Gestational diabetes
| Gestational diabetes | |
|---|---|
| Other names | Gestational diabetes mellitus (GDM) |
| Universal blue circle symbol for diabetes[1] | |
| Specialty | Obstetrics and endocrinology |
| Symptoms | Typically few symptoms[2] |
| Complications | Pre-eclampsia, stillbirth, depression, increased risk of requiring a Caesarean section[2] |
| Usual onset | Most common last three months of pregnancy[2] |
| Causes | Not enough insulin in the setting of insulin resistance[2] |
| Risk factors | Overweight, previously having gestational diabetes, family history of type 2 diabetes, polycystic ovarian syndrome[2] |
| Diagnostic method | Screening blood tests[2] |
| Prevention | Maintaining a healthy weight and exercising before pregnancy[2] |
| Treatment | Diabetic diet, exercise, insulin injections[2] |
| Frequency | ~6% of pregnancies[3] |
Gestational diabetes is a condition in which a woman without diabetes develops high blood sugar levels during pregnancy.[2] Gestational diabetes generally results in few symptoms.[2] Obesity increases the rate of pre-eclampsia, cesarean sections, and embryo macrosomia, as well as gestational diabetes.[2] Babies born to individuals with poorly treated gestational diabetes are at increased risk of macrosomia, of having hypoglycemia after birth, and of jaundice.[2] If untreated, diabetes can also result in stillbirth.[2] Long term, children are at higher risk of being overweight and of developing type 2 diabetes.[2]
Gestational diabetes can occur during pregnancy because of insulin resistance or reduced production of insulin.[2] Risk factors include being overweight, previously having gestational diabetes, a family history of type 2 diabetes, and having polycystic ovarian syndrome.[2] Diagnosis is by blood tests.[2] For those at normal risk, screening is recommended between 24 and 28 weeks' gestation.[2][3] For those at high risk, testing may occur at the first prenatal visit.[2]
Maintenance of a healthy weight and exercising before pregnancy assist in prevention.[2] Gestational diabetes is treated with a diabetic diet, exercise, medication (such as metformin), and sometimes insulin injections.[2] Most people manage blood sugar with diet and exercise.[3] Blood sugar testing among those affected is often recommended four times daily.[3] Breastfeeding is recommended as soon as possible after birth.[2]
Gestational diabetes affects 3–9% of pregnancies, depending on the population studied.[3] It is especially common during the third trimester.[2] It affects 1% of those under the age of 20 and 13% of those over the age of 44.[3] Several ethnic groups including Asians, American Indians, Indigenous Australians, and Pacific Islanders are at higher risk.[3][2] However, the variations in prevalence are also due to different screening strategies and diagnostic criteria. In 90% of cases, gestational diabetes resolves after the baby is born.[2] Affected people, however, are at an increased risk of developing type 2 diabetes.[3]
- ^ "Diabetes Blue Circle Symbol". International Diabetes Federation. 17 March 2006. Archived from the original on 5 August 2007.
- ^ a b c d e f g h i j k l m n o p q r s t u v w x y Antoniou A, Papadimitriou N, Kotrotsiou S, Theofanidis D, Diamantidou V, Sapountzi-Krepia D (2020). "Investigation of the Effects of Obesity on Pregnant Women: A Systematic Review". International Journal of Caring Sciences. 13 (3): 1699–1710. ProQuest 2480363576.
- ^ a b c d e f g h Donovan PJ, McIntyre HD (October 2010). "Drugs for gestational diabetes". Australian Prescriber. 33 (5): 141–144. doi:10.18773/austprescr.2010.066.