Diabetes and pregnancy - An unspeakable danger for pregnant women and their unborn babies

Posted by Resident Doctor Trinh Ngoc Anh - Endocrinologist - Department of General Internal Medicine - Vinmec Times City International Hospital

During pregnancy, especially around weeks 24-28, many women can develop gestational diabetes. However, a diagnosis of gestational diabetes does not mean that you have had diabetes before, or that you will develop it after giving birth. According to the Centers for Disease Control and Prevention, the prevalence of gestational diabetes is about 9.2%. Gestational diabetes occurs when a woman's blood sugar level during pregnancy is higher than normal, but most women return to normal after giving birth.

During pregnancy, the placenta produces a number of hormones to maintain the fetus, these hormones make the cells more resistant to insulin.
Normally the pancreas will respond producing more than normal insulin levels to overcome this resistance. But there are times when the pancreas can't do that. When that happens, too little glucose gets into the cells and too much stays in the blood, leading to gestational diabetes.

Any pregnant woman can develop gestational diabetes, but some women are at higher risk than others. Risk factors for gestational diabetes include:
Age: Women over the age of 35 have an increased risk of gestational diabetes. Personal and family history: Your risk is increased if you have ever had pre-diabetes – a precursor to type 2 diabetes – or close family members such as a parent or father and your mother has type 2 diabetes. You are also at higher risk if you have had gestational diabetes in a previous pregnancy, or if you have had a history of having a high-birth-weight baby or a history of stillbirth. undefined reason. Weight: Being overweight before pregnancy increases the risk of gestational diabetes. History of childbirth >4 kg All women with the above risk factors should be screened for gestational diabetes as early as possible in the first weeks of pregnancy.

Most women with gestational diabetes give birth to healthy babies. However, untreated or poorly controlled blood sugar can cause problems for both mother and baby.
4.1. Complications of gestational diabetes for the fetus Too much weight: Too much sugar in the mother's blood can cross the placenta, affecting the fetus's pancreas to increase insulin secretion, which can make the fetus grow faster than normal. Accordingly, large fetuses often require a cesarean section to ensure safety for both mother and fetus. In addition, babies born to mothers with a history of gestational diabetes are more susceptible to respiratory failure and trauma, and more susceptible to infections, than those born vaginally. Low blood sugar: There have been cases of fetuses of pregnant women with gestational diabetes having low blood sugar (hypoglycemia) in the short period after birth because of excessive insulin secretion. At this time, it is necessary to feed the child immediately or intravenously to bring the child's blood sugar to normal. Development of type 2 diabetes later in life: Babies born to mothers with gestational diabetes have a higher risk of obesity and type 2 diabetes later in life. Miscarriage: Gestational diabetes, if not well controlled, can lead to miscarriage, premature birth and stillbirth in the abdomen before the due date. Cases of stillbirth in the abdomen can occur in the last weeks of pregnancy with "no" warning signs. Fetal malformations: Fetal malformations are rare in gestational diabetes but are very likely to occur if the pregnant woman has pre-existing diabetes and is not well controlled in the first 3 months.

4.2. Gestational diabetes complications for pregnant women Preeclampsia: This condition is defined by symptoms of high blood pressure, excessive proteinuria in the urine, and swelling of the legs and feet. Preeclampsia can lead to serious or even life-threatening complications for both mother and fetus. Gestational diabetes in a later pregnancy: Once you've had gestational diabetes in one pregnancy, you're at increased risk of having it again in a subsequent pregnancy. You are also at risk of developing type 2 diabetes or later. Although it leaves many dangerous complications, if well managed, gestational diabetes may not be harmful to both the mother and the fetus. However, in developing countries, the detection and treatment of diabetes in antenatal period is still facing many difficulties, mainly due to lack of proper attention in the community.
Understanding that situation, Vinmec International Hospital always tries its best to overcome these problems including screening for diabetes management for young women at risk, pre-marital counseling patients and prenatal care related to diabetes as well as early detection and screening of gestational diabetes in order to promptly treat pregnant women who come to the hospital for examination, minimizing dangerous complications affecting their health. maternal and fetal health.
Especially, in order to improve the quality of medical examination and treatment services, Vinmec has been and continues to deploy a package maternity service as a solution to help pregnant women feel secure because of the companionship of the team. obstetrician-gynecologist during pregnancy. When choosing Maternity package, pregnant women will enjoy the following benefits:
Pregnancy is monitored by a team of qualified doctors Regular check-ups, early detection of abnormalities Maternity package to facilitate the birthing process Newborns receive comprehensive care To register for examination and treatment at Vinmec International General Hospital, you can contact Vinmec Health System nationwide, or Register online HERE