Diabetes Pregnancy Causes, Treatment complications of Diabetes Pregnancy
Diabetes pregnancy is also called as gestational diabetes. Diabetes pregnancy is a condition in which fasting blood glucose level is increased more 126 mg/dl. The diabetes pregnancy is due to insulin deficiency or due to peripheral tissue resistance to the action of insulin. The ultimate effect uncontrolled diabetes is hyperglycemia. And Diabetes pregnancy has name as “pregnancy induced glucose tolerance”. Gestational diabetes is the another name for pregnancy diabetes.
Potential causes of diabetes pregnancy
- Family history of diabetes may cause diabetes during pregnancy.
- Having a previous birth of an overweight baby of 4 kg or more may cause diabetes pregnancy.
- Previous still birth with pancreatic islet hyperplasia revealed on autopsy also causes diabetes pregnancy.
- Unexplained perinatal loss also causes diabetes pregnancy.
- Presence of polyhydramnios or recurrent birth canal candidiasis in present pregnancy may cause diabetes.
- Persistent glycosuria
- People aged over 30 are prone to get number of health disorders.
- Obesity is the main cause type 2 diabetes mellitus.
- Ethnic group: Some groups of people have risk to get pregnancy diabetes.
- All these risks may cause diabetes pregnancy.
Causes of Pregnancy Diabetes
When the pregnancy hormones are interfering with the utilization of the insulin from the cells; it leads to diabetes pregnancy. Or diabetes pregnancy is also caused with lack of production of insulin in the pancreas or due to peripheral resistance to the insulin.
Hazards or complications of pregnancy Diabetes
The diabetes pregnancy will cause more effects on the baby as well as on pregnant mother. These risks can be prevented by reducing the blood glucose level. The risks of diabetes pregnancy includes…
Congenital anomalies: The baby born for the mother with gestational diabetes will get more birth defects. The baby will get heart diseases and neural tube defects are spina bifida (a defect in the spinal cord), anencephaly, microcephaly (Small head of the baby), sacral agenesis, renal agenesis, hydronephrosis, ureteral duplication, duodenal atresia, anorectal atresia, single umbilical artery and other Congenital anomalies are the hazards of diabetes pregnancy.
Recurrent abortion: Due to increase in the blood glucose level the pregnant mother will have more chances of getting miscarriage, is may be caused by diabetes pregnancy.
Premature birth: The pregnancy diabetes or gestational diabetes will cause the premature birth of the baby, due to premature rupture of the membrane is common with diabetes pregnancy.
Macrosomia: Macrosomia is defined as the birth of the baby above 4 kg or more birth weight. The baby with macrosomia looks very big. Macrosomia happens due to the sugar from the mother will cross and reach the fetus. So it leads the fetus to produce extra insulin and it converts the sugar into the fat and cause the baby to become bigger in size. Macrosomia is the common complication of untreated diabetes pregnancy.
Stillbirth: The baby born dead after 37 weeks of gestation is called as still birth; may happen because of diabetes pregnancy.
Immediate complication of the new born baby: there is a respiratory problem and hypoglycemia and icterus.
Obesity: there is a chance of getting obesity in the baby born for the diabetic mother.
Pre-eclamsia: If the mother is having gestational diabetes will have more risk of getting pre-eclampsia that is increase in blood pressure of the mother. Pre-eclampsia may be associated with diabetes pregnancy.
Polyhydromnios: Polyhydromnios is another important major risk in diabetic mother. There will be increase in the amount of the amniotic fluid level more than 2500 ml is called polyhydromnios; the complication of diabetes pregnancy.
Cesarean delivery: Due to the large size of the baby the mother has to undergo cesarean section in some cases of diabetes pregnancy.
Diet for diabetes pregnancy
The mother during her pregnancy has to focus her attention on food; especially the mother who is having diabetes must have to take so much of care in her diet to prevent hyperglycemia. The mother has to take a planned amount of calories per day; it should consist of all the contents like vitamins and proteins, fat, and carbohydrates. Mother with diabetes pregnancy has to get nutritional counseling.
The calories for each day are calculated by the dietitians, the diet regimen is divided in to three meals, and three snacks.
Nearly 20 % of calories should obtain from proteins. The protein including items are lean meats, milk and milk products, fish, beans, cereals, eggs and nuts. And more about 30 to 40% from primarily unsaturated fats. The main source of fats are from plants and vegetables sources.
Main source of calories from carbohydrates nearly about 40 to 50 % from main complex foods such as grains, whole-grain bread, fruits, cereal, pasta and, as well as rice and vegetables.
Precaution of sweets should be avoided by diabetes pregnancy mother.
Diagnosis of diabetes pregnancy
It is important to rule out the other pathological conditions during pregnancy so the mother must undergo the following diagnoses…
Ultrasound scanning: Ultrasound scanning is used to find the condition of the fetus, especially in the last trimester of pregnancy, to identify diabetes pregnancy.
Non stress test: This test is very essential to find out the heart rate of the mother and as well as the baby’s heart rate. It is repeated every weekly or more frequently.
Counting of the fetal movement: The pregnant mother has to take records over the fetal movement in one or two hours.
Management of diabetes pregnancy
The patient with diabetes pregnancy needs more frequent antenatal supervision with periodic check up of fasting blood glucose level which should be less than 95 mg%. The control of high blood glucose is done by restriction of sugar containing diet; exercise with or without insulin for mother with diabetes pregnancy. Human insulin should be started if fasting plasma glucose level exceeds 105 mg/dl and 2 hours postprandial value is greater than 130 mg/dl. Even on diet control. Diet 2000-2500 Kcal/day for normal weight diabetes pregnancy woman and restriction to 1200-1800 Kcal/day for overweight woman is recommended. Exercise program are safe in diabetes pregnancy and may obviate the need of insulin therapy.
Consultation with the physician or the diabetalogist is important to treat the gestational diabetes. Blood sugar control is important aim of gestational diabetes treatment. Frequent monitoring and medical supervision may assist in controlling geatational diabetes and getting health baby as a result of pregnancy.
Obstetric management of women with good glycemic or blood sugar control and who do not require insulin may wait for spontaneous onset of labor. However, elective delivery is considered in patients requiring insulin or with complications at around 38 weeks of pregnancy.
Follow up: Nearly 50% of women with gestational diabetes would develop overt diabetes over a follow up period of 5-20 years. Women with fasting hyperglycemia have got worse prognosis to develop type-2 diabetes and cardiovascular complications. Recurrence risk in subsequent pregnancy is more than 50%.