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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Written by Chen Xie
Endocrinology
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Gestational diabetes screening time

The screening time for gestational diabetes refers to all pregnant women undergoing a 75-gram glucose tolerance test between 24 to 28 weeks of pregnancy to measure blood sugar levels and determine the presence of gestational diabetes. However, for pregnant women at high risk, including those with a history of gestational diabetes, delivery of a large fetus, obesity, polycystic ovary syndrome, a family history of diabetes, positive urinary glucose in early pregnancy, or unexplained recurrent miscarriages, fetal malformations, stillbirths, or even a history of childbirth with neonatal respiratory distress syndrome, blood sugar should be monitored as early as possible to understand the situation.

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Written by Chen Xie
Endocrinology
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The dangers of gestational diabetes

The harms of gestational diabetes mainly include two aspects: the effects on the child and the effects on the pregnant woman herself. For the fetus, the early impacts mainly manifest as spontaneous miscarriage, fetal abnormalities, abnormal fetal development, macrosomia, and delayed maturation of fetal lungs. At birth, this may lead to complications such as premature birth and hypoglycemia. Newborns face a higher risk of respiratory distress syndrome compared to healthy infants. The long-term effects on the child mainly include a significantly increased incidence of glucose intolerance and diabetes, increased risk of obesity, and notable rise in cardiovascular abnormalities and neuromotor developmental disorders. For the mother, the impacts mainly manifest as concurrent miscarriage, gestational hypertension and pre-eclampsia, an increased likelihood of diabetic ketoacidosis. A macrosomic fetus can lead to difficult labor, trauma to the birth canal, prolonged surgical labor, postpartum hemorrhage, and an increased risk of gestational diabetes in subsequent pregnancies, extended hospital stays, and a significantly increased incidence of Type 2 diabetes postpartum.

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Written by Chen Li Ping
Endocrinology
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Does gestational diabetes cause itching in the vulva?

During gestational diabetes, white blood cells have various functional defects, reduced chemotaxis, phagocytic action, and bactericidal activity. This can easily lead to infections during pregnancy or childbirth, and even develop into sepsis, often caused by bacteria or fungi. Therefore, when blood sugar is not controlled in gestational diabetes, there may be symptoms like vulvar itching, or even infections of the urinary or reproductive systems. If the infection is not further treated, it may cause preterm birth, or even septic shock. Therefore, in gestational diabetes, it is crucial to actively control blood sugar and prevent infections.

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Written by Tang Zhuo
Endocrinology
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How to control gestational diabetes

Gestational diabetes refers to the onset of diabetes during pregnancy, or the first detection of varying degrees of hyperglycemia, including glucose intolerance and diabetes that were not identified before pregnancy. The risks of gestational diabetes are more severe in patients with serious conditions or poor blood sugar control, as it can easily lead to miscarriage and preterm birth, infections, and in severe cases, ketoacidosis. So, how can gestational diabetes be controlled? It can be managed through dietary control and insulin treatment. Dietary control is crucial; the ideal dietary management aims to ensure and meet the caloric and nutritional needs during pregnancy while preventing hyperglycemia or ketosis due to starvation, ensuring normal fetal growth and development. For cases where dietary management is insufficient to control diabetes, insulin is the primary medication. (Please seek professional medical guidance before using any medication, and do not self-medicate.)

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Written by Tang Zhuo
Endocrinology
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Gestational diabetes standard values

Standards for gestational diabetes, so what is gestational diabetes? It refers to diabetes that either develops during pregnancy or is first detected at this stage, presenting varying degrees of hyperglycemia, including previously unrecognized glucose intolerance or diabetes prior to pregnancy. Pregnancies in known diabetic patients are not included in this category, and may also be referred to as diabetes complicating pregnancy. So, how is gestational diabetes diagnosed? We can conduct a 75g anhydrous glucose tolerance test, where a fasting blood glucose greater than or equal to 5.1 mmol/L, and blood glucose greater than 10 mmol/L one hour after, meets the criteria to diagnose gestational diabetes.