Gestational Diabetes
Gestational diabetes mellitus (GDM) resembles type 2 diabetes in several respects, involving a combination of
relatively inadequate insulin secretion and responsiveness.
It occurs in about 2%–5% of all pregnancies and may improve or disappear after delivery. Gestational diabetes is
fully treatable but requires careful medical supervision throughout the pregnancy. About 20%–50% of affected women
develop type 2 diabetes later in life.
Even though it may be transient, untreated gestational diabetes can damage the health of the fetus or
mother.
Risks to the baby include macrosomia (high birth weight), congenital cardiac and central nervous system
anomalies, and skeletal muscle malformations. Increased fetal insulin may inhibit fetal surfactant production and
cause respiratory distress syndrome.
Hyperbilirubinemia may result from red blood cell destruction. In severe cases, perinatal death may occur, most
commonly as a result of poor placental perfusion due to vascular impairment. Induction may be indicated with
decreased placental function.
A cesarean section may be performed if there is marked fetal distress or an increased risk of injury associated
with macrosomia, such as shoulder dystocia.
A 2008 study completed in the U.S. found that more American women are entering pregnancy with preexisting
diabetes.
In fact the rate of diabetes in expectant mothers has more than doubled in the past 6 years.
This is particularly problematic as diabetes raises the risk of complications during pregnancy, as well as
increasing the potential that the children of diabetic mothers will also become diabetic in the future.
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