08/04/2022
Gestational diabetes mellitus (GDM) is high blood glucose 🩸 that can develop during pregnancy in women who do not already have diabetes. Annually, 10-15% of pregnancies 🤰🏻 in Malaysia 🇲🇾 are affected by GDM.
Unlike Type 1 diabetes, GDM is not caused by a lack of insulin, but by other hormones (e.g., estrogen, cortisol, human placental lactogen) produced by the placenta during pregnancy that can make insulin less effective. This usually begins about 24-28 weeks 🗓 into the pregnancy.
Although any woman 💁🏻♀️ can develop GDM, some risk factors include:
• Overweight or obesity 🍔
• Family history of diabetes 👨👩👧👦
• Age (women >25 are at higher risk) 👩🏼💼
• Pre-diabetes (i.e., impaired glucose tolerance)
Will GDM affect the baby? 🧐
Unlike Type 1 diabetes, GDM generally occurs too late to cause birth defects, which usually originate during the 1st trimester. However, affected infants 👶🏻 may experience chemical imbalances (e.g., low serum calcium or magnesium), and can suffer from macrosomia or hypoglycemia.
Macrosomia refers to a baby 👶🏻 who is considerably larger than normal. All the nutrients the fetus receives come from the mother's blood 🩸. If the maternal blood has excessive glucose, the fetus’ pancreas senses the high glucose levels 🍬 and produces more insulin to utilise this glucose. The extra glucose is converted to fat 😳
Hypoglycemia refers to low blood sugar 🔻 in the baby 👶🏻 immediately after delivery. This occurs if the mother's blood sugar levels 🍬 have been consistently high 🔺, causing the fetus to have a high level of insulin in its circulation. After delivery 🤰🏻, the baby continues to have a high insulin level, but without the high level of sugar from its mother 👩👦, resulting in the newborn's blood sugar level becoming very low.