Gestational diabetes

"Gestational diabetes increases the risk of various obstetric complications for mother and baby. Therefore, it is of vital importance to diagnose it early and treat it correctly".

DR. JAVIER ESCALADA SAN MARTÍN
DIRECTOR. ENDOCRINOLOGY AND NUTRITION DEPARTMENT

Pregnancy is a diabetogenic state that produces, if it can be explained in this way, a slight elevation of blood sugar.

The gestational state generates hormones in large quantities. One of these is placental lactogen, which causes women to have a certain resistance to the action of insulin. This causes the insulin in the blood not to adequately introduce the sugar into the cells, increasing its concentration in the blood.

Patients who have developed gestational diabetes are those who were not diabetic before pregnancy but who, during pregnancy, produce high blood sugar levels. These patients are less at risk than those with pre-pregnancy diabetes, but they must also be controlled and treated.

Gestational diabetes increases the risk of fetal distress, macrosomia, intrauterine death, cesarean deliveries and neonatal problems.

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What are the symptoms of gestational diabetes?

The first thing that a patient with diabetes notices is that she is very thirsty because she also urinates a lot. Sugar is lost in the urine and causes a lot of urine to be produced in order to eliminate it. In addition, they are usually very hungry.

There are other manifestations that derive from the complications of diabetes, such as alterations in the nerves, neuropathy, or a diabetic coma, which is a serious complication.

In the long term, the disease, when blood glucose is not well controlled, can produce alterations in the smallest blood vessels, the capillaries, and affect the kidney and the retina, which favors the appearance of arteriosclerosis and nephropathy.

There are several circumstances that increase the risk of gestational diabetes. It is important to know them in order to carry out the opportune controls and avoid complications:

  • Family history of diabetes.
  • Pregnancy at an age over 35 years.
  • History of a previous birth with a baby weighing more than 4 kg.
  • History of miscarriages.
  • High blood pressure.
  • Overweight or obesity before pregnancy.

Do you have any of these symptoms?

You may have gestational diabetes

How is gestational diabetes diagnosed?

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The O'Sullivan test is the test that confirms the existence of gestational diabetes.

For the diagnosis of possible pregnancy-induced diabetes, one of the outward signs is a significant weight gain by the mother between visits to the doctor.

If a woman has this increase, a diabetes screening test will be performed. This test is called the O'Sullivan test. It should be done between 24 and 28 weeks. If she is altered, she should have her blood glucose curve done, on an empty stomach, with 100 g of glucose for three hours. The diagnosis is made if there are two or more elevated data including fasting.

Generally, diabetes in women who become pregnant is type 1, because they are usually young.

How is gestational diabetes treated?

To treat gestational diabetes, the most important thing is to properly control, with diet and light exercise, the mother's sugar levels.

The current recommendations establish the need to initiate pharmacological treatment, once the diet and physical exercise program fails to maintain the established basal and postprandial glycemic objectives.

Another factor to be considered for the initiation of insulinization is the ultrasound assessment of fetal growth.

  • The drug of choice is human insulin in a bolus-basal pattern, with one or two doses of NPH insulin, accompanied by regular pre-prandial insulin if needed.
  • Oral antidiabetics should not be taken.
  • Fetal growth and well-being should be monitored from the 34th week of pregnancy.
  • Pre-pregnancy diabetes does not have to be aggravated after pregnancy.
  • Pregnancy-induced diabetes, type A1 and A2, does have a higher risk of the mother developing type 2 diabetes in the future.

Where do we treat it?

IN NAVARRE AND MADRID

OUR MEDICAL TEAM

Specialists from the Department of Endocrinology and Nutrition

The Department is organized into care units with specialists totally dedicated to the study, diagnosis and treatment of this type of disease.

We work with established protocols, which ensure that all diagnostic tests to be performed are done in the shortest time possible and that the most appropriate treatment is started as soon as possible in each case.

Organized in care units

  • Obesity Area.
  • Diabetes Unit.
  • Thyroid and Parathyroid Disease Unit.
  • Osteoporosis Unit
  • Other diseases: e.g. Cushing's syndrome.
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Why at the Clinica?

  • European Center of Excellence in the diagnosis and treatment of Obesity.
  • Team of specialized nurses at the Day Hospital of Endocrinology and Nutrition.
  • We have a Metabolic Research Laboratory of international prestige.

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