Gestational diabetes mellitus is a glucose tolerance disorder that first appears during pregnancy or is diagnosed during pregnancy. It is reported at a rate of 1-14% in different societies. Its frequency is increasing. This is due to the increased incidence of obesity. The American Diabetes Association reported that 4% of pregnant women, that is, approximately 135,000 women per year, have gestational diabetes. Screening tests are usually 24-28. done in weeks.
RISK FACTORS FOR GESTATIONAL DIABETES
1. over 25 years old
2. body mass index over 25-27kg/m2
3. gestational diabetes common ethnicity
4. presence of gestational diabetes or type 2 diabetes in first degree relatives
5. history of gestational diabetes in previous pregnancies
6. polycystic ovary syndrome
7. Presence of hypertension
RISKS OF GESTATIONAL DIABETES FOR MOTHER AND CHILD
1. Macrosomia: The generally accepted definition of macrosomia is the birth weight of the baby over 4000gr. While the incidence of macrosomia in gestational diabetes has been reported as 16-29% in studies, this rate is 10% in patients without diabetes.
2. There is an increase in the rates of hypoglycemia, hypocalcemia, hyperbilirubinemia and polycythemia in the neonatal period in babies of mothers with gestational diabetes.
3. Another common problem in those with gestational diabetes is HYPERTENSION.
4. Patients with gestational diabetes are more likely to have type 2 diabetes in the future. The risk of developing type 2 diabetes is higher in those who had to take insulin therapy during pregnancy.
IF A PREGNANT HAS TYPE 1 OR TYPE 2 DIABETES, DOES HIS DIABETES TRANSFER TO MY CHILD?
A pregnant woman with type 1 diabetes has a 2% risk of her child having type 1 diabetes. However, if the father has type 1 diabetes, the child’s risk of type 1 diabetes is around 6%. If both parents have type 1 diabetes, this risk increases by 30%.
On the other hand, if the pregnant woman has type 2 diabetes, the risk of the child having type 2 diabetes is 25%. If the father has type 2 diabetes, the risk for the child is the same. If both parents have type 2 diabetes, this risk increases by 50%.
WHICH DISEASES CAN BE SEEN IN DIABETIC PREGNANCY
“Peripheral insulin resistance” and the “hyperinsulinemia” and “hypoglycemia” caused by it are important findings in gestational diabetes. In diabetic pregnant;
1. spontaneous abortions increase,
2. stillbirths are frequent,
3. polyhydramnios develops,
4. frequency of preeclampsia is high
5.placental anomalies are common,
6.the tendency to urinary tract infections is increased.
MATTERS TO BE CONSIDERED IN DIABETIC PREGNANCY
A) It should not be used as there is insufficient information about the use of oral hypoglycemic drugs during pregnancy.
B) Lactation (breastfeeding) should be encouraged in all gestational diabetes patients.
C) Pregnancy exercises should be recommended.
D) Gestational diabetes is not a cesarean indication alone. Delivery should be done around 38 weeks. (after that, macrosomia increases)
E) After delivery, blood sugar returns to normal in most of the cases. It should be considered that approximately 25-30% of cases with gestational diabetes develop diabetes within 20 years.
F) In cases of gestational diabetes, the risk of recurrence of gestational diabetes in later pregnancies is high.
G) Children of cases with gestational diabetes have a higher risk of diabetes later in life.
DR. ELYESA KARACA
INTERNAL DISEASES (INTERNATIONAL) SPECIALIST
