Impact of gestational diabetes on the fetus and pregnant women

Written by Chen Xie
Endocrinology
Updated on September 21, 2024
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The effects of gestational diabetes on the mother mainly include an increased risk of miscarriage, concurrent conditions such as gestational hypertension and preeclampsia, as well as the potential for diabetic ketoacidosis. The presence of a large fetus can lead to difficult labor, damage to the birth canal, prolonged surgical delivery, and an increased likelihood of postpartum hemorrhage. Additionally, women with gestational diabetes have an increased risk of developing the condition again in future pregnancies. In terms of long-term effects, the risk of developing type 2 diabetes significantly increases after experiencing gestational diabetes. For the fetus, the impacts of gestational diabetes primarily manifest as an increased risk of spontaneous miscarriage, congenital anomalies, and abnormal development. There is also a heightened risk of hyperinsulinemia, which can even affect the proper development and maturity of the fetal lungs, leading to delays. After birth, conditions such as hypoglycemia and neonatal respiratory distress syndrome are more likely to occur. In the long term, offspring of women with gestational diabetes are at higher risk for glucose intolerance, diabetes, obesity, and metabolic syndrome. These conditions significantly increase the risks to the cardiovascular system and can affect neuromotor development.

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Gestational diabetes standard values

The screening for gestational diabetes should be conducted between the 24th and 28th weeks of pregnancy. This includes a 75g glucose test, where 75 grams of anhydrous glucose is dissolved in water and consumed within five minutes on an empty stomach. This test monitors fasting blood sugar, blood sugar one hour after the meal, and blood sugar two hours after the meal. A diagnosis of gestational diabetes is made if any of the following criteria are met or exceeded: fasting blood sugar is greater than or equal to 5.1 mmol/L, blood sugar one hour after the meal is greater than or equal to 10 mmol/L, and blood sugar two hours after the meal is greater than or equal to 8.5 mmol/L.

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High-risk factors for gestational diabetes

High-risk factors for gestational diabetes include: women older than 35 years, those with a history of gestational diabetes, history of delivering large babies, obesity, patients with polycystic ovary syndrome, first-degree relatives with a family history of diabetes, early pregnancy checks showing fasting hyperglycemia or positive glucosuria, patients who have had multiple spontaneous miscarriages without obvious causes, fetal malformations, stillbirths, and patients with a history of delivering newborns with respiratory distress syndrome. Women with the above high-risk factors should undergo early testing for fasting blood glucose and a 75-gram glucose tolerance test to diagnose gestational diabetes and initiate early intervention.

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Effects of gestational diabetes on the fetus

The impact of gestational diabetes on the fetus mainly manifests in early stages as spontaneous miscarriage, fetal malformations, and abnormal fetal development. As the fetus grows, the high maternal blood sugar levels can lead to a large fetus, which increases the risk of birth injuries during delivery. Due to the high insulin levels in the mother, the fetus may have hyperinsulinemia, which can cause recurrent hypoglycemia at birth. Additionally, the development and maturation of the fetal lungs are delayed, making the newborn more susceptible to respiratory distress syndrome. Furthermore, gestational diabetes also increases the risk of preterm birth.

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What should people with gestational diabetes eat?

For patients with various types of diabetes, the general principle of dietary control is low salt, low fat, and a diabetes-specific diet. This means that fats and calories must be controlled. However, pregnancy is a special period that requires an adequate intake of nutrients to meet the needs of the fetus. Therefore, gestational diabetes should be managed based on one's nutritional status, and, after evaluating one's condition, sufficient high-quality protein should be supplemented. It is advisable not to consume fats, such as chicken, duck, fish, and meat, but cooking methods should be chosen carefully. Fish can be consumed steamed, and meat can be steamed or stewed, as these meats are sources of protein. However, soup should not be consumed as it is particularly high in fat. Additionally, foods like pig's feet or animal organs, which have high cholesterol levels, should be consumed in moderation. The overall principle is the same as for diabetes, but it is essential to ensure the pregnant woman's nutritional needs are met and that the fetal weight gradually increases as the pregnancy progresses. Of course, if insulin intervention is needed to some extent, insulin must be used to keep blood sugar levels within the required range.

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What are the symptoms of gestational diabetes?

The symptoms of gestational diabetes vary depending on the severity of the disease. Most cases of gestational diabetes are symptomless and are only detected when high blood sugar levels are found during diabetes screening. Therefore, it is recommended to perform a 75g glucose screening during pregnancy, at the very least, fasting blood sugar should also be checked because most diabetic patients do not notice any symptoms on their own. If the diabetes is more severe, the patient may experience symptoms such as increased thirst, increased appetite, weight loss, and frequent urination.