Gestational Diabetes

What is the Cause of Gestational Diabetes?

Gestational diabetes prevents your body from using carbohydrate properly. Carbohydrate is a nutrient found in foods that is turned into sugar (glucose) by the body. Foods that contain carbohydrate include sweet foods such as table sugar, honey, jams, sweets, soft drinks, and starchy foods such as bread, cereal, pasta, potatoes, fruit and milk. The inability to use carbohydrate properly results in blood sugars that are not within normal levels.

When you eat food, your body breaks down carbohydrates into sugar during digestion and the sugar enters your blood stream. Your body needs sugar to provide energy just like your car needs gasoline to run. Energy is needed y your brain for thinking and by your muscles for activity. The pancreas, located behind your stomach, senses how much sugar is present in the blood and delivers the right amount of a hormone called insulin. Insulin lowers blood sugar by allowing sugar to enter your body's cells.

Who Is Likely To Have It?
Your chances of developing gestational diabetes increase if you:

• Have a family history of diabetes
• Had a previous birth of a very large baby or a stillbirth
• Are overweight
• Had an earlier pregnancy with gestational diabetes
• Have too much amniotic fluid (polyhydramnios)
• Are older than 25 years

Pregnant women are usually screened for gestational diabetes between 24 – 28 weeks. Women with a strong family history of diabetes or with gestational diabetes in an earlier pregnancy may be tested at 16 – 20 weeks. Just because you did not have the condition in your first pregnancy does not mean you will not develop it in later pregnancies.

Insulin Resistance
In all pregnancies, the placenta creates hormones that work against the action of insulin, reducing its effectiveness. This is called “insulin resistance”. These pregnancy hormones are at their highest level at about 24 – 28 weeks of pregnancy. As pregnancy progresses and the placenta grows, more hormones of pregnancy and produced and there is even greater insulin resistance. In most women the pancreas is able to make extra insulin to overcome insulin resistance. If your pancreas cannot make enough insulin and your blood sugar remains too high, this is known as gestational diabetes. Your body's organs cannot use the sugar for energy and an unhealthy level builds up in your blood. Your body tries to rid itself of the sugar through the urine.

What Could Happen To My Baby?
When gestational diabetes is detected early, it can be managed and controlled to prevent complications for both you and your baby. The key is to keep your blood sugar at normal levels as soon as gestational diabetes is detected. You will learn how to do this by suing the following tools:

• Meal Planning
• Blood Glucose Monitoring
• Insulin (if needed)

When blood sugar is not kept under control, two conditions could affect your baby:
Macrosomia and hypoglycemia.

Large Baby (macrosomia) – Your baby receives nutrients directly from your blood through the placenta. If your blood has more sugar than normal, your baby responds by producing it's own insulin. The baby's insulin could cause your baby to grow faster and bigger, a condition called macrosomia. Although the baby grows larger, it does not mature more rapidly, so a normal size baby may still be premature. Occasionally, a baby grows so large that a cesarean section delivery becomes necessary. An ultrasound test is usually done to determine the size of your baby and the best method of delivery. Macrosomia can be avoided by keeping your blood sugar level as close to normal as possible.

Low Blood Sugar (hypoglycemia) – Once your baby is born, the baby's insulin could still be present, causing a sudden drop in your baby's blood sugar. Gestational diabetes increases the chances of hypoglycemia or low blood sugar. As a safeguard, your baby's sugar level will be checked at birth and several times afterward. Your baby may be fed sugar water and placed in a special care nursery for observation. Keeping your blood sugar at a normal level during pregnancy can prevent low blood sugar in your baby at birth.

What about birth defects?
You should not worry that gestational diabetes will cause birth defects in your baby. Birth defects that can occur as a result of diabetes usually happen during the first trimester or first 13 weeks of pregnancy. The insulin resistance that develops as a result of gestational diabetes does not begin until about the 24th week of pregnancy.

Could my baby be born with diabetes?
Having gestational diabetes does not cause your baby to have diabetes. Your child's risk of developing diabetes is related to family history, body weight and lifestyle choices, such as eating habits and exercise.