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Lecture Notes

So like I said on the previous slide, gestational diabetes is a form of insulin resistance that develops during pregnancy, and it develops in about 18% of all pregnancies, and it's very important to make sure that women are tested for this disease so they can be treated, because if untreated, or it's poorly managed, what can happen is that the mother can develop high blood glucose levels, and then that blood glucose crosses the placenta, and the baby becomes exposed to these elevated blood glucose levels. And the baby's pancreas, by about 13 weeks, is able to make its own insulin, so insulin from the mother does not cross the placenta, but her blood glucose levels do, so the baby's pancreas responds to this extra glucose in the blood by producing increased insulin. Because of that extra glucose in the blood, the baby is getting more energy than it needs, and it stores that energy as fat just like we would, and that's why one of the conditions, if gestational diabetes is not treated, is called macrosomia, or a fat baby, and the baby has stored excess fat by being exposed to this excess glucose. All of this can be avoided if the mother is treated for this gestational diabetes, and usually it goes away in the mother after pregnancy, but the mother does have an increased risk of developing type 2 diabetes in the future. And some of the risk factors for developing gestational diabetes are someone's ethnicity—again, African Americans are more likely to develop this; if you have a history of diabetes already; and also if you're obese. And the treatment for gestational diabetes always includes some kind of special meal plan and regular physical activity, so some lifestyle changes, but it may also include daily blood glucose testing and also insulin injections, just depending on the person.