The disease defined as gestational diabetes or pregnancy-related diabetes is one of the most important problems of pregnancy. High blood sugar levels detected for the first time during pregnancy in a pregnant woman who did not have diabetes before pregnancy puts her in this disease group.
The insulin hormone is the hormone that regulates blood sugar. If a person is resistant to this hormone, blood sugar will be high and diabetes will be diagnosed. If insulin resistance is triggered during pregnancy, gestational diabetes will develop. The pregnant woman's blood sugar levels will be high, and since the glucose level in the blood going to the baby will also be high, her insulin hormone levels will also be high. Since the insulin hormone acts as a growth factor, the baby's development is monitored above normal. This abnormal enlargement continues as long as the mother's blood sugar level is high. As a result, macrosomia (excessive size) occurs in the baby. This leads to many problems in the baby during and after birth. Large babies are babies who are more likely to be harmed during vaginal birth. A condition called shoulder dysplasia, which results in paralysis or damage to the nerves going to the baby's arm, is most commonly observed in babies of diabetic mothers. In addition, the probability of babies of diabetic mothers being born by cesarean section increases. The amniotic fluid in the baby's amniotic sac increases more than normal and a condition called polyhydramnios may occur. Many metabolic problems can be observed after birth and the baby's likelihood of being admitted to intensive care increases.
All these negativities can be prevented by screening for gestational diabetes. A glucose tolerance test is performed on pregnant women to detect existing diabetes or gestational diabetes. The aim here is to investigate whether the pregnant woman can metabolize glucose. The test is usually performed after the 24th week of pregnancy. Because these are the weeks when gestational diabetes begins. The pregnant woman is given a solution prepared with 50 grams of glucose at any time of the day and regardless of her fasting state. If the glucose value in the venous (i.e. arm) blood sample taken one hour later is above a certain limit, the screening test is considered positive. In other words, this woman is at high risk.
A 100-gram glucose tolerance test is performed on high-risk pregnant women to try to make a definitive diagnosis. This test requires absolute fasting. After 12 hours of fasting, the fasting blood sugar level is measured first. A 100-gram glucose solution is given, then blood sugar levels are measured at 1, 2 and 3 hours. If the three values are above the limit, Gestational Diabetes is diagnosed.
The diagnosed pregnant woman is first put on a calorie-restricted nutrition program under the control of a dietician in order to provide diet regulation. It is examined whether blood sugar can be regulated with diet alone for at least two weeks. Most patients are regulated with diet alone. Exercise is an important factor that activates insulin and glucose metabolism. For this reason, an exercise program is definitely added to all patients. During this period, fasting-postprandial blood sugar measurements are monitored at certain intervals.
Insulin treatment can be started for pregnant women whose blood sugar levels do not drop to the desired levels after two weeks. Patients in this group are monitored very closely to minimize the negative effects on the baby and the mother-to-be.
After birth, blood sugar levels quickly return to normal and most patients do not develop diabetes in the following years. However, a 20% group of patients later develop a disease called Type II Diabetes. For this reason, patients diagnosed with Gestational Diabetes during pregnancy should be monitored and informed about how to adjust their lifestyles in a way that will not accelerate diabetes.
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