Gestational Diabetes And Low Blood Sugar In Newborns

Diabetes acquired during gestation period, a period of fetal development in the uterus from conception to birth is termed as gestational diabetes or gestational diabetes mellitus (GDM). Women who have never experienced diabetes and have been diagnosed with abnormal blood sugar levels only during pregnancy suffer from gestational diabetes.

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Being one of the most common health problems for pregnant women, gestational diabetes affects about 18% of pregnant women, as per the records of American Diabetes Association.

How Does High Blood Sugar Level In the Mother Affect the Newborn?

Since, the rise in blood sugar levels occur after the development of the body of the fetus, no birth defects or body deformities are observed, unlike babies who are born to women who have been diagnosed of diabetes prior to pregnancy. However, insulin imbalances in the mother can certainly affect the metabolism of glucose in the growing fetus. Even though, insulin cannot cross the placenta, glucose and other nutrients can pass through, leading to the accumulation of glucose in the blood of the fetus, which forces the fetus’s pancreas to produce ample amount of insulin for metabolizing glucose.

High levels of insulin interfere with fat metabolism, leading to an increase in the size of the babyand the formation of macrosomia or a “fat baby”. This not only predisposes newborns to obesity and diabetes but also subjects them to many birth traumas like collar bone fracture, damaged shoulder nerves, etc. Moreover, delivery becomes possible only through a cesarean operation, which causes discomfort to the mother during her post-delivery period.

Elevated levels of glucose can also affect the lungs of the newborns, thus requiring more oxygen and causing breathing problems, commonly termed as respiratory distress syndrome. Excess production of red blood cells gives a flushed and red appearance to the newborn babies skin and makes them more prone to jaundice. Reduction in the levels of minerals is yet another sign of a hypoglycemic newborn, which manifests itself in the form of muscle twitching and cramping. Other prominent symptoms of hypoglycemic newborns include poor suck, refusal to feed, jitteriness, high pitched cry, lethargy, temperature instability, hypothermia, listlessness, etc.

What Are the Causes of Gestational Diabetes?

Often women are subjected to constant hormonal fluctuations, more so during pregnancy, which in turn, affects the functioning of insulin. Our body converts carbohydrates from the diet into glucose and releases it into the bloodstream. Glucose enters the cells and is metabolized further, to be used as a primary source of energy.

However, the transfer from the blood and the utilization of glucose by cells requires a hormonecalled insulin that is released by the pancreas. The hormones released by the placenta, a channel used for the movement of nutrients, blood and water from the mother to the fetus, render the insulin dysfunctional, thereby requiring three times more insulin than the normal levels that are maintained in the mother’s body.

Failure of the pancreatic beta cells to produce adequate amounts of insulin or insulin resistance developed by the body’s cells in pregnant women does not allow her body to counteract the effect of the rise in the blood sugar levels, thus leading to hyperglycemia and gestational diabetes. Strong family history of diabetes, obesity, an age over 35, high blood pressure, an unexplained still birth in the past, etc., can also increase the risk of developing gestational diabetes in pregnant women.

How Do You Know You Have Gestational Diabetes?

No symptoms have been identified so far for gestational diabetes, which makes it mandatory for conducting glucose-screening tests during the 24-28 weeks of pregnancy. An oral glucose tolerance test is conducted to test for the ability of the woman’s body to metabolize sugar. After being made to fast for 4-6 hours, the blood sugar levels of the expectant women are measured.

She is then made to drink large quantities of a sugar drink and the measurement of the blood sugar levels is done two hours after the consumption of the drink. A higher than normal range of glucose levels indicates a higher susceptibility of the pregnant women to develop gestational diabetes and makes it extremely important for her to constantly monitor her blood sugar levels.

Is There A Treatment For Gestational Diabetes?

If left untreated, gestational diabetes can pose serious health problems for both the baby and the mother. Hence, maintaining a healthy weight through a healthy diet and exercise can help a woman suffering from gestational diabetes in controlling her blood sugar levels and giving birth to a healthy baby.

Once you are diagnosed with gestational diabetes, a team of health care providers including a gynecologist, a registered dietician, a diabetes specialist or a diabetes educator can advice you on the different ways of bringing your blood sugar levels under control. Physical activity or moderate exercises during pregnancy including walking for about 30 minutes a day, yoga and light aerobic exercises that do not place a lot of strain on your abdominal area can mimic the effects of insulinin driving the movement of glucose into the cells from the bloodstream.

Can Hypoglycemia In Newborns Be Treated?

Frequent breast feeding or feeding using a feeding tube that goes directly into the stomach of the baby is one of the most effective ways of keeping blood sugar levels at an optimum level in babies. Moreover, studies have found that breast feeding has a strong impact on glucose metabolism in babies and hence can help in stabilizing the blood sugar levels.

Besides serving as a means of nourishing the baby’s body, breastfeeding can provide protection to the mother by assisting her in losing weight, thus reducing the risk of developing type 2 diabetes and its long-term complications like cardiovascular diseases, neuropathy, retinopathy, etc.

Yet another treatment involves the intravenous infusions of glucose in the infants to make up for the low levels of glucose. Babies diagnosed with respiratory distress syndrome require an external source of oxygen or a breathing tube to enable the proper functioning of their lungs. Besides monitoring the mother’s glucose levels, it is just as important to frequently regulate and monitor the blood sugar levels in infants to avoid complications like seizures.

What Pregnancy Diet Is To Be Followed By Women Suffering From Gestational Diabetes?

Even though, it is normal to gain weight during pregnancy, it is advisable to keep your blood sugar levels under control by balancing your intake of protein, fat and carbohydrates. Make healthy food choices and stay active to allow your body to utilize glucose more efficiently. Keep a track of your calorie and sugar intake and constantly monitor your glucose levels using a glucose meter or strips. Do not adhere to crash diets that deplete your body of all the essential nutrients, vitamins and minerals.

Consult a professional nutritionist, who will help you design a well-balanced diet including the correct ratio of proteins, fats and carbohydrates. In order to stabilize your glucose levels, do not skip meals and avoid foods containing animal fat, trans fatty acids, refined sugar and other high sugar containing foods like cakes, ice creams, candies, cookies , chocolates, soft drinks and soda. If the blood glucose levels remain high, despite a change in your eating habits, you should consider consulting a doctor and taking oral medication or insulin injections for controlling blood sugar levels.

Gestational diabetes is a temporary phase and pregnant women, generally do not remain diabetic after the delivery. It can, however, put them at a higher risk of developing diabetes during the next pregnancy or diabetes mellitus during the later stages of their lives. Moreover, regulating blood glucose levels in pregnant women plays a crucial role in preventing obesity, diabetes, cardiovascular diseases, among other things in children.

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