Gestational diabetes is a condition in which women who have not previously been diagnosed with diabetes develop high blood glucose levels during pregnancy. Diabetes can occur in mother before pregnancy - pregestational diabetes or during pregnancy - gestational diabetes. The possibility of life-threatening structural anomalies is the most concerned issue in a case of maternal diabetes. However, there is no association of birth defects in offspring born to a diabetic father or in mother who develop diabetes after first trimester of pregnancy. Hyperglycemia disturbs the development of embryo by decreasing levels of arachidonic acid, myoinositol and accumulation of sorbitol and trace metals. Any newborn weighing more than 4 kg irrespective of gender and age of gestation are macrosomic or large babies.
Birth related injuries (Shoulder dystocia & Brachial plexus injury), asphyxia and increases the need of cesarean deliveries in mother. It has been seen that impaired glucose control in later 2 trimesters of pregnancy co-relate more with fetal obesity. Strict blood glucose control in 2nd and 3rd trimester may reduce the incidence of large babies to near normal. Episodic maternal hyperglycemia promotes fetal catabolic state where excessive oxygen utilization occurs. Therefore, seeking medical attention to attain a normal glycemic state throughout the pregnancy is critical to prevent hazards to both baby and mother. A birth of a baby with down syndrome is a period of anxiety and breakdown to family members and most to the parents. Frequent infections, such as gum or skin infections and vaginal or bladder infections Although type 1 diabetes can develop at any age, it typically appears during childhood or adolescence. Treatment for type 1 diabetes involves insulin injections or the use of an insulin pump, frequent blood sugar checks and carbohydrate counting.

No specific cause has been identified, but it is believed that the hormones produced during pregnancy increase a woman’s resistance to insulin, resulting in raised blood glucose levels. High blood sugar level in mother is not just harmful to her but also to the baby developing in her womb. Compared to a mother with normal blood glucose level, a mother with diabetes before pregnancy has 4 to 8 times higher risk of major fetal anomalies. A study done in 1992 showed a clear preponderance of babies weighing more than 4.5 kg in mothers with diabetes compared to non-diabetic mothers.
The girth of abdomen increases significantly due to deposition of fat due to high glucose in fetal circulation. Increased mortality and morbidity has been seen in Infants born to Diabetic Mothers (IDM) in 1st 28 days of life.
Polycythemia: Fetal hypoxia stimulates secretion of erythropoietin from kidney, a hormone which has role in hemoglobin synthesis. Hypoglycemia: Low blood sugar level in newborn can occur due to high insulin level causing symptoms like seizure, coma and brain damage during early life. Jaundice or Hyperbilirubinemia: Prematurity and Polycythemia are the main factors contributing to jaundice in IDM. Respiratory Distress Syndrome (RDS): Can result from prematurity, surfactant deficiency, fluid retention in lungs (transient tachypnea) and cardiomyopathy. Pediatrician receives the delivery, fetal bradycardia with maternal hypertension was the scenario. Potentially reversible diabetes conditions include prediabetes — when your blood sugar levels are higher than normal, but not high enough to be classified as diabetes — and gestational diabetes, which occurs during pregnancy. Treatment of type 2 diabetes primarily involves monitoring of your blood sugar, along with diabetes medications, insulin or both. Women with gestational diabetes are at a higher risk of developing high blood pressure during pregnancy, of needing a Caesarean section, of developing Type 2 diabetes after pregnancy, and of having children who are prone to childhood obesity and to developing diabetes later in life.While treatment with medication or insulin may be required, the most important treatment is to modify diet and to increase levels of exercise.

According to studies, the defects mostly involve the brain and spinal cord, followed by heart, genitourinary system and limb defects. Increased Glycated hemoglobin (HbA1c) which can be measured by laboratory blood testing has seen to be highly co-related with development of teratogenesis. This results in a condition called Polycythemia where there is increased level of hemoglobin in blood.
Hence, blood sugar level monitoring is necessary during newborn period and is done as per standard protocol.
I often write my views online as well as share few important topics for medical students, doctors and specially parents. Exercise lowers your blood sugar level by transporting sugar to your cells, where it’s used for energy. Increased glucose level in mother leads to increased insulin secretion in fetus which leads to storage of excess nutrients. Instead, you’ll need plenty of fruits, vegetables and whole grains — foods that are high in nutrition and low in fat and calories — and fewer animal products and sweets. Exercise also increases your sensitivity to insulin, which means your body needs less insulin to transport sugar to your cells. Even sugary foods are OK once in a while, as long as they’re included in your meal plan. A registered dietitian can help you create a meal plan that fits your health goals, food preferences and lifestyle.

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