Pregnancy-Related Diabetes

Diabetes mellitus (diabetes) is a condition characterized by higher-than-normal sugar levels in the blood. Some women have diabetes before becoming pregnant, this is called pregastational diabetes. In some women, high blood sugar starts for the first time during pregnancy, this is called gestational diabetes. It is estimated that one out of every 200 pregnancies has pregestational diabetes, and in addition, 5 out of every 200 pregnant women develop gestational DM (diabetes during the course of pregnancy).

Prof. Dr. Ulun ULUĞ
Written by Prof. Dr. Ulun ULUĞ. 0 comments 4816 views

If you had diabetes before you became pregnant, it may be more difficult than before to keep your blood sugar level under control during pregnancy. You may need to change your insulin dose during pregnancy.

Problems that may occur due to diabetes during pregnancy

- High sugar level in the blood can cause the baby to become very large. Large babies have a greater risk of developing problems before and during birth. Large babies have a higher risk of needing a cesarean section. In addition, shoulder wear during birth, birth trauma, prolongation of labor are also risks for a large baby.

– In patients who were diabetic before pregnancy, that is, in patients with pregestational diabetes, the risk of some anomalies in the baby increases. However, there is doubtful research that pregnancy-onset gestational diabetes (GDM) does not cause anomalies in the baby or may be very mildly related (source).

Pregnant women with diabetes have an increased risk of developing preeclampsia (high blood pressure) during pregnancy.

– Increased risk of preterm birth.

- Sudden infant death may occur

– RDS (lung, that is, breathing in the baby) distress may develop after birth. Lung development is delayed in children of diabetic mothers.

– After birth, the baby may develop hypoglycemia (low blood sugar) and high bilirubin, polycythemia (excess blood cells in the baby)

– Placental dysfunction and as a result of this, IUGR (developmental retardation) may occur in those with pregastational diabetes.

– Polyhydramnios is common in diabetic pregnancies. Oligohydramnios may also develop in pregestational diabetes.

– Sudden fetal ex may occur in the womb.

– Maternal mortality has increased due to reasons such as preeclampsia and ketoacidosis.

– The risk of urinary system infection, respiratory tract infections, postpartum puerperal infections and wound infection is increased in diabetic pregnant women.

– Diabetic ketoacidosis may occur. In diabetic pregnant women, excessive nausea, vomiting, infections, beta mimetic or steroid drugs may predispose to diabetic ketoacidosis.

If you get the right treatment before and during pregnancy and have regular check-ups, you have a high chance of giving birth to a healthy baby.

Pregnancy-related diabetes symptoms

Many pregnant women do not notice the symptoms of diabetes and this can be understood by tests, but there may be symptoms such as feeling thirsty, weight loss, eating too much, urinating too much, fatigue.

If a woman with diabetes becomes pregnant, she should know that the disease will be difficult to control and may worsen during pregnancy.

Diagnosis

For diagnosis, tests called glucose loading tests (sugar water test) are performed. 24-28. 50 gr. for screening purposes to all pregnant women during their pregnancy glucose test is done. The 50 gram glucose load test is only a screening test and does not definitively diagnose diabetes. A 100-gram glucose tolerance test is performed for those whose 50-gram glucose test value is higher than 140. Diabetes can be diagnosed based on the result of a 100-gram glucose test. These tests are described in detail under a separate heading.

Treatment

Diet is sometimes sufficient for the treatment of gestational diabetes. When the diet is not sufficient, insulin therapy is started. Diabetes-lowering drugs in tablet form cannot be used during pregnancy.

You can find detailed information about the use of insulin during pregnancy by clicking here.

How and when should the birth occur?

In diabetic pregnancies, if there is no abnormality, if there is no other situation that requires cesarean section, the birth is done in the form of normal delivery and at the normal time. Cesarean section may be required in cases such as large baby (macrosomia) or unsuitable maternal bone structure. The risk of preterm birth is increased in diabetic pregnancies.

Pregnancy-related sugar; Does diabetes continue after birth?

In most women, this goes away after the baby is born. OGTT (sugar loading test) with 75 grams of glucose is applied to mothers who have been diagnosed with gestational diabetes during their pregnancy, 6 weeks after delivery. With this test, it is learned whether diabetes continues or not. Even if this test is normal, the mother's risk of developing diabetes in subsequent pregnancies or later in life is higher than other people. Approximately half of patients with gestational diabetes develop overt diabetes within 20 years.

Except for gestational diabetes, those with pre-pregnancy diabetes will likely return to their pre-pregnancy status after delivery.

The risk of developing diabetes in the child in the coming years is high.

– The risk of developing Type 2 diabetes and GDM in the future is 20 times higher in children born to diabetic mothers compared to children born to non-diabetic mothers.

– The risk of developing diabetes in the children of a mother who had diabetes during pregnancy is 33%.

Additional information on pregnancy-related diabetes

– Diabetes in the father does not cause an increase in congenital anomalies in the baby. While gestational diabetes in the mother does not cause an increase in fetal anomaly, pregastational diabetes can cause an increase in anomaly.

– The risk of fetal amoma is increased in pregnant women with pregestational diabetes. The fetal anomaly with the highest risk is caudal regression and situs inversus . Caudal regression is 250 times more common in diabetic pregnant women than non-diabetic women, and situs inversus is 80 times more common. However, the most common fetal anomaly in diabetic pregnancies is cardiac anomalies, as in non-diabetic pregnancies, followed by neural tube defects.

In the presence of diabetes in the mother, problems such as hypoglycemia, hypocalcemia, hyperbilirubinemia, polycythemia, hyperviscosity, respiratory distress syndrome, and hypertrophic cardiomyopathy may occur in the newborn after birth.

– There is an increased risk of developing obesity, overt diabetes, hypertension, hyperlipidemia, and cardiovascular diseases in women diagnosed with diabetes during pregnancy. For this reason, patients with high diabetes mellitus due to pregnancy should be careful about healthy eating, active lifestyle, and regular exercise throughout their life in the postpartum period.

You can visit our Youtube page to get fast and accurate information about pregnancy-related diabetes, IVF, gynecological diseases, drug use trainings, and many more .

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