What does diabetes in pregnancy mean?

Gestational diabetes or GDM is a type of diabetes that some women get during their pregnancy. Diabetes is a disease in which the amount of blood sugar (glucose) in the body increases too much. After eating, the body breaks down the sugar and starch of food and turns it into glucose. The body gets energy by consuming glucose. The pancreas is an organ located behind the stomach that produces a hormone called insulin. The role of insulin is to maintain the blood sugar level in the appropriate range. The body of people with diabetes does not produce enough insulin or cannot use this hormone well, as a result of which, blood sugar levels rise. This condition causes problems such as heart disease, kidney failure and blindness. In Iran, all pregnant women are screened for gestational diabetes in the first trimester of pregnancy. Most of the time, gestational diabetes can be controlled and treated during this period. Complications of gestational diabetes if not treated can cause problems for mother and fetus. The effects of gestational diabetes on the fetus are usually resolved within a period of time after delivery. However, if a person develops gestational diabetes, they are at high risk of developing diabetes in the future.

What are the complications of gestational diabetes during pregnancy?

If untreated, gestational diabetes can cause complications during pregnancy. Among these complications, the following can be mentioned: ### Cesarean section Caesarean section is a surgical procedure in which the doctor removes the baby by making an incision on the mother's abdomen and uterus. People will need a cesarean section if they suffer from the complications of gestational diabetes, such as an excessively large fetus (macrosoma). Although most women with gestational diabetes can give birth naturally, the possibility of needing a cesarean section is higher in affected women. ### High blood pressure and preeclampsia High blood pressure (hypertension) is an excessive increase in the force exerted by the blood on the blood vessel wall. This disease can put pressure on the heart and cause problems during pregnancy. Pre-eclampsia is a condition in which a pregnant woman, in addition to high blood pressure, has symptoms that indicate the lack of proper functioning of some of her internal organs such as the liver and kidneys. Symptoms of preeclampsia include protein in the urine, changes in vision, and severe headaches. High blood pressure and preeclampsia can increase the risk of preterm birth. ### Macrosomia Macrosomia is one of the complications of gestational diabetes on the fetus. Macrosomia means that the baby weighs more than 4 kg at birth. Having such a weight puts the baby at risk of injury during labor and birth. In these cases, cesarean surgery may be needed to keep the baby healthy.

### Postnatal depression One of the complications of gestational diabetes is a type of depression that occurs to the mother during pregnancy or in the first year after giving birth. Depression is a disease that causes a feeling of unhappiness or lack of interest in favorite activities. Depression can affect a person's feelings, thoughts, and behavior and disrupt daily life. Depression needs treatment. ### Premature birth Giving birth before the 37th week of pregnancy is called premature birth. Most women with gestational diabetes experience a full pregnancy that lasts 39 to 40 weeks. However, in case of complications of gestational diabetes, induction of labor may be needed before the due date. Labor induction means taking medicine or tearing the amniotic sac with the aim of starting the labor process. ### Shoulder dystocia or other birth defects Shoulder dystocia occurs when the baby's shoulder gets stuck in the mother's pelvis during childbirth. This phenomenon usually occurs in very large babies. Shoulder dystocia can cause serious damage to mother and baby. Complications of shoulder dystocia for the mother include heavy bleeding after delivery. The most common injuries for babies are clavicle fractures and damage to the brachial plexus. These nerves originate from the spinal cord of the neck and extend down to the lower arm. These nerves are responsible for the feeling and movements of the shoulder, arm and hand. Mother's diabetes and effect on fetal heart development ### Stillbirth The death of the fetus in the womb after the 20th week of pregnancy is called stillbirth.

Gestational diabetes complications after the birth of the fetus

Gestational diabetes can also cause problems for the baby after delivery. Among these cases, the following examples can be stated:

- **Respiratory problems including respiratory distress syndrome:** This is a respiratory problem caused by the lack of sufficient surfactant in the lungs. Surfactant is a type of protein that prevents the small air sacs in the lungs from overlapping - **Jaundice**: In this disease, the baby's skin and eyes turn yellow. This disease occurs when the liver functions or develops inappropriately - Low blood sugar (hypoglycemia) - Suffering from obesity in the future - Diabetes in the future Gestational Diabetes Screening

Long-term complications of gestational diabetes

Gestational diabetes usually resolves after delivery. However, women with a history of it are at risk for the following: - Gestational diabetes in subsequent pregnancies - Type 2 diabetes (a lifelong type of diabetes) Affected individuals should be tested for diabetes 6 to 13 weeks after delivery. If the test result is normal, it is necessary to perform this test once a year. If you have symptoms of high blood sugar, such as extreme thirst, frequent urination, and dry mouth, do not delay and see a doctor. Since many people with diabetes do not show any symptoms, people should have these tests even if they feel well. The doctor offers recommendations to patients in the field of reducing the risk of diabetes, including having a balanced diet, regular exercise, and maintaining a proper weight. Some studies have shown that babies of mothers with gestational diabetes are at a higher risk of developing diabetes or obesity in the future.

Postpartum care

https://med.stanford.edu/news/all-news/2015/10/elevated-blood-sugar-levels-in-pregnancy-tied-to-babys-heart-defect-risk.html https://www.webmd.com/baby/gestational-diabetes-you#1