What You Should Know About Pregestational Diabetes Mellitus
Pregestational diabetes is defined as a condition in which the mother’s blood sugar level at delivery exceeds normal range. The term prediabetic refers to someone with prediabetes. Prediabetes is usually diagnosed when the fasting blood sugar level is greater than or equal to 140 mg/dl (5.6 mmol/l). Prediabetic diabetes is a chronic disease that causes significant health problems such as high blood pressure, heart attack, stroke, kidney failure and blindness.
The risk of death increases if the person does not take steps to control their blood sugar levels.
Pregestational diabetes mellitus (pre-diabetes) is a condition in which the mother’s blood sugar level at birth is above normal range. Pre-diabetes is generally diagnosed after the child reaches school age. Children with pre-diabetes have prediabetes and are at increased risk of developing type 2 diabetes later in life. Type 1 diabetes occurs when the body cannot produce enough insulin to regulate blood sugar levels.
Pre-diabetics need regular checkups to monitor their blood sugars and determine whether they will develop type 2 diabetes later in life. Children with pre-diabetes are at higher risk of developing cardiovascular diseases such as heart attack and stroke when they become adults. They should also maintain a healthy lifestyle by eating nutritious food and engaging in regular exercise.
The risk of pre-gestational diabetes is increased by several factors such as weight, age, and family history of diabetes. Lifestyle changes such as quitting smoking, avoiding obesity, maintaining a healthy diet and physical activity can prevent the occurrence of pre-gestational diabetes in mothers.
What You Should Know About Pregestional Diabetes Defined
Pregestional diabetes is a condition that occurs before birth where the mother’s blood sugar level exceeds normal range. It is also known as gestational diabetes or glucose intolerance of pregnancy and is usually associated with the birth of a baby that is either underweight (low birth weight) or larger than average (large for gestational age).
To test for pregestational diabetes, the mother’s blood sugar level is measured several times during her pregnancy. The tests are typically performed after the 24th week of gestation. High blood sugar levels may require several tests to diagnose with the highest level being above a fasting level of 126 mg/dL (7 mmol/l), a postprandial (after meals) level of 200 mg/dL (11.1 mmol/l), a one-hour value of 157 mg/dL (8.6 mmol/l) or a two-hour value of 140 mg/dL (7.8 mmol/l).
After a diagnosis of pregestational diabetes has been made, the physician will alter the management of the pregnancy from that point onwards. This typically involves regular monitoring of the mother’s blood sugar levels to ensure they remain within a healthy range. In some cases insulin may be required to prevent adverse health outcomes in the developing baby.
Blood sugar levels are typically increased in babies of mothers with pregestational diabetes. A large baby is more likely when blood sugar is frequently above normal ranges. Large babies have an increased risk of injury during birth.
Several factors increase the risk of pregestational diabetes in mothers. These factors include being overweight or obese, having a family history of type 2 diabetes, thyroid disease, and chronic high blood pressure among others.
Research suggests that the development of gestational diabetes is related to the number of excess pounds a woman has. The more excess weight a pregnant woman has, the higher her risk of developing gestational diabetes.
Pregestational diabetes is more common among older pregnant women. The risk of developing gestational diabetes increases with age. Acute fatty liver of pregnancy, a complication in which the mother’s liver is swollen with fat, is also more common among older mothers.
What you should do if you are diagnosed with gestational diabetes?
During your pregnancy, your health care team will closely monitor your baby’s growth and check for any other potential complications caused by gestational diabetes.
The health care provider will look for any sign that your baby is not getting enough nutrients or oxygen. This may lead to your baby being born too early or having a low birth weight. Your health care provider will try to keep your blood sugar in the normal range and may prescribe medicine, such as insulin or pills to help you manage it.
Your health care provider may suggest a diet that is low in fat and carbohydrates and high in protein to help keep your blood sugar levels down. You will receive education about nutrition, weight management, physical activity, and other lifestyle strategies to help with the management of gestational diabetes.
If you are found to have gestational diabetes, you will be closely monitored by your health care provider. You should visit your health care provider at least once a week during your pregnancy. Your health care provider will perform a physical examination and ask about any problems you may be experiencing. Frequent testing of your blood sugar levels is another important aspect of monitoring gestational diabetes.
Your health care provider may ask you to keep a food diary, which records what you eat and the amount of physical activity in the daily diet. This helps your health care provider determine whether changes need to be made in your diet. You should also record the results of any blood sugar testing done outside of the doctor’s office.
Blood sugar levels that are too low or high can both cause problems for you and your baby. Severe complications may be prevented with routine monitoring and care. In some cases, however, gestational diabetes may lead to larger than normal babies or a greater risk of cesarean section delivery. If these complications develop, your health care provider will make appropriate changes to your care plan.
If left untreated, gestational diabetes can increase your chances of having a heart attack, stroke or other serious health conditions. Having gestational diabetes also increases the risk of developing type 2 diabetes later in life. The risk of your future pregnancies resulting in gestational diabetes is increased as well.
Gestational diabetes is a serious health condition that needs to be monitored and treated by your health care provider. If you have gestational diabetes:
You will be given a healthy, low-fat diet plan that is easy to follow. You should try to follow this diet as closely as possible during your pregnancy.
A health care provider will give you advice about the amount of physical activity that is right for you and your particular situation.
Your blood sugar levels will need to be monitored on a regular basis.
If you are having problems maintaining your blood sugar levels, you may be given medicine to help control your blood sugar. Your health care provider will teach you how to correctly inject the insulin or how to properly give yourself an insulin shot.
The amount of insulin or other diabetes medicines that you will be taking is based on many factors. These factors include your activity, diet, and weight. It is important that you do not change the dose of medication on your own.
If you have gestational diabetes, you are more likely to develop type 2 diabetes later in life. Your health care provider will give you advice on how to monitor your blood sugar at home after your pregnancy in order to help prevent the development of type 2 diabetes. You should try to maintain a healthy weight by eating a well-balanced diet and getting regular exercise.
Reviewed by doctors at the National Institutes of Health (NIH)
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Sources & references used in this article:
Women’s perceptions of being pregnant and having pregestational diabetes by T Lavender, MJ Platt, E Tsekiri, I Casson, S Byrom… – Midwifery, 2010 – Elsevier
Diabetes-induced birth defects: what do we know? What can we do? by EA Reece – Current diabetes reports, 2012 – Springer
Pregnancy in women with diabetes—after the CEMACH report, what now? by IF Casson – Diabetic medicine, 2006 – Wiley Online Library
The maternal experience of having diabetes in pregnancy by JA Nolan, S McCrone… – Journal of the American …, 2011 – Wiley Online Library
Gestational and pre-gestational diabetes: comparison of maternal and fetal characteristics and outcome by KO El Mallah, H Narchi, NA Kulaylat… – International Journal of …, 1997 – Elsevier