Gestational Diabetes: Causes, Signs, Complications and Prevention!
Pregnancy, gestational diabetes, pregnancy diabetes or sugar disease during pregnancy are different names for one and the same disease: Pregnancy diabetes.
Any disturbance of the metabolism of sugars recognized during pregnancy is referred to as pregnancy diabetes, irrespective of whether the disease has recurred during pregnancy or was previously unknown. Clearly, diabetes already known before the onset of pregnancy is distinguished. This is usually a type I diabetes.
Causes of gestational diabetes
About 2.5 percent of all pregnant women are diabetic. The reason for the occurrence of the disturbance has not been clearly clarified. There is probably a genetic predisposition for the diabetic metabolic system. The affected women have probably already before pregnancy the potential for an increased blood glucose level.
Since a strong change in the hormone balance occurs during pregnancy, it is assumed that interactions between the female sex hormones (estrogen, progesterone ), the placenta hormones ( HCG, HPL) and the hormone insulin regulate the blood glucose. It is possible that high-concentration hormones stimulate the release of insulin until the reserves are exhausted, or they reduce its effect on the end organ (muscle, liver).
At the same time, insulin is degraded in the placenta (mother’s cake), which further reduces sugar consumption and promotes a high sugar content in the blood.
Symptoms and signs
“Gestational diabetes” differs from “ordinary” diabetes in that the high sugar levels occur particularly after food intake. In addition, an increased tendency to vomiting is observed in the first weeks of pregnancy, which makes it difficult to control the blood glucose level through targeted feeding.
For pregnant women, sugar disease also means increased susceptibility to urinary tract infections and greater risk of developing a gestosis, a serious pregnancy complication. The frequently increased formation of fruit water by the fetus (Hydramnion) can lead to tension in the abdomen, to a disturbance of the food intake and to aggravated breathing. There is also the risk that the metabolic derailment persists after delivery.
For the unborn, the consequences are usually more severe than for the mother. The negative effect of the sugar on the vessels leads to a reduced circulation of the placenta, which puts the feeding of the fetus at risk (placental failure). This problem is exacerbated by the mechanical pressure, which can originate from the Hydramnion.
Untreated diabetic pregnancy
If a diabetic pregnancy is treated untreated, the newborn often shows the typical characteristics of the so-called diabetic fetopathy (in about 40 percent of the cases). This is characterized by the contrast between an abnormally large child (4.5 kilograms and more) and a clear development residue. The lungs are particularly affected by immaturity, which may lead to the respiratory syndrome.
During pregnancy, the unborn child responds to the mother’s sugar surplus with an increased insulin release to keep his own blood glucose level low (insulin lowers the sugar concentration in the blood). A further problem arises from the low blood glucose level in the newborn shortly after delivery. Due to the absence of the high maternal sugar intake, the child has a too high insulin level in relation to the now restricted sugar supply.
Check placental bleeding
In Switzerland, all pregnant women routinely perform blood glucose control. In the case of suspicion, the size and condition of the fetus is measured by ultrasound, in addition to the usual diabetes examinations. Through these regular observations, in addition to abnormalities, the development and growth of the unborn child can also be recognized.
The control of placental bleeding is performed with Doppler sonography. In the 16th week of pregnancy, the alpha-fetoprotein (AFP) is also determined to exclude malformations. With optimal therapy, the risk for mother and child can be reduced to a minimum. Complications during and after birth can often be avoided by careful monitoring and immediate action. Fortunately, the metabolic disorder disappears after pregnancy in the majority of cases.
The main danger to the mother (and consequently also to the child) is that it can lead to a massive circulatory derangement (gestosis, grafting) with oedema, renal function disorders (increased protein excretion) and hypertension. In this case, an early birth also threatens, especially if an infected person is present. If the patient is not treated in a timely and professional manner, life-threatening convulsions (eclampsia) can occur.
Birth problems are caused by the unsatisfactory placenta and the child’s excess. The fruit can be disturbed by the diabetes of the mother in the early development. This can lead to abortion or permanent damage (two to three times more frequently than with non-diabetic women) at the embryo (embryopathy). These particularly affect the lower extremities, the heart and kidneys.
After a childbirth, a problematic metabolism (low sugar level, disturbed electrolyte and water balance, high bilirubin levels) and other problems (ANS, respiratory syndrome) can threaten the life of the infant. In approximately one-third of the affected children, the immature lungs cannot fully function.
Pregnant women can contribute significantly to their child’s well-being through the regular measurement of the blood glucose level and through disciplined compliance with the diet. The early detection and treatment of diabetes is of great importance from the physicians’ side.