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Pre-gestational diabetes can be classified as Type 1 or Type 2 depending on the physiological mechanism. Type 1 diabetes mellitus is an autoimmune disorder leading to destruction of insulin-producing cell in the pancreas; type 2 diabetes mellitus is associated with obesity and results from a combination of insulin resistance and insufficient insulin production.
Diabetes mellitus and pregnancy deals with the interactions of diabetes mellitus (not restricted to gestational diabetes) and pregnancy. Risks for the child include miscarriage, growth restriction, growth acceleration, fetal obesity (macrosomia), polyhydramnios and birth defects.
Treatment of this condition is very similar to treatment of non-gravid heart failure patients, however, safety of the fetus must be prioritized. For example, for anticoagulation due to increased risk for thromboembolism, low molecular weight heparin which is safe for use during pregnancy is used instead of warfarin which crosses the placenta. [37]
During pregnancy, spontaneous hyperglycemia can develop and lead to gestational diabetes mellitus (GDM), a frequent pregnancy complication . With a prevalence of 6-20% among pregnant women globally, gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance developing or initially recognized during pregnancy. [67]
Gestational diabetes is a condition in which a woman without diabetes develops high blood sugar levels during pregnancy. [2] Gestational diabetes generally results in few symptoms; [2] however, obesity increases the rate of pre-eclampsia, cesarean sections, and embryo macrosomia, as well as gestational diabetes. [2]
Risk factors for pre-eclampsia include obesity, prior hypertension, older age, and diabetes mellitus. [2] [4] It is also more frequent in a woman's first pregnancy and if she is carrying twins. [2] The underlying mechanisms are complex and involve abnormal formation of blood vessels in the placenta amongst other factors. [2]
Diabetes was the eighth leading cause of death in the United States in 2020. People with diabetes are twice as likely to develop heart disease or stroke as people without diabetes. There are three types of diabetes: Type 1, Type 2, and gestational (diabetes while pregnant). Type 2 diabetes accounts for 90%-95% of all cases. [1]
The complications of diabetes can dramatically impair quality of life and cause long-lasting disability. Overall, complications are far less common and less severe in people with well-controlled blood sugar levels. [3] [4] [5] Some non-modifiable risk factors such as age at diabetes onset, type of diabetes, gender, and genetics may influence risk.