Gestational Diabetes

Causes, incidence, and risk factors

Gestational diabetes is a disorder that begins or is first recognized during pregnancy. It usually becomes apparent during the 24th to 28th weeks of pregnancy. In many cases, the blood glucose level returns to normal after delivery. It is recommended that all pregnant women be screened for gestational diabetes during the 24th and 28th weeks of their pregnancy. The symptoms are usually mild and not life-threatening to the pregnant woman. However the increased maternal glucose levels are associated with increased rate of fetal or newborn deaths. Maintaining control of blood glucose levels significantly reduces the risk to the offspring. The infant born to a woman with gestational diabetes may have an increased birth weight, low blood glucoce levels during the early newborn period, and high bilirubin levels. The risk factors for gestational diabetes are maternal age over 25 years, a family history of diabetes, obesity, a birth weight over 9 pounds in a previous infant, an unexplained death in a previous infant or newborn, a congenital malformation in previous child, and recurrent infections.

Prevention

An awareness of risk factors and prenatal screening at 26 to 28 weeks of pregnancy will lead to early detection of gestational diabetes.

Symptoms

•  increased thirst

•  increased urination

•  weight loss in spite of increased appetite

•  fatigue

•  nausea

•  vomiting

•  frequent infections including bladder, vaginal, skin

•  blurred vision

 *Note: Usually there are no symptoms.

Signs and tests

An oral glucose tolerance test followed by a blood draw between the 24th and 28th weeks of pregnancy.