Gestational Diabetes

What is Gestational Diabetes?
  • Pregnant women who have never had diabetes before but who have high blood glucose (sugar) levels during pregnancy are said to have gestational diabetes.
  • According to a 2014 analysis by the Centers for Disease Control and Prevention, the prevalence of gestational diabetes is as high as 9.2%.
Causes:
  • There are no specific reasons for the cause of gestational diabetes, but there are some clues:
  • The placenta supports the baby as it grows. Hormones from the placenta help the baby develop.
  • But these hormones also block the action of the mother’s insulin in her body.
  • This problem is called insulin resistance. Insulin resistance makes it hard for the mother’s body to use insulin.
  • She may need up to three times as much insulin.
  • Gestational diabetes starts when your body is not able to make and use all the insulin it needs for pregnancy.
  • Without enough insulin, glucose cannot leave the blood and be changed to energy. Glucose builds up in the blood to high levels.
How Gestational Diabetes Can Affect the Baby:
  • Gestational diabetes affects the mother in late pregnancy, after the baby’s body has been formed, but while the baby is busy growing. Because of this, gestational diabetes does not cause the kinds of birth defects sometimes seen in babies whose mothers had diabetes before pregnancy.
  • However, untreated or poorly controlled gestational diabetes can cause complications for your baby. When you have gestational diabetes, your pancreas works overtime to produce insulin, but the insulin does not lower your blood glucose levels. Although insulin does not cross the placenta, glucose and other nutrients do. So extra blood glucose goes through the placenta, giving the baby high blood glucose levels. This causes the baby’s pancreas to make extra insulin to get rid of the blood glucose. Since the baby is getting more energy than it needs to grow and develop, the extra energy is stored as fat.
  • This can lead to macrosomia, or a “fat” baby. Babies with macrosomia face health problems of their own, including damage to their shoulders during birth. Because of the extra insulin made by the baby’s pancreas, newborns may have very low blood glucose levels at birth and are also at higher risk for breathing problems. Babies with excess insulin become children who are at risk for obesity and adults who are at risk for type 2 diabetes.
    This is the only type of diabetes which can disappear after pregnancy but can again bounce in the later stages of life as Type 2 diabetes in women.

Type 2 Diabetes

Type 2 diabetes is a metabolic disorder caused by deficiency in insulin secretion / action.

The following symptoms are common in diabetes. However, people with type 2 diabetes have some symptoms which are so mild that they go unnoticed.

Common symptoms of diabetes includes:
  • Frequent Urination (Polyuria) – The body tries to get rid of the extra sugar in blood by excreting in the urine.
  • Excessive thirst (Polydypsia)
  • Excessive Hunger – Lack of insulin or insulin resistance in which the body cant convert the food into energy. This lack of energy causes hunger even though a person is eating his appropriate regular meals.
  • Extreme fatigue / Weakness
  • Blurry vision – Frequently occurs due to high blood glucose levels
  • Slow healing of Cuts/bruises/wounds
  • Unexplained Weight loss – People with diabetes are not able to process the food they eat. They may lose weight evn though they eat appropriate or even amount of food. Losing water and sugar in the urine and the accompanying dehydration also contributes to weight loss. This is majorly seen in Type 1 diabetes.
  • Neurological symptoms : Tingling, pain/ numbness in the hands/feet and toes. Tingling or burning feeling, pain while walking which may be worst at night, muscle weakness, difficulty in walking. This is majorly seen in Type 2 diabetes
  • Excessive Hunger – Lack of insulin or insulin resistance in which the body cant convert the food into energy. This lack of energy causes hunger even though a person is eating his appropriate regular meals.
  • Extreme fatigue / Weakness
  • Blurry vision – Frequently occurs due to high blood glucose levels
  • Slow healing of Cuts/bruises/wounds
  • Unexplained Weight loss – People with diabetes are not able to process the food they eat. They may lose weight evn though they eat appropriate or even amount of food. Losing water and sugar in the urine and the accompanying dehydration also contributes to weight loss. This is majorly seen in Type 1 diabetes.
  • Neurological symptoms : Tingling, pain/ numbness in the hands/feet and toes. Tingling or burning feeling, pain while walking which may be worst at night, muscle weakness, difficulty in walking. This is majorly seen in Type 2 diabetes
Other symptoms include:
  • Infections – Certain frequent yeast infections of the genitals, skin infections, itchy skin & Urinary tract infections. This can also be an indicator of poor glucose control.
  • Erectile dysfunction in Men, vaginal dryness and other sexual difficulties in women.
  • Altered mental status – Agitation, unexplained lethargy, Irritability, ketoacidosis.
  • Slow stomach emptying leading to nausea, vomiting and loss of appetite.

Type 1 Diabetes

Type 1 diabetes (Juvenile onset Diabetes) develops when the body is unable to produce any amount of insulin. This results in high amount of glucose in blood. Hence children with type 1 diabetes have to take lifelong insulin. This type of diabetes usually occurs before the age of 40 and around 5% of people have type 1 diabetes. But a common myth is that type 1 is more severe than type 2 diabetes. In reality all type of diabetes are severe diabetes and have to be controlled with proper management.

Cause of type 1 Diabetes :

The exact cause of type 1 diabetes is unknown. However there are number of factors which might have lead to the destruction of beta cells of pancreas which produces insulin. It is an autoimmune disorder characterized by genetic predisposition, though 80% have no relatives with the disease.

Symptoms :

The symptoms include the same classical symptoms of type 2 diabetes

  1. Polyuria ( Frequent Urination)
  2. Polydypsia (Increased thirst)
  3. Polyphagia ( Increased Hunger)
  4. Dry skin and mouth
  5. Rapid weight loss
  6. Drowsiness
  7. Abdominal Pain
  8. Vomitting
  9. Ketoacidosis