage to their shoulders during birth. Because of the extra
insulin made by the baby's pancreas, newborns may have very low blood
glucose levels at birth and are also at higher risk for breathing
problems. Babies with excess insulin become children who are at risk for
obesity and adults who are at risk for type 2 diabetes.
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