By: Hello Doctor
By: Hello Doctor
Gestational diabetes is characterized by being a disease typical of pregnancy due to elevated blood glucose levels. It is defined as glucose intolerance that begins or is first recognized during pregnancy.
It is due to the fact that during pregnancy there are hormones produced by the placenta such as human placental lactogen, progesterone, growth hormone among others and that have an insulin blocking effect and being one of the functions of insulin is to maintain adequate blood glucose levels.
That is why this problem occurs in women who are susceptible to developing diabetes mellitus even later.
– Age, older than 25 years.
– Obesity.
– Ethnic group, higher incidence in Hispanics.
– Family history of diabetes and macrosomic products (babies born with equal weight l or greater than 4 kilos at birth).
– Polycystic ovary syndrome.
How to identify if you have This problem is through a metabolic screen which is carried out at the beginning of your pregnancy, if you have risk factors for developing gestational diabetes.
If you do not have risk factors, it can be done from the week 24 to 28 through a blood test called the oral glucose tolerance curve in blood for pregnant patients in which a baseline determination is made and subsequently two blood determinations at the hour and two hours after the ingestion of 75 g of glucose.
There are several possible complications, including congenital malformations, mainly cardiac, defects of the neu ral and renal anomalies, first trimester abortion and stillbirth (stillbirth), preterm birth, macrosomic products (more than 4 kilos at birth) or with intrauterine growth restriction, polyhydramnios (a lot of amniotic fluid), among others.
It is important to receive a comprehensive management, since your pregnancy is considered high risk, they require management by a specialist either a gynecologist or obstetrician-gynecologist who is closely monitoring the proper development and growth of your baby.
As well as the Dietology Service to have an adequate diet since in many cases it is the only treatment that patients require, they will also require an evaluation by an ophthalmologist, endocrinologist and dentist.
Carry one Appropriate control and recording of your capillary glucose determinations before and after your meals to see if with the diet you manage to have an adequate metabolic control.
Otherwise, allowed hypoglycemic medications will be started during pregnancy or insulin management will be required depending on your case and the doctors will advise you on how to use them.
Your obstetrician or gynecologist will request different studies such as a thyroid profile since there is an association of developing thyroid problems in patients with gestational diabetes, as well as urine tests of 24 hrs to see if there is any alteration in your kidneys.
At the end of your pregnancy, the specialist will determine the best way to terminate the pregnancy, be it delivery or cesarean section, according to the characteristics of your pregnancy and the estimated fetal weight of your baby or if there are any other associated complications such as gestational hypertension or 2021 Preeclampsia.
Is It is important to keep your prenatal care appointments, especially if you have gestational diabetes.