GESTATIONAL DIABETES

Taylor Goett
NTR341

http://abcnews.go.com/Health/video/gestational-diabetes-pregnancy14074481

DIABETES MELLITUS
several disorders that are characterized by
hyperglycemia

HYPERGLYCEMIA
high blood sugar
DM: alterations in insulin pathway

T YPES OF DIABETES MELLITUS (DM)

Type 1 Diabetes Mellitus (T1DM)
Type 2 Diabetes Mellitus (T2DM)
Gestational Diabetes Mellitus (GDM)

T YPE 1 DIABETES MELLITUS (T1DM)

decreased function, or lack thereof, in -cells of
the pancreas

T YPE 2 DIABETES MELLITUS (T2DM)

Decrease in insulin sensitivity

GESTATIONAL DIABETES MELLITUS (GDM)

Decreased insulin secretion and/or a decrease
in insulin sensitivity during pregnancy

PREVALENCE OF GDM
affects approximately 4% or 200,000 of the
pregnancies annually in the United States

DIAGNOSIS OF GDM
Screening: between 24-28 weeks of gestation
Glucose Challenge Test
Oral Glucose Tolerance Test

MECHANISMS OF GDM
Reduced functioning of pancreatic -cells,
insulin resistance, and altered glucose
metabolism

In addition to an increase in adipose tissue and

insulin resistance that comes with pregnancy

GENETIC RISK FACTORS

GDM may be linked to same genes which
contribute to onset of T2DM, as many women
with GDM develop T2DM soon after delivery.

RISK FACTORS FOR GDM

Increased maternal age
Certain ethnicities (ex. Native American)
Being overweight or having excess body fat
Prior macrosomic (LGA) infant births
Mild to severe cardiac conditions

ONSET OF GESTATIONAL DIABETES

Low amounts of physical activity
(protective effects of exercise)
Cigarette smoking
(inconclusive, no significance)

ONSET OF GESTATIONAL DIABETES: DIET

Inconclusive evidence: saturated fat,
polyunsaturated fat, carbohydrate, and total
kilocalorie intake
Directly proportional to risk: cholesterol intake,
modern western diet
Inversely proportional to risk: glycemic load,
Vitamin C, Vitamin D

PHARMACEUTICAL CONTROL OF GDM

Insulin therapy to control hyperglycemia:
Fasting plasma glucose 105 mg/dL
1 hr postprandial plasma glucose 155 mg/dL
2 hr postprandial plasma glucose 130 mg/dL

GESTATIONAL WEIGHT GAIN AND GDM

GWG is directly proportional to risk for GDM
60-80% of GDM patients are overweight /
obese

INFANT CONSEQUENCES OF GDM

Increased insulin sensitivity

INFANT CONSEQUENCES OF GDM

Macrosomia, large for gestational age (LGA)

CONSEQUENCES OF MACROSOMIA
Shoulder dystocia
Brachial plexus trauma

CONSEQUENCES OF MACROSOMIA
Prolonged labor
Cesarean section

NUTRITIONAL INTERVENTIONS FOR GDM

Decreased energy (kcal) intake
Increased physical activity
Careful monitoring by a physician

NUTRITION RECOMMENDATIONS: GDM

All pregnant women: 175 g CHO
GDM: less than 45% of kcal from CHO
GDM: low CHO, high protein breakfast

SAMPLE MENU FOR WOMEN WITH GDM

Breakfast:
Prenatal vitamin
1% milk, Whole grain toast (1.5)
with PB & banana
Lunch:
Veggie wrap with chicken, small
apple
Dinner:
Turkey burger on whole grain
bun with cheese and avocado,
veggie salad, carrot sticks
Snacks:
Non-fat Greek yogurt
Trail mix (nuts, seeds)

2002 total kcal

23% from protein

36% from fat

43% from carbs
(216 g carbs)

ACTIVIT Y: DIABETIC DOG

http://www.nobelprize.org/educational/medici
ne/insulin/index.html
How do the below factors affect blood sugar?
Exercise
Food (different types)
Insulin