Gestational Diabetes-Part 1

Testing for gestational diabetes

Screening for gestational diabetes is now a routine part of prenatal care. Blood glucose levels are routinely checked in the 2nd and 3rd trimester. If there is a history of diabetes in the family, the glucose levels are checked much early on in the first trimester. If the fasting blood sugars are elevated, all individuals have to undergo a glucose challenge test to confirm the diagnosis.

The majority of women who develop gestational diabetes deliver healthy babies. However, if the glucose levels are persistently high during pregnancy, some complications can occur. These include: Increased weight of baby is common in mothers who are diabetic or develop diabetes during the pregnancy.

The persistent high glucose can cross into the placenta and into the fetal circulation. The baby responds by making more insulin to counter the high glucose. Insulin also has the ability to induce growth and thus the fetus usually grows large. It is not unusual for diabetic mothers to give birth to babies which weight more than 10 pounds. Low blood sugars can also occur in the baby soon after birth. This is because the baby has been exposed to high sugars while in the womb and has high levels of insulin to counteract the sugars.

When the baby is delivered, the glucose from the mother is suddenly discontinued because the placenta is clamped but the insulin levels remain high. The elevated insulin can cause a profound hypoglycemia. This can be easily treated by administering glucose via an intravenous. Difficulty with the lung expansion or respiratory distress syndrome does occur in babies that are delivered early. This condition makes breathing difficult because the lungs are still immature.