Pregnancy sugar, gestational diabetes, pregnancy diabetes or diabetes during pregnancy are different names for the same disease: Gestational diabetes.
Any disturbance of the metabolism of sugars recognized during pregnancy is referred to as pregnancy diabetes, irrespective of whether the disease has recurred during pregnancy or was previously unknown. Clearly, the diabetes already known before the pregnancy occurs . This is usually a type I diabetes.
Causes of gestational diabetes
About 2.5 percent of all pregnant women are diabetic. The reason for the occurrence of the disturbance is not clearly clarified. There is probably a genetic predisposition for the diabetic metabolic system. The affected women probably have the potential for an increased blood glucose level already before pregnancy.
Since a strong change in the hormone balance occurs during pregnancy, it is assumed that interactions occur between the female sex hormones (estrogen, progesterone), the placenta hormones and the blood sugar regulating hormone insulin. The hormones present in high concentrations may stimulate the release of insulin until the reserves are exhausted, or they reduce its effect on the end organ (muscle, liver).
At the same time, insulin is degraded in the placenta, which further reduces sugar consumption and promotes a high sugar content in the blood.
Symptoms and signs
“Gestational diabetes” differs from “ordinary” diabetes in that the high sugar levels occur particularly after food intake. In addition, an increased tendency to vomiting is observed in the first weeks of pregnancy, which makes it difficult to regulate the blood glucose level through targeted food intake.
For pregnant women, sugar disease also means increased susceptibility to urinary tract infections and greater risk of developing a gestosis, a serious pregnancy complication. The frequently increased formation of fruit water by the fetus (Hydramnion) can lead to tension in the abdomen, to a disturbance of the food intake and to aggravated breathing. There is also the risk that the metabolic derailment persists after delivery.
For the unborn, the consequences are usually more severe than for the mother. The negative effect of the sugar on the vessels leads to a reduced circulation of the placenta, which endangers the feeding of the fetus (placental failure). This problem is exacerbated by the mechanical pressure, which can originate from the hydramnium.
Untreated diabetic pregnancy
If a diabetic pregnancy is treated untreated, the newborn often shows the typical characteristics of the so-called diabetic fetopathy (in about 40 percent of the cases). This is characterized by the contrast between an abnormally large child (4.5 kilograms and more) and a significant developmental residue. From the immaturity particularly the lungs are affected, so it can lead to respiratory distress syndrome.
During pregnancy, the unborn child responds to the mother’s sugar surplus with an increased insulin release to keep his own blood glucose level low (insulin lowers the sugar concentration in the blood). Another problem arises from the low blood glucose level in the newborn shortly after delivery. Due to the absence of the high maternal sugar supply, the child has a too high insulin level in relation to the now restricted sugar supply.
controlling bleeding placenta
In Switzerland, all pregnant women routinely perform blood glucose control. In the case of suspicion, the size and condition of the fetus is measured by means of ultrasound, in addition to the usual diabetes examinations. Through these regular observations, in addition to abnormalities, the development and growth of the unborn child can be recognized.
The control of placental bleeding is performed with Doppler sonography. In the 16th week of pregnancy the alpha-fetoprotein (AFP) is also determined to exclude malformations. With optimal therapy, the risk for mother and child can be reduced to a minimum. Complications during and after birth can often be avoided by careful monitoring and immediate action. Fortunately, the metabolic disorder disappears after pregnancy in the majority of cases.
complications of gestational diabetes
The main danger to the mother (and consequently also to the child) is that it can lead to a massive circulatory derangement (gestosis, grafting) with edema, renal function disorders (increased protein excretion) and hypertension. In this case also threatens a premature birth, especially if at the same time an infection is present. If the patient is not treated in a timely and professional manner, life-threatening convulsions (eclampsia) can occur.
Birth problems are caused by the unsatisfactory placenta and the child’s excess. The fruit can be disturbed by the diabetes of the mother in the early development. This can lead to abortion or permanent damage (two to three times more frequently than with non-diabetic women) at the embryo (embryopathy). These particularly affect the lower extremities, the heart and kidneys.
After the birth of a problematic metabolism (lower glucose levels, impaired electrolyte and water balance, high bilirubin levels) and respiratory problems (ANS, respiratory distress syndrome) threaten the life of the infant. In approximately one third of the affected children, the immature lungs can not fully function.