Gestational diabetes is a glucose tolerance disorder that first appears during pregnancy or is diagnosed during pregnancy. It is reported at rates of 1-14% in different societies. Its frequency is increasing. This is due to the increased frequency of obesity. The American Diabetes Association reports that gestational diabetes is detected in 4% of pregnant women, approximately 135,000 women per year. Screening tests are usually done between 24-28 days.
RISK FACTORS FOR GESTATIONAL DIABETES
1. Over 25 years of age
2. Having a body mass index over 25-27kg/m2
3. Ethnicity where gestational diabetes is common
4. Presence of gestational diabetes or type 2 diabetes in first degree relatives
5. history of gestational diabetes in previous pregnancies
6. polycystic ovary syndrome
7. presence of hypertension
RISKS OF GESTATIONAL DIABETES FOR THE MOTHER AND CHILD
1. Macrosomia: The generally accepted definition of macrosomia is that the baby's birth weight is over 4000g. While studies report the incidence of macrosomia in gestational diabetes as 16-29%, this rate is 10% in those without diabetes.
2. An increase in the rates of hypoglycemia, hypocalcemia, hyperbilirubinemia and polycythemia is detected in the neonatal period in babies of mothers with gestational diabetes.
3. Another common problem in those with gestational diabetes is HYPERTENSION.
4. In patients with gestational diabetes, the likelihood of developing type 2 diabetes in the future increases. The risk of developing type 2 diabetes is higher in those who had to take insulin treatment during pregnancy.
IF A PREGNANCY HAS TYPE 1 OR TYPE 2 DIABETES, CAN HER DIABETES BE TRANSMITTED TO HER CHILD?
The risk of a pregnant woman with type 1 diabetes and her child having type 1 diabetes is about 2%. However, if the father has type 1 diabetes, the child's risk of type 1 diabetes is around 6%. If both mother and father have type 1 diabetes, this risk increases by 30%.
On the other hand, if the pregnant woman has type 2 diabetes, the risk of the child having type 2 diabetes is 25%. The child's risk is the same if the father has type 2 diabetes. Both a If both mother and father have type 2 diabetes, this risk increases by 50%.
WHAT DISEASES MAY OCCUR IN DIABETIC PREGNANCY
In gestational diabetes. "Peripheral insulin resistance" and the "hyperinsulinemia" and "hypoglycemia" it causes are important findings. In diabetic pregnant women;
1.spontaneous abortions increase,
2.stillbirths are common,
3.polyhydramnios develops,
4.preeclampsia is common,
5.placental anomalies are common ,
6. The tendency to urinary tract infections increases.
THE ISSUES TO BE CONSIDERED IN DIABETIC PREGNANCY
A) It should not be used because there is not enough information about the use of oral hypoglycemic drugs during pregnancy.
B) Lactation (breastfeeding) should be encouraged in all gestational diabetics.
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C) Pregnancy exercises should be recommended.
D) Gestational diabetes alone is not an indication for cesarean section. Birth should be given around the 38th week. (macrosomia increases after this)
E) Blood sugar returns to normal in most cases after birth. It should be taken into consideration that approximately 25-30% of cases with gestational diabetes develop diabetes within 20 years.
F) In cases of gestational diabetes, the risk of recurrence of gestational diabetes in subsequent pregnancies is high.
G) Children of cases with gestational diabetes have a high risk of diabetes in later life.
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