Glucose comes from the breakdown of food. It is the body's energy source. It can pass from the blood to cells with a hormone called insulin. Without insulin, glucose will build up in the blood. This is called hyperglycemia. At the same time, your body's cells are starved for glucose (energy).
When this happens during pregnancy it is called gestational diabetes. The extra glucose in the blood can cross to the baby. This condition can cause problems for the mother and baby.
The exact cause is unknown. But these factors may contribute to the condition:
These factors increase your chance of developing this condition:
This condition may not cause any symptoms. If symptoms occur, they may include:
If you are at high risk, you may need glucose testing as soon as possible. If your initial test is negative, you should be retested between 24-28 weeks of gestation.
If you are at average risk, you may be given the 50-gram glucose test (see below). This is given between 24-28 weeks of gestation.
If you are at low risk, you do not need glucose testing. To be low risk, you must meet all of the following criteria:
This involves:
In some cases, a urine glucose test may be done. These are not as reliable as the blood test.
This involves:
The aim of treatment is to return glucose levels to normal. Treatment includes:
Physical activity helps the body use glucose. The insulin you produce will be more effective. Ask your doctor about an exercise routine.
Use a monitor to check your glucose levels. Show your doctor the results at prenatal visits.
If you've made lifestyle changes and your glucose levels stay above normal, you may need to inject insulin each day.
After delivery, glucose levels usually return to normal. You will need a glucose tolerance test 6-8 weeks after delivery. Exercising, breastfeeding, and losing weight will help to reduce your chance of developing type 2 diabetes .
RESOURCES:
American College of Obstetricians and Gynecologists
http://www.acog.org/
American Diabetes Association
http://www.diabetes.org/
CANADIAN RESOURCES:
Canadian Diabetes Association
http://www.diabetes.ca/
Women's Health Matters
http://www.womenshealthmatters.ca/
References:
American Diabetes Association. Position statement: gestational diabetes mellitus. Diabetes Care . 2003;26(suppl 1):S103-105.
American Dietetic Association. Nutrition practice guidelines for gestational diabetes mellitus.American Dietetic Association . 2001.
Buchanan TA, Xiang AH. Gestational diabetes mellitus. J Clin Invest . 2005;115:485-491.
Taylor JS, Kaemar JE, Nothnagh M, Lawrence RA. A systematic review of the literature associating breastfeeding with type 2 diabetes and gestational diabetes. J Am Coll Nutr . 2005;24:320-326.
Urine glucose. EBSCO Health Library website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=81 . Updated May 2008. Accessed June 25, 2008.
Urine ketone testing. National Center for Chronic Disease Prevention and Health Promotion website. Available at: http://www.cdc.gov/nccdphp/ . Updated December 2005. Accessed June 25, 2008.
What is gestational diabetes? National Institute of Child Health and Human Development website. Available at: http://www.nichd.nih.gov/publications/pubs/gdm/sub1.htm . Accessed October 7, 2005.
*¹2/5/2009 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed/what.php
: Cheng YW, Chung JH, Kurbisch-Block I, Inturrisi M, Shafer S, Caughey AB. Gestational weight gain and gestational diabetes mellitus: perinatal outcomes.
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Hillier TA, Pedula KL, Vesco KK, et al. Excess gestational weight gain: modifying fetal macrosomia risk associated with maternal glucose.
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Last reviewed February 2009 by Rosalyn Carson-DeWitt, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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