Gestational diabetes: causes, symptoms and consequences of diabetes in pregnancy
It is a clinical picture baptized with the medical name of gestational diabetes, and of every 100 pregnant women, between 3 and 5 women tend to develop this pathology. As its name suggests, it consists of a particular type of diabetes that arises during pregnancy (pregnancy), in which the body of the future mother is not able to produce adequate amounts of insulin to cope with the increased amount of sugar in blood that exists during this period.
Regardless of the age and the existence or not of risk factors, it is extremely important to find this disease in the pregnant woman, since the perinatal mortality is increased, although it is totally controllable from the follow-up of an adequate treatment, especially when it is diagnosed early.
In this sense, glucose is the nutrient that most abundantly crosses the placenta. The baby tends to synthesize its own insulin, but if the pregnant mother has increased blood glucose levels, that excess will pass to her baby, so he will receive more energy than he needs, and he will gain weight. In turn, a study in women diagnosed with gestational diabetes mellitus found that its diagnosis and treatment could improve maternal weight control (1), but only limited this benefit to late pregnancy.
Causes of gestational diabetes
During pregnancy the placenta produces the human placental lactogen, a hormone capable of acting against insulin. What can lead to the appearance of typical gestational diabetes.
As we mentioned at the beginning, during pregnancy a greater amount of blood sugar is required, mainly because the fetus, especially in the third trimester, tends to grow at a higher speed, using the different reserves of the future mother. Among those required and important reserves we find glucose.
As a way to compensate and facilitate this contribution to the baby (we must not forget that the fetus will consume around 50% of the mother's glucose), it is possible that the mother's tissues express some resistance to insulin, which will influence direct and determinant way in the development of gestational diabetes. In addition, it is known that women with a history of gestational diabetes mellitus have a higher risk of diabetes (2).
Although it is true that any woman can suffer from this disorder, the reality is that there are certain risk factors that can predispose to a certain mother may have a greater risk, either before or during pregnancy. The most common and habitual are the following:
- Women with a family history of gestational diabetes (or diabetes).
- Women over 30 years.
- Presence of overweight or obesity before pregnancy (3).
- Presence of arterial hypertension.
- Existence of an excess of amniotic fluid.
- Antecedents of spontaneous abortions.
What are the symptoms of gestational diabetes?
As with type 2 diabetes, it is very common for this gestational disease to go unnoticed and not be diagnosed until the mother has a routine blood test, or the well-known Testing sugar in pregnancy (or O'Sullivan Test), which consists of a diagnostic test to diagnose -or not- the possible existence of gestational diabetes.
However, when symptoms arise, signs or signals commonly associated with this disease are:
- Sensation of fatigue and fatigue.
- Blurry vision.
- Sensation of constant thirst, coupled with greater water consumption.
- Increased urination (polyuria).
- Nausea and vomiting.
- Vaginal candidiasis
- Urinary infections.
Consequences of diabetes in pregnancy for the baby and the mother
Within this disease we find ourselves with different consequences for the baby:
- Neonatal hypoglycemia: At the time of birth, glucose is interrupted from the mother to the baby, so low blood glucose levels can cause serious disturbances.
- Respiratory insufficiency: In relatively severe cases, the fetus may have respiratory failure called Respiratory Distress Syndrome, which can be fatal if not treated properly.
- Injuries in the baby: Due to the excessive size of the baby at the time of delivery, the fetus may be traumatized.
- Weight gain at birth (macrosomia): Since the baby is found with more glucose than usual, receives more energy than necessary, so you can gain weight.
It is also possible that some consequences in the normal development of pregnancy, being able to produce:
- Congenital malformations:The existence of a gestational diabetes can affect the development of congenital malformations, which are defects in the functioning of the organs, the system itself or the anatomy of the baby's body.
- Delayed fetal growth.
- Premature delivery:That is, as a consequence of these high blood sugar levels, and their lack of control, labor can be anticipated.
- Chakkalakal RJ, Hackstadt AJ, Trochez R, Gregory R, Elasy TA. Gestational Diabetes and Maternal Weight Management During and After Pregnancy. J Womens Health (Larchmt). 2018 Nov 17. doi: 10.1089 / jwh.2018.7020.
- Prados M, Flores-Le Roux JA, Benaiges D, Llauradó G, Chillarón JJ, Paya A, Pedro-Botet J. Gestational diabetes mellitus in a multiethnic population in Spain: Incidence of and factors associated with impaired glucose tolerance one year after delivery. Endocrinol Diabetes Nutr. 2018 Oct 8. pii: S2530-0164 (18) 30191-5. doi: 10.1016 / j.endinu.2018.07.007.
- Kawanabe S, Nagai Y, Nakamura Y, Nishine A, Nakagawa T, Tanaka Y. Association of the muscle / fat mass ratio with insulin resistance in gestational diabetes mellitus. Endocr J. 2018 Nov 3. doi: 10.1507 / endocrj.EJ18-0252.
- Wang, Chen et al. A randomized clinical trial of pregnancy during pregnancy to prevent gestational diabetes mellitus and improve pregnancy outcome in overweight and obese pregnant women. American Journal of Obstetrics & Gynecology, Volume 216, Issue 4, 340-351.