Symptoms and Causes
Unlike type 1 diabetes, gestational diabetes is not caused by a lack of insulin, but by other hormones produced during pregnancy that can make insulin less effective, a condition referred to as insulin resistance.
Approximately 3 to 8 percent of all pregnant women in the United States are diagnosed with gestational diabetes.
Gestational Diabetes Symptoms
The American Diabetes Association recommends screening for undiagnosed type 2 diabetes at the first prenatal visit in women with diabetes risk factors. In pregnant women not known to have diabetes, GDM testing should be performed at 24 to 28 weeks of gestation.
In addition, women with diagnosed GDM should be screened for persistent diabetes 6-12 weeks postpartum. It is also recommended that women with a history of GDM undergo lifelong screening for the development of diabetes or prediabetes at least every three years.
What Causes Gestational Diabetes?
Although the cause of gestational diabetes is not known, there are some theories as to why the condition occurs. The placenta supplies a growing fetus with nutrients and water, and also produces a variety of hormones to maintain the pregnancy. Some of these hormones (estrogen, cortisol, and human placental lactogen) can have a blocking effect on insulin. This is called contra-insulin effect, which usually begins about 20 to 24 weeks into the pregnancy.
As the placenta grows, more of these hormones are produced, and the risk of insulin resistance becomes greater. Normally, the pancreas is able to make additional insulin to overcome insulin resistance, but when the production of insulin is not enough to overcome the effect of the placental hormones, gestational diabetes results.
Although any woman can develop GDM during pregnancy, some of the factors that may increase the risk include:
- Overweight or obesity
- Family history of diabetes
- Having given birth previously to an infant weighing greater than 9 pounds
- Age (women who are older than 25 are at a greater risk for developing gestational diabetes than younger women)
- Race (women who are African-American, American Indian, Asian American, Hispanic/Latino, or Pacific Islander have a higher risk)
- Prediabetes, also known as impaired glucose tolerance
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