Gestational diabetes

Gestational diabetes
Other namesGestational diabetes mellitus (GDM)
Universal blue circle symbol for diabetes[1]
SpecialtyObstetrics and endocrinology
SymptomsTypically few symptoms[2]
ComplicationsPre-eclampsia, stillbirth, depression, increased risk of requiring a Caesarean section[2]
Usual onsetMost common last three months of pregnancy[2]
CausesNot enough insulin in the setting of insulin resistance[2]
Risk factorsOverweight, previously having gestational diabetes, family history of type 2 diabetes, polycystic ovarian syndrome[2]
Diagnostic methodScreening blood tests[2]
PreventionMaintaining a healthy weight and exercising before pregnancy[2]
TreatmentDiabetic 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] however, 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 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 who are affected is often recommended four times a day.[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] A number of 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 being used. 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]

  1. ^ "Diabetes Blue Circle Symbol". International Diabetes Federation. 17 March 2006. Archived from the original on 5 August 2007.
  2. ^ 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 (September–December 2020). "Investigation of the Effects of Obesity on Pregnant Women: A Systematic Review". https://www.internationaljournalofcaringsciences.org/docs/19_sapountzi_original_13_3_2.pdf. {{cite web}}: External link in |website= (help)[dead link] " Alt URL
  3. ^ 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.