Sunday 13 December 2009, 22:57

Pregnancy diabetes

What gestational diabetes is and how it can be treated

Pregnancy diabetes

Pregnancy or gestational diabetes is a specific pathology of middle-late pregnancy, which is usually diagnosed between the 24th and the 34th week of gestation. It is not related to pre-gestational diabetes (present before pregnancy) and it usually subsides at the end of pregnancy. However, nearly 50% of women affected by gestational diabetes will develop type 2 diabetes within 5 years postpartum.


Gestational diabetes develops as a consequence of the production and secretion of certain hyperglycaemic hormones by the placenta, whose effects are counterbalanced by the hypoglycaemic action of the maternal pancreatic insulin. When the maternal pancreas is no longer able to produce a sufficient amount of insulin, an uncontrolled increase in blood glucose occurs and gestational diabetes develops.


Risk factors for gestational diabetes include obesity, advanced age (more than 25 years old), previous personal or family history of diabetes, and race (black, Hispanic, American Indian and Asian women are predisposed).


If undiagnosed or untreated, pregnancy diabetes can have serious consequences for the newborn baby. He may be born oversized (macrosomia) and with serious metabolic disorders often leading to hypoglycaemia. He may also be born with respiratory faiulure or with icterus or become icteric after a very few days. Therefore it is important to promptly diagnose and treat diabetes in the mother.


Gestational diabetes can be diagnosed with a screening test (Carpenter's test) at 24-28 weeks of pregnancy followed, if positive, by a diagnostic oral glucose tolerance test. The diagnostic test is positive when blood glucose level is equal or greater than 140 mg/dl.


The primary cures for pregnancy diabetes are diet and exercise. Blood glucose levels have to be kept under tight control, yet without reducing the intake of energy and nutrients necessary for the fetus development. The diet must be properly balanced, containing about 1800 kcal a day (50-60% of calories from carbohydrates, 20% from proteins, 25% from preferably unsaturated fats), with abundant fiber content and void of alcoholic drinks, sugary beverages, prunes, chestnuts, fruit in syrup and any high-sugar food.


Regular, moderate exercise (walking, swimming) promotes better use of insulin and improves body's ability to use and store glucose. It is therefore an effective means to control blood glucose levels.


Other control measures include the daily check of blood glucose, the fetal growth and health monitoring and, when strictly required, the administration of insulin shots.


By Chiara De Carli

Category: Diabetes

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