Introduction
Gestational diabetes is a condition that can affect pregnant women, causing their blood glucose levels to become too high during their pregnancy. This can put the mother and baby’s health at risk and affect them both later in life. However, only 2-10% of pregnant women suffer from gestational diabetes in the United States each year (CDC, 2019). Luckily, there are things mothers can do to help manage this condition. Usually, mothers with gestational diabetes have their blood glucose levels lowered back to normal after delivering their babies (CDC, 2019). This report will discuss the disease of gestational diabetes in depth. Including the phases of a normal pregnancy, the pathophysiology, signs, and symptoms, of gestational diabetes, how to manage this disease, and a conclusion discussing the prognosis of this disease and what it means for life after the affected pregnancy.
Normal anatomy and Physiology
During all pregnancies, women’s bodies change drastically to prepare to house a fetus for a long duration of time. This includes increased hormone production, weight loss or gain, increased appetite, and many other changes. Also, all pregnant women have a slight insulin resistance during pregnancy because the changes happening in the mother’s body cause her to use insulin less efficiently (CDC, 2019). For most mothers, this is not an issue and the baby continues to grow inside and get bigger while the mother stays healthy as well. Then around nine months later, a baby is born without a second thought about the insulin status in the mothers.
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In the human body, the pancreas is the organ that produces insulin. When food is ingested and digested, insulin is released by beta cells. Insulin plays an extremely important role in the human body and has the function of lowering blood glucose levels and is also used for the storage of sugar in multiple body tissues. When the beta cells in your pancreas that produce insulin are compromised, this causes your pancreas to not be able to produce insulin. This causes an insulin deficiency which can cause gestational diabetes.
Pathophysiology
The cause of Gestational diabetes is something that doctors do not always know the cause of but some factors cause women to be at a higher risk for it (Mayo Clinic, 2020). If a woman had insulin resistance before she became pregnant this can put her at higher risk. This is because she would have an already higher need for insulin and the hormone changes in her body that cause pregnant women to not use insulin efficiently would worsen this resistance (CDC, 2019). Other risk factors include being overweight/obese, not getting enough physical activity, polycystic ovary syndrome, having prediabetes or previous gestational diabetes, diabetes in a close relative, giving birth to a baby that weighed 9 or more pounds, and race (Mayo Clinic, 2020). Women who are African American, Asian American, Hispanic, and American Indian all are more susceptible to being diagnosed with gestational diabetes during their pregnancy (Mayo Clinic, 2020).
While a woman is pregnant the placenta, an organ vital to pregnancy provides the fetus being carried with nutrients and oxygen it needs to be healthy (Stanford Children’s Health, n.d.). Another job of the placenta is to make hormones that the baby and mom both need. In the later stages of the pregnancy, the hormones estrogen, cortisol, and human placental lactogen can inhibit the flow and dispersion of insulin, causing insulin resistance (Stanford Children’s Health, n.d.). This causes glucose to not be able to reach the parts of the body that it needs to and blood glucose levels will start to rise. This is when mothers are diagnosed with gestational diabetes.
When insulin in the body is not able to reach the glucose in the blood, it blocks the glucose from being able to be used as fuel for the parts of the body that need it. This is what causes the glucose levels in the blood to rise and hyperglycemia to occur (Stanford Children’s Health, n.d.). This disease affects the endocrine system and causes a breach in homeostasis. Not only does gestational diabetes affect the endocrine system but it can cause a wide variety of issues throughout the body. Gestational diabetes can cause damage in parts of the circulatory system such as blood vessels and the heart and also affect the nerves of the nervous system (Stanford Children’s Health, n.d.). On top of that gestational diabetes can cause health issues in the body systems of the fetus.
Clinical Manifestations
Gestational diabetes is usually not accompanied by any symptoms and can only be proven through a test. If the woman that is pregnant experiences any of the risk factors or has a medical history that could lead doctors to believe she has this condition they will have her tested (CDC, 2019). However, doctors will test all expecting mothers no matter what because this condition is very dangerous for the mother and fetus. If the soon to be mother has gestational diabetes, there is a higher chance for her blood pressure to be elevated and this hightens the likelihood of having to have a cesarean section (Mayo Clinic, 2020). On top of these risks, there are other factors involving the fetus that are hightened when having gestational diabetes.
Mothers with gestational diabetes might give birth to a baby that is much heavier than normal or have their baby born preterm (Mayo Clinic, 2020). This is because high blood sugar causes the baby to become larger than normal and this can heighten the need to get the baby out due to its already large size. Babies born to mothers with gestational diabetes are also more likely to experience severe breathing impairment, hypoglycemia, and have a higher chance of being obese or have type two diabetes later in life (CDC, 2019). Sadly if gestational diabetes is untreated, there is a also likely chance that the baby will be stillborn. All of these complications and affects put the fetus in serious danger and put extrme stress on the mother.
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On top of the stress that mothers with gestational diabetes experience, the also are put at risk for certain health risks due to this condition. Mothers with gestational diabetes have a greater chance of needing a C-section instead of being able to give birth vaginally (Mayo Clinic, 2020). This is an invasive procedure that allows the baby to be removed from the stomach without it every going into the vaginal canal. Having gestational diabetes also puts makes it more likely for you to have it again in future pregnancies, develop type two diabetes later in life, have high blood pressure and suffer from preeclampia (Mayo Clinic, 2020). Between 24 and 28 week of pregnancy, mothers who do not already suffer from diabetes are tested. This test is called a glucose screening test and during this mothers ingest a glucose drink and then have their blood sugar tested for the next two hours (Stanford Children’s Health, n.d.). If the results from the first test show an elevated blood surgar for the mother, then a three hour glucose tolerance test is administered (Stanford Children’s Health, n.d.). Elevated blood glucose levels from the second test are what determine the mother has gestational diabetes.
Medical Management
Treatment for gestational diabetes includes monitoring the fetus, the mothers blood glucose levels, mainatining a healthy and steady diet, and getting a lot of physical activity (CDC, 2019). More treatments for gestational diabetes are also insulin injections and medications that are used to treat high blood sugar (Stanford Children’s Health, n.d.). Monitoring the mother blood glucose levels and the fetuses movements and condition allows doctors to know when changes have occurred and keep tabs on the development of the baby. Maintaining a healthy diet and getting exercise helps the mothers blood pressure and chances of developing type two diabetes afterward become lower. Also using insulin injections are used to provide insulin that the body is not producing naturally which will be beneficial due to the mothers insulin reistance. The medication that is given to treat hypoglycemia is also beneficial for treating the mothers high blood sugar and returning it to normal. Gestational diabetes is not an incurable disease and only lasts until the baby is born. Mothers who suffer from gestational diabetes only have this condition until they give birth, then the only risk they have is for being more susceptible to type two diabetes.
Conclusion
Gestational diabetes is a serious condition that can affect both the expecting mother and fetus during pregnancy and should always be treated as such. Luckily, multiple treatment options and monitoring both the mother and fetus are easily achievable and can greatly impact the course of this disease. Understanding that when the insulin resistance occurs in the preganant woman, this means the mother is not producing enough insulin in her body to maintain normal blood sugar levels. When these levels are not normal is puts the fetus at risk for medical issues and the mother too. Following the diagnosis of this disease doctors will give a treatment plan that needs to be followed at all times. If the mother does this and all goes well, there is a very likely chance that the baby will be born healthy and the mother will remain so too. However there are complications that the mother and doctor will need to monitor after the baby is born as well.
Reference List
Centers for Disease Control and Prevention. (2019, May 30). Gestational Diabetes. https://www.cdc.gov/diabetes/basics/gestational.html#:~:text=Gestational%20diabetes%20is%20a%20type,pregnancy%20and%20a%20healthy%20baby.
Mayo Clinic. (2020, August 26). Gestational Diabetes. https://www.mayoclinic.org/diseases-conditions/gestational-diabetes/symptoms-causes/syc-20355339
Stanford Children’s Health. (n.d.). Diabetes During Pregnancy. https://www.stanfordchildrens.org/en/topic/default?id=diabetes-and-pregnancy-90-P02444#:~:text=High%20blood%20sugar%20can%20cause,defects%20in%20a%20growing%20baby.
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