Le Gestational Diabetes ou pregnancy diabetes is diabetes that starts during pregnancy, usually during the 2nd^e or the 3^e trimester. Doctors also make a diagnosis of gestational diabetes when a glucose intolerance (prediabetic condition) is detected in a pregnant woman. In other words, gestational diabetes is not always straightforward diabetes, but in all cases, blood sugar (or “sugar” level in the blood) is above normal.

Sometimes diabetes was present before the pregnancy, but had not yet been detected. a blood sugar test is practiced in pregnant women in early pregnancy. This makes it possible to quickly treat women with gestational diabetes, and to strictly control their sugar level (glycemia) from conception, which allows the reduction of spontaneous abortions, deformities such as macrosomia (child of too much weight) and complications. perinatal (around the time of childbirth).

In Canada, gestational diabetes is a growing concern: it now affects about 7% of pregnant women. The rate is much higher in indigenous populations: 13%, on average.

Pregnancy and glucose metabolism

During 2^e and 3^e quarters of the pregnancy, the needs in insulin of pregnant women are 2 to 3 times greater than normal. This could be explained by the gradual increase, during pregnancy, of the production of “anti-insulin” hormones (for example, placental hormones, cortisol and growth hormones), which reduce the effects of insulin. on the body. They are essential for the good progress of a pregnancy, therefore for the health of the fetus and mother. Normally, this insulin resistance stimulates the pancreas to produce more insulin to compensate. However, in some women, the pancreas does not produce this excess insulin. In them, then settles an excessively high level of sugar in the blood, hyperglycemia.

Possible consequences

Gestational diabetes puts mother and child at increased risk:

For the mother

• Hypertension and edema (preeclampsia).
• spontaneous abortions
• Urinary tract infection.
• Delivery by cesarean section (in case of heavy weight of the child).
• Premature delivery.
• Type 2 diabetes after pregnancy.

For the child

• Weight exceeding 4 kg (9 lbs) at birth (macrosomia). This is the case for 17% to 29% of children born to mothers with gestational diabetes, against 5% to 10% for all mothers.
• Neonatal hypoglycemia.
• Exaggeration of jaundice of the newborn.
• Respiratory distress syndrome.
• Possibly, developing diabetes, most often type 2. (It is suspected that gestational diabetes may lead to an increased risk of type 2 diabetes in the unborn child later in adulthood due to ‘early exposure to a potentially harmful environment in the prenatal period).

After childbirth

In 90% of cases, the Gestational Diabetes goes away within a few weeks of giving birth. However, gestational diabetes increases the risk of diabetes in women afterwards. Thus, a certain proportion of women with gestational diabetes suffer, a few months or several years later, from type 2 diabetes or, much more rarely, from type 1 diabetes.

feeding

Gestational diabetes is not a contraindication forbreastfeeding. On the contrary, studies indicate that it may confer some protected against diabetes (see our Type 1 diabetes sheet). This is all the more important since the children of mothers who suffer from pregnancy diabetes themselves are probably more at risk of developing diabetes.