About gestational diabetes
Gestational diabetes means you have a high blood sugar level, but only during pregnancy. When you aren’t pregnant you don’t have diabetes. Around three to four in every 100 pregnant women will get gestational diabetes during their pregnancy.
Normally, your body releases a hormone (a chemical messenger carried in your blood) called insulin to make sure that sugar in your blood is taken up by your cells to turn into energy. Any excess sugar that isn’t needed is stored in your cells as fat. Usually during pregnancy your hormones, such as oestrogen and progesterone, cause an increase in insulin resistance. This means that your body needs to produce more insulin to have the same effect on blood sugar as it would have when you aren’t pregnant. This happens so that more sugar remains in your blood to be made available for your baby to use for energy and growth.
During pregnancy, your body naturally releases more insulin to overcome the effects of your pregnancy hormones. This ensures that any blood sugar not used by you, or taken up by your growing baby, is still stored. If you develop diabetes in pregnancy, it means that either your body isn’t releasing enough insulin, or your cells aren’t responding to it. The result is that your blood sugar level remains high. This can have a number of effects on you and your growing baby.
Gestational diabetes usually begins between weeks 13 to 28 of pregnancy and will go away after your baby is born. If you still have diabetes after the birth of your baby, it’s likely that you already had underlying diabetes, but it was only picked up because you were pregnant. In this situation you will need to have treatment.
Symptoms
Usually there are no symptoms, or the symptoms are mild and not life threatening to the pregnant woman. Often, the blood sugar(glucose) level returns to normal after delivery.
Symptoms may include:
Blurred vision
Fatigue
Frequent infections, including those of the bladder, vagina, and skin
Increased thirst
Increased urination
Nausea and vomiting
Weight loss in spite of increased appetite
Diagnosis of gestational diabetes
Doctors differ in their opinions about when and how to test pregnant women for gestational diabetes so the timing of tests you have may differ from what is described here.
At your first antenatal appointment your GP will ask about your medical history and examine you. He or she will check for any risk factors you may have and, based on this, you may be offered tests to find out if you already have diabetes, or are at risk of developing the condition during your pregnancy. The tests involve taking a blood sample and for some of these you may need to follow fasting instructions. This means not eating or drinking, typically for about six hours beforehand.
If you don’t have any of the risk factors, you’re likely to be tested for gestational diabetes at an antenatal appointment when you’re between 24 and 28 weeks pregnant. This is because even without any risk factors, being pregnant can increase the likelihood of diabetes developing. You will be asked to drink a sugary drink and then have blood samples taken to see how well your body processes the sugar.
Treatment of gestational diabetes
Your GP will refer you to a clinic where the doctors and nurses are experienced in looking after pregnant women with diabetes. You will have more frequent antenatal appointments than women who don't have gestational diabetes.
The treatment for gestational diabetes aims to maintain your blood sugar level within the normal range for someone who doesn’t have diabetes. The blood sugar ranges for people without diabetes are shown below. The units are millimoles per litre (mmol/l), which is a measurement of the concentration of sugar in your blood.
Before meals: 3.5 to 5.5mmol/l.
Two hours after meals: less than 8mmol/l.
There are many different opinions about the ideal range to aim for when you have gestational diabetes. This is individual to you, so the target levels will be agreed between you and the doctors and nurses who are caring for you.
As a guide, the target levels that you may be expected to aim for are shown below.
Before meals: 4 to 7mmol/l.
Two hours after meals: less than 8.5mmol/l.
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