Diabetes in Pregnancy

Synonyms

Gestational diabetes, gestational diabetes, gestational sugar

English: gestational diabetes

definition

A distinction is made between pre-existing diabetes mellitus and so-called gestational diabetes (gestational diabetes), which is only triggered by pregnancy and breastfeeding. About one in hundred pregnant women is affected. The main symptom of both forms is the impairment of the utilization of carbohydrates, so that the blood sugar level is too high.

Pre-existing diabetes mellitus

If it already exists diabetes it occurs more often due to hypoglycemia or hypoglycemia Gestational diabetes, the latter mostly due to the reduced need insulin triggered in the first trimester of pregnancy.

Gestational diabetes

Gestational diabetes (gestational diabetes) is relatively symptom-free, so the pregnant woman has to rely on a doctor to discover the disease.

Diabetes harbors some risks for pregnant women: the weakened immune system can lead to increased urinary tract infections (e.g. cystitis) and the likelihood of developing preeclampsia or eclampsia (S. gestosis) is increased. The complications of the retina (see eye) of a diabetic (diabetic retinopathy) can worsen rapidly during pregnancy, so that regular visits to the ophthalmologist are advisable! In some cases there are also deposits under the skin in the eye area, so-called xanthelasma.

Note: diabetic coma

If the pregnant woman falls into a diabetic because of insufficient or no treatment comaImmediate therapy is required, since 50% of the fetus (unborn child) dies in the womb. If the pregnancy is sufficiently advanced, an early delivery should be carried out by Caesarean section respectively.

On the one hand, the dangers of gestational diabetes for the fetus lie in the increased malformation rateleading to the so-called Diabetic fetopathy With Heart defects and malformations of the lower half of the body (caudal regression syndrome) leads. On the other hand, the growth of the fetus is caused by a poorer blood circulation in the mother cake (p. placenta) throttled (small-for-date-baby).

Also read our page High risk pregnancy.

Furthermore, due to the increased blood sugar levels in the maternal blood, the fetus now begins to produce insulin itself, since the maternal insulin is no longer sufficient. This leads to the excessive size (macrosomia) of the fetus with a birth weight of often more than 4000g. At the same time there is a certain immaturity. In this case, the birth should be initiated approx. 2 weeks before the calculated due date in order to avoid complications. Such newborns are more likely to develop coagulation disorders, respiratory distress syndrome or to become ill. Hypoglycemia also occurs in these newborns, which must be avoided because of the risk of brain damage.

In gestational diabetes, the fetus, just like a diabetic, has to urinate more, which increases the volume of the amniotic fluid (hydramnios). Due to the increased mobility of the fetus, this in turn harbors the risk of an unfavorable position for the birth and the umbilical cord being wrapped around the child's neck.

Info: prenatal care

In the Obstetrics the diabetic pregnant woman is monitored more closely. For example, in the last few weeks of pregnancy, she should attend you once a week Labor recorder connected.

To a Determine gestational diabetes, the urine is checked for sugar. At later stages of pregnancy the test may be positive without a Diabetes mellitus present. Nevertheless, if the test result is positive, you should get a so-called oral glucose tolerance test carry out. The pregnant woman drinks a fixed amount of sugar liquid and then takes a measurement of the blood sugar level at regular intervals.

A low-carbohydrate therapy is often sufficient for gestational diabetes diet. If this does not normalize the blood sugar level, the pregnant woman has to inject insulin. Pregnant women who have already had diabetes have to keep a diet and switch to insulin as early as possible before pregnancy because oral antidiabetic drugs are not suitable during pregnancy because of the side effects on the fetus (p. Therapy diabetes mellitus)