Gestational diabetes is the
medical term used to describe diabetes mellitus that presents during pregnancy
and disappears after the baby has been delivered. The American Diabetes
Association estimates that approximately 4% of women who are pregnant will
develop gestational diabetes. This condition requires very specialized care for
the remainder of the pregnancy in order to protect the health of both the
mother and child. During pregnancy some women develop a resistance to insulin
that results in gestational diabetes. Insulin is the hormone that draws sugar
from the bloodstream into the cells where it is burned to supply energy at the
cellular level.
Without the sugar the body is forced to burn fat for
fuel. This has a significant negative effect on both the mother and baby. The
extra sugar in the bloodstream also causes complications in the health of the
mother and child. Because of the significant negative effects for both mother
and child current standard treatment in pregnancy calls for a screening test
after the 1st trimester. Women who are greater risk for gestational diabetes
will undergo a 5 hour glucose tolerance test. The screening test is a simple
blood test that is drawn to look for the presence of too much sugar in the
blood.
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The five hour glucose tolerance test (GTT) is a much
more complex test. During a five hour GTT the woman is given between 8-16 ounce
of a high sugar drink and then urine and blood is tested at 30 minute intervals
for the next 5 hours. This test looks at how the woman's body handles the extra
sugar load, how much insulin is secreted and how much sugar is left in the
blood stream and spills into the urine. It is important for women to understand
and recognize the symptoms of gestational diabetes for those whose condition
develops after the screening test has happened.
These symptoms can be very
subtle, such as an increased amount of thirst, more trips to the bathroom,
hungrier and blurred vision. All of these symptoms are caused by increased blood
sugar but can also be attributed to other underlying medical conditions.
Because the sugar isn't absorbed into the cells the mother also experiences
greater fatigue than she would have just being pregnant. As the kidneys try to
filter out the excess sugar, take out more water the woman also gets
dehydrated. She becomes thirsty from the dehydration and visits the bathroom
more frequently because of the increased water intake.
Some of these symptoms are also those of pregnancy.
Some women may believe that they are going to the bathroom more frequently
because of the weight of the baby over the bladder. However, thirst isn't a
symptom of pregnancy. Between the 20th and 24th week the woman's energy level
also returns so she shouldn't feel fatigued at this point. When the woman is
suffering from gestational diabetes she may feel some relief from the fatigue
but then it returns in full force as she doesn't have energy because of the
insulin resistance. Researchers have found that babies who suffer from
gestational diabetes have negative effects in later years.
Left
untreated the condition causes complications during the delivery and for the
mother. For these reasons it is very important to identify and treat
gestational diabetes as early as possible. A simple fasting blood sugar is
enough to rule out the condition. Women who have higher risk factors, such as
family history of diabetes, obesity, lack of exercise or a previous pregnancy
with gestational diabetes should have a five hour gtt to rule out the
possibility and prevent medical complications.
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