Gestational Diabetes Complications

Most Gestational diabetes complications can be avoided if you keep a tight rein on the management of your diabetes.

Gestational diabetes is just as dangerous as any of the other types of diabetes, even though it is short-lived (only lasting during gestation).

Considering that it is not only your own health, but also the health of your unborn child that are affected by it. From this point of view, it must be seen as even more serious as the other types of diabetes.

The development of your baby during the pregnancy will determine largely the lifelong health of your child. This will of course be determined on how well you've managed to avoid the gestational diabetes complications. It really is up to you.

Uncontrolled blood sugar levels can be quite dangerous, as it can cause severe problems for you and your baby. These problems are highlighted in the gestational diabetes complications listed below.

Most women however, who have gestational diabetes, deliver healthy babies.
You can also be counted amongst them, all it takes is to manage your disease with care. It really is up to you.

The dangers of gestational diabetes complications does not lie so much with the fact that your body does not control its sugar levels adequately.
The danger is more in these elevated blood glucose levels. You can and must assist your body to keep your blood sugar levels within the normal range.

If your blood sugar are kept at normal levels, then you or your baby will not fall victim to gestational diabetes complications.


How can your Baby be Affected by
Gestational Diabetes Complications?

When you have gestational diabetes, your baby could be at increased risk for these gestational diabetes complications:

Fetal macrosomia.

  • Excessive growth.
  • Extra glucose will cross the placenta, which triggers your baby's pancreas to make extra insulin.
  • The baby will naturally store excess glucose as body fat.
  • Excess insulin (from the baby's pancreas) can cause your baby to grow too large (macrosomia).
  • Very large babies are more likely to become wedged in the birth canal, sustaining birth injuries, like shoulder dystocia which can potentially cause paralysis.
  • The baby is larger than normal and you may need to deliver by cesarean section.


Low blood sugar (hypoglycemia)

  • Sometimes babies of mothers with gestational diabetes develop hypoglycemia (low blood sugar) shortly after birth because their own insulin production is high.
  • Severe episodes of this problem may provoke seizures in the baby.
  • Prompt feedings and sometimes an intravenous glucose solution can return the baby's blood sugar level to normal.


Respiratory distress syndrome

  • A condition where breathing is difficult.
  • If your baby is born early, respiratory distress syndrome is a possibility.
  • Babies born to women with gestational diabetes have more breathing problems than do those born to women without the problem, even at the same gestational age.
  • Babies, who have respiratory distress syndrome, may need help breathing until their lungs become stronger.


Jaundice

  • Also called hyperbilirubinemia.
  • Yellowish discoloration of the skin and the whites of the eyes.
  • Occurs when the baby's liver is not mature enough to break down bilirubin.
  • Bilirubin is a substance that forms when the body recycles old or damaged red blood cells.
  • During pregnancy, the placenta excretes the bilirubin, when the baby is born, the baby's liver must take over this function.
  • Usually not serious and fades without the need for medical treatment.
  • Although jaundice usually is not a cause for concern, careful monitoring is important.


Death

  • There is a slightly higher chance of stillbirth or death as a newborn.
  • This is rare as long as your baby's glucose levels are well managed after birth.
  • This is rare as long as your glucose levels are well controlled during the pregnancy. It really is up to you.


Diabetic Ketoacidosis. (DKA)

  • A state of high blood sugar resulting in the accumulation of organic acids and ketones in the blood.
  • Ketoacidosis can cause fetal death at any stage.
  • All women should test urine for ketones when blood glucose is high.


Developmental problems

  • An increased risk of attention problems.
  • An increased risk of hyperactivity disorders.
  • An increased risk of problems with motor skill development.
  • Other activities requiring balance and coordination.


Later in life

  • There is an increased risk of the baby becoming obese as a child, although this may be due to the family's eating habits rather than any effect on the baby in the womb.

  • Babies born in a gestational diabetes pregnancy have a higher risk of developing type 2 diabetes later in life.



How can You be Affected by
Gestational Diabetes Complications?


Gestational diabetes is not an immediate threat to your health.
However, poorly controlled diabetes in pregnancy puts you at a higher risk of various problems:

Preeclampsia

  • The main signs are high blood pressure and protein in your urine. Usually only after week 20 of pregnancy.
  • Gestational diabetes increases the risk of preeclampsia.
  • Preeclampsia causes high blood pressure.
  • Untreated preeclampsia can lead to serious, life-threatening complications for both mother and baby.
  • Can damage your liver, kidneys, brain and the placenta.
  • It is very important to get the right treatment quickly, thus early awareness of the signs are vital.


Urinary tract infections

  • This is likely due to excess glucose in the urine.
  • Women with gestational diabetes experience more urinary tract infections during pregnancy than non diabetic woman.


Future diabetes

  • If you have gestational diabetes, you are more likely to have it again with a future pregnancy.
  • You are more likely to develop type 2 diabetes, as you get older.
  • The good news is that making healthy lifestyle choices such as eating healthy foods and exercising can help reduce the risk of future type 2 diabetes.


Hypoglycemia

  • Low blood sugar.
  • Hypoglycemia and loss of awareness is common in early pregnancy.
  • Caused by number of things:
  • Too large dose of insulin.
  • Eaten too little food.
  • Not eating on time.
  • Too much exercise.
  • Testing is the best method, but there are other indicators:
  • Shakiness or dizziness.
  • Sweating.
  • Clumsy or jerky movements.
  • Hunger.
  • Headache.
  • Sudden moodiness or behavior changes, such as crying for no apparent reason.
  • Pale skin color.
  • Difficulty in paying attention.
  • Confusion.
  • Tingling sensations around the mouth.


Hyperglycemia

  • High blood sugar.
  • Happens when there is too little insulin or when eating too much.
  • Untreated, Ketoacidosis could occur.

Caused by:

  • Eating more than planned.
  • Exercise less than planned.
  • Stress from illness, like a cold or the flu.
  • Emotional stresses, such as conflicts at work or within the family.

Signs and symptoms:

  • High levels of sugar in the urine.
  • Frequent urination.
  • Increased thirst.
  • Headaches.
  • Tiredness and fatigue.


Ketoacidosis

  • Diabetic coma.
  • Needs immediate treatment as it is life threatening.
  • Happens when your body has too many ketones.

Ketones:

  • Ketones are acid substances that are produced when the body breaks down fats, because no other source of energy is available.
  • Your cells are not using the glucose available due to not enough insulin or insulin resistance.
  • Your body cannot tolerate large amounts of ketones, but cannot get rid of them fast enough through the urine, so it builds up in the blood.
  • Small amounts of ketones in the morning are not uncommon during pregnancy.
  • All women should test urine for ketones when blood sugar is greater than 200 mg/dl (11mmol/L).
  • Usually develops gradually over many hours.

Warning signs:

  • A dry mouth.
  • Thirsty but not hungry.
  • Nausea.
  • Excessive urination.
  • Dry skin.
  • Fruity-smelling breath.
  • Abdominal pain.
  • Vomiting.
  • If advanced, unconsciousness.


Early miscarriage

  • Premature labour.
  • Diabetes that is not well controlled can increase your chances of having a miscarriage in the first three months of pregnancy. Especially when you are unaware that you do have diabetes.

Too much amniotic fluid

  • Amniotic fluid is the fluid around your baby.
  • Having too much fluid can lead to early labour and problems for both you and your baby.


Pyelonephritis

  • This is an infection of your kidneys.
  • It is more common in pregnancy and in people who have diabetes.
  • The symptoms of pyelonephritis are:
  • A fever.
  • Feeling or being sick.
  • Pain in your middle and upper back.
  • Going to the toilet to pass urine often and finding it painful when you do.
  • If you think you have pyelonephritis see your doctor straightaway for advice.
  • Pyelonephritis during pregnancy usually needs to be treated in hospital with antibiotics.

Low and high blood sugar levels

  • You may sometimes have very high or low blood glucose levels, the same as any other diabetic.
  • Both high and low blood glucose levels can be very serious for both you and your baby.
  • It is important that you check your blood glucose regularly and that you and your friends and family know what to do if you become unwell.


Delivery

  • Having diabetes means that your baby may be larger and you may be more likely to have a slow or very painful labour.
  • You are likely to be offered a planned birth with either induced labour or a caesarean section when your pregnancy has reached 38 weeks.
  • If your diabetes is well controlled and you do not have any other major health problems, a normal birth is possible.
  • Cesarean section rates are often higher than in non-diabetic women.
  • As with any woman, whether you have diabetes or not, how your baby is born is very individual and will depend on your health and that of your baby's.
  • The timing of delivery is individualized. In women with good diabetes control and no complications, the pregnancy may be allowed to continue naturally to full term (39-40 weeks).
  • Epidurals can be used safely in women who have diabetes.
  • You should have your baby in a hospital that has the facilities to care for you both should there be any problems and if you need treatment quickly.
  • You and your baby will be closely monitored all of the time that you are in labour to make sure that everything is happening safely.


Some final Thoughts on
Gestational Diabetes Complications

With all these potential gestational diabetes complications, you will now understand why it is vital to attend your all of your appointments whilst you are pregnant and to have your blood pressure and urine checked regularly.

If you feel unwell at all during your pregnancy, you should talk to your doctor health care team for advice. It could very well be some of the gestational diabetes complications setting in.

Having diabetes during your pregnancy does increase your risk of some health problems. These problems are less likely if your diabetes is well controlled and your blood glucose levels are stable.

You can reduce the risks to yourself by following your treatment carefully, monitoring your blood glucose levels and keeping all your appointments with the doctor and other members of your health care team.
Do what they tell you to do.

Gestational diabetes should not be taken lightly. The risk of having one or more of the gestational diabetes complications are very real.

Immediate risks to the mother and fetus are very serious; however, these gestational diabetes complications can be minimized with good care and follow up. It really is up to you.

Gestational diabetes complications can be downgraded to less serious, only if you take the diabetes very, very seriously.


› Gestational Diabetes Complications


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doctor and/or other members of your health care team
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