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Risk Factors, Symptoms And Management Of Gestational Diabetes
The glucose reaches the cells of your body through bloodstream, which use it as fuel for their various functions. Insulin, a hormone produced by pancreas, facilitates the uptake of glucose by cells and thus regulates the blood level of glucose. When insulin is deficient or there is resistance to its action, the glucose levels in blood rise, resulting in diabetes.
The hormonal changes in pregnancy can make the cells resistant to the action of insulin. But in most pregnant women, the pancreas responds by producing more insulin. If the response of pancreas is not adequate, then gestational diabetes results.
The risk factors for gestational diabetes are family history of type 2 diabetes, maternal age over 35 yrs, overweight, high blood pressure, unexplained miscarriage or stillbirth and previous child with a high birth weight. It is more common in smokers. However, around 50% of those with gestational diabetes do not have any risk factor.
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There may not be any symptoms. When present, the symptoms may be somewhat specific to diabetes, like increased thirst and urination, and increase in appetite. There could be general symptoms like fatigue, blurred vision and frequent infections.
Properly controlled diabetes during pregnancy may not pose any major problems either for the mother or for the child. If gestational diabetes is improperly managed, it can lead to (a) Complications due to difficulties in delivery because of large size of the baby, such as birth injury, (b) Increased risk of stillbirth and newborn death, and (c) Development of diabetes within a few years following delivery, the risk being greater in women who are obese.
Gestational diabetes usually occurs midway through pregnancy. Hence, all pregnant women should get screened for diabetes between 24 and 28 weeks of pregnancy. Those who have one or more risk factors for gestational diabetes should get a screening test done even earlier.
This is usually in the form of oral glucose tolerance test. If gestational diabetes is diagnosed, then you should self-monitor your blood glucose levels at home to see how it is being controlled.
Management of Gestational Diabetes
Eat a balanced and healthy diet. In general, your diet should not be high in carbohydrates. Cut down the intake of foods high in sugar, like soft drinks, pastries and fruit juices. Seek the help of a dietitian, if need be, to plan your diet. Typically, the appropriate diet will depend on your weight, height and level of activity.
Moderate exercise is beneficial in keeping blood glucose level in check. You can try some aerobic activity, such as 30 min of walking every day. Swimming can also be tried depending on comfort level.
If diet and exercise do not control the blood glucose level, then some form of antidiabetic medication needs to be taken. Oral antidiabetics like glyburide or metformin can be very effective. A minority of women may need insulin injections.
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