Complications
Most women who have gestational diabetes deliver healthy babies. However, gestational diabetes that's not carefully managed can lead to uncontrolled blood sugar levels and cause problems for you and your baby, including an increased likelihood of needing a C-section to deliver.
Complications that may affect Baby
If you have gestational diabetes, your baby may be at increased risk of:
Excessive birth weight. Extra glucose in your bloodstream crosses the placenta, which triggers your baby's pancreas to make extra insulin. This can cause your baby to grow too large (macrosomia).
Early (preterm) birth and respiratory distress syndrome. A mother's high blood sugar may increase her risk of early labor and delivering her baby before its due date. Or her doctor may recommend early delivery because the baby is large.
Babies born early may experience respiratory distress syndrome — a condition that makes breathing difficult. Babies with this syndrome may need help breathing until their lungs mature and become stronger. Babies of mothers with gestational diabetes may experience respiratory distress syndrome even if they're not born early.
Low blood sugar (hypoglycemia). Sometimes babies of mothers with gestational diabetes develop low blood sugar (hypoglycemia) shortly after birth because their own insulin production is high. Severe episodes of hypoglycemia may provoke seizures in the baby.
Type 2 diabetes later in life. Babies of mothers who have gestational diabetes have a higher risk of developing obesity and type 2 diabetes later in life. Untreated gestational diabetes can result in a baby's death either before or shortly after birth.
Complications that may affect Mother:
Gestational diabetes may also increase the mother's risk of:
High blood pressure and preeclampsia. Gestational diabetes raises your risk of high blood pressure, as well as, preeclampsia — a serious complication of pregnancy that causes high blood pressure and other symptoms that can threaten the lives of both mother and baby.
Future diabetes. If you have gestational diabetes, you're more likely to get it again during a future pregnancy. You're also more likely to develop type 2 diabetes as you get older. However, making healthy lifestyle choices such as eating healthy foods and exercising can help reduce the risk of future type 2 diabetes.
Of those women with a history of gestational diabetes who reach their ideal body weight after delivery, fewer than 1 in 4 eventually develops type 2 diabetes.
Prevention
Beginning prenatal care early and having regular prenatal visits helps improve your health and the health of your baby. Having prenatal screening at 24 - 28 weeks into the pregnancy will help detect gestational diabetes early.
If you are overweight, decreasing your body mass index (BMI) to a normal range before you get pregnant will decrease your risk of developing gestational diabetes.
Treatment
The goals of treatment are to keep blood sugar (glucose) levels within normal limits during the pregnancy, and to make sure that the growing baby is healthy.
WATCHING YOUR BABY
- Your health care provider should closely check both you and your baby throughout the pregnancy. Fetal monitoring will check the size and health of the fetus.
- A nonstress test is a very simple, painless test for you and your baby.
- A machine that hears and displays your baby's heartbeat (electronic fetal monitor) is placed on your abdomen.
- Your health care provider can compare the pattern of your baby's heartbeat to movements and find out whether the baby is doing well.
DIET AND EXERCISE
- The best way to improve your diet is by eating a variety of healthy foods. You should learn how to read food labels, and check them when making food decisions. Talk to your doctor or dietitian if you are a vegetarian or on some other special diet.
- In general, when you have gestational diabetes your diet should:
- Be moderate in fat and protein
- Provide your carbohydrates through foods that include fruits, vegetables, and complex carbohydrates (such as bread, cereal, pasta, and rice)
- Be low in foods that contain a lot of sugar, such as soft drinks, fruit juices, and pastries
- If managing your diet does not control blood sugar (glucose) levels, you may be prescribed diabetes medicine by mouth or insulin therapy.
- Most women who develop gestational diabetes will not need diabetes medicines or insulin, but some will.
L-carnitine
L-carnitine is the biologically active form of the nonessential amino acid carnitine. Carnitine is produced in your body from the two amino acids methionine and lysine, and also is found in foods such as dairy products, meats and avocados.
Supplementation with L-carnitine under medical supervision may benefit diabetic sufferers, although more research is needed to fully assess its efficacy.
L-carnitine and Gestational Diabetes Mellitus (GDM)
L-carnitine is involved in the transport of certain fatty acids into cells where they go through a process of oxidation. As a result of this process, energy is released. Supplementation with L-carnitine improves the usage of fat as a source of energy, lowers cholesterol and trygliceride levels and may reduce the risk of health problems in diabetics, who have impaired fat metabolism. L-carnitine has a protective effect on heart muscles and function, thus diabetics may benefit again from this supplement, as diabetes increases the risk of developing heart conditions. In clinical research, L-carnitine has been found to enhance the efficacy of conventional drugs in improving glucose and lipid levels in diabetics.
Scientists from the University of Vienna noted deficiency of carnitine in pregnant women from the 12th week of gestation through delivery leads to down-regulation of expression of certain enzymes involved in fatty acid metabolism; low mRNA levels of these enzymes promotes an increase in free fatty acid levels conducive to insulin resistance. The researchers found supplementation with L-carnitine tartrate increased relative mRNA levels of these enzymes in pregnant women.
In a release on the findings, researchers noted there appears to be increasing evidence that L-carnitine may play an important role during pregnancy, particularly in women following a meat-reduced or vegetarian diet.
CRT-E in Gestational Diabetes Mellitus (GDM)
Keep Up The Vigor
L Cartinine Supplementation to Prevent or Gestational diabetes mellitus(GDM):
“The results of the present study provide evidence that L-carnitine supplementation in pregnancy (2 g/day) avoids a striking increase in plasma FFA(free fatty acid), which are thought to be the main cause of insulin resistance and consequently gestational diabetes mellitus.”
Gynakol Geburtshilfliche Rundsch. 2009;49(4):230-5. doi: 10.1159/000301075. Epub 2010 May 19.
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