Gestational Diabetes (GDM/Diabetes In Pregnancy)- Causes, Pathogenesis, Signs & Symptoms & Treatment

gestational diabetes is defined as any degree of glucose intolerance with onset or first recognition during pregnancy in simple words it is a condition characterized by high blood glucose levels during pregnancy either started or first recognized in the pregnancy itself gestational diabetes occurs in two to nine percent of all pregnancies this condition typically results after the delivery however some women May develop outright diabetes within the next 10 years in a normal pregnancy there is a slight elevation of several hormones in maternal blood including estrogen progesterone leptin cortisol placental lactogen and placental growth hormone these hormones especially placental lactogen reduce the insulin sensitivity of maternal cells the main function of insulin is to reduce blood glucose levels by enhancing its uptake from peripheral tissues when the insulin sensitivity of cells is reduced blood glucose level rises this glucose is then transported across the placenta to fuel the growth of the fetus in addition during a normal pregnancy there is a slight elevation of insulin secretion by the pancreas to compensate for the increased insulin resistance and this will increase the pumping of glucose into maternal cells however in some women this mechanism is impaired with continuous secretion of insulin pancreatic beta cells get exhausted and the mother will fail to overcome the insulin resistance as a result she will develop gestational diabetes several risk factors are associated with the development of gestational diabetes including obesity decreased physical activity a first degree relative with diabetes previous history of gestational diabetes high blood pressure low HDL cholesterol levels in blood High triglyceride levels in blood polycystic ovarian syndrome and history of cardiovascular disease if not recognized and managed early gestational diabetes can lead to serious complications maternal complications include labor dystocia or abnormally slow delivery elective or emergency Caesarean section vaginal laceration pre-eclampsia and eclampsia two serious conditions characterized by increased maternal blood pressure increased weight gain during pregnancy cardiovascular disease postpartum weight retention and increased risk of diabetes in later life fetal complications include High birth weight low blood glucose levels after cutting the umbilical cord shoulder dystocia or nerve injury during delivery metabolic syndrome in adulthood polycythemia or increased red blood cells in blood which increases the risk of thrombosis or formation of blood clots and neonatal jaundice due to these complications mothers are regularly monitored in screening for gestational diabetes therefore women who are compliant with medical therapy will not experience such complications first line treatment of gestational diabetes is Lifestyle Changes these include dietary modifications exercise and blood glucose monitoring medical therapy of gestational diabetes includes oral hypoglycemic agents such as metformin and injectable agents such as insulin