Saturday, 14 December 2013

Pregnancy - Gestational Diabetes - Symptoms, Causes & Risk Factors

Gestational Diabetes is defined as a condition of high blood glucose of a pregnant women who is experience such diseases or symptoms only during pregnancy as a result of hormonal change, but return to normal blood sugar after giving birth. Gestational diabetes is considered as an indication of type II diabetes. It affects approximately 3% of pregnant women.

Symptoms is similar to those with diabetes, including
1. Frequent thirst
As a result of high concentration of glucose in the blood
2. Infections
Women who have gestation diabetes prone to have frequent infection, it may be result of high levels of glucose in the urine that cause bacteria invasion.
3. Nausea and vomiting
Nausea and vomiting is associated to early pregnancy, but in some cases, it can be a symptoms of gestational diabetes.
4. Fatigue
Fatigue may be a result of high blood sugar cause of inability of the body in sugar metabolism.
5. Increased urination
It is caused by the affect high blood sugar in the function of the kidney, instead of over growth of the uterus putting pressure to the bladder.
Blurred vision
Blurred vision can be caused by accumulation of fluid in the retina of your eye.
7. Weight loss
Women who are losing weight during pregnancy can be caused high blood sugar in the blood.
8. Etc.

Causes and risks factor
Insulin resistant
Insulin resistant may be caused by the body normal reaction if the body to secure glucose supply to the growing fetus.
According to the article "Gestational Diabetes: Detection, Management, and Implication" by Darcy Barry Carr, MD, and Steven Gabbe, MD, the authors wrote that The mechanism of insulin resistance is likely a postreceptor defect, since normal insulin binding by insulin-sensitive cells has been demonstrated.16 The pancreas releases 1.5–2.5 times more insulin in order to respond to the resultant increase in insulin resistance.17 Patients with normal pancreatic function are able to meet these demands. Patients with borderline pancreatic function have difficulty increasing insulin secretion and consequently produce inadequate levels of insulin. GDM results when there is delayed or insufficient insulin secretion in the presence of increasing peripheral resistance.

2. Placental hormones
Some researchers suggested that gestation diabetes in pregnancy may be caused by placental hormone as a result of increased fat deposits during pregnancy.

3. According to study of " Gestational diabetes mellitus by Thomas A. Buchanan and Anny H. Xiang, researchers found that
a. Autoimmune diabetes and GDM
Type 1 diabetes results from autoimmune destruction of pancreatic β cells....A small minority (less than 10% in most studies) of women with GDM have the same markers present in their circulation. Although detailed physiological studies of these women are lacking, they most likely have inadequate insulin secretion resulting from autoimmune damage to and destruction of pancreatic β cells. They appear to have evolving type 1 diabetes.
b. Monogenic diabetes and GDM
Monogenic diabetes mellitus has been identified outside of pregnancy in 2 general forms. Some patients have mutations in autosomes (autosomal dominant inheritance pattern, commonly referred to as maturity-onset diabetes of the young [MODY].... Mutations that cause several subtypes of MODY have been found in women with GDM.
c. Insulin resistance, β cell dysfunction, and GDM
The majority of women with GDM appear to have β cell dysfunction that occurs on a background of chronic insulin resistance.

4. Family history
Women who have a previous record of the incidence are at higher risk of Gestational diabetes.

5. Age
Women who are pregnant at age of 30 and older are at higher risk of the incidence.

6. Obesity
Obesity is a major risk of gestational diabetes or especially when developing rapidly after pregnancy.

7. History of an unexplained miscarriage or stillbirth
Nevertheless, on the assumption that repeated unexplained abortions might be a prediabetic
or latent diabetic phenomenon, Williams,24 Gilbert14 and Hoet25 have performed glucose
tolerance tests in the mothers, and frequently found them to be abnormal, according to the article of PREDIABETES A Synthesis By W. P. U. JACKSON, M.A., M.D., M.R.C.P., D.C.H..

8. History of giving birth to over weight baby (9 Lbs or more)
Women who have had a previous history of giving birth to one or more over weight baby are at higher risk of developing gestation diabetes, according to the article of"PREDIABETES A Synthesis" By W. P. U. JACKSON, M.A., M.D., M.R.C.P., D.C.H.
9. Hydramnios
Birth defect is a very frequent concomitant of the diabetic pregnancy. Its incidence in prediabetes has not yet been elucidated., according to the article of " PREDIABETES" A Synthesis By W. P. U. JACKSON, M.A., M.D., M.R.C.P., D.C.H.

8. Glycosuria
The excretion of glucose into the urine as a result of the kidneys are unable to reclaim all of the filtered glucose back into the bloodstream may be a sign of gestational diabetes.

9. Toxaemia
Women who are pregnancy of pre-eclampsia or eclampsia are at high risk of gestational diabetes due to presence of bacterial toxins in the blood.

10. Etc.

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