Metabolic Challenges: Understanding Gestational Diabetes Mellitus (GDM)
Gestational diabetes is a condition in which a woman without diabetes develops high blood sugar levels during pregnancy. It typically occurs during the second or third trimester.
The Mechanism of Insulin Resistance
During pregnancy, the placenta produces hormones such as human placental lactogen (hPL). These hormones help the baby grow but also create a "contra-insulin" effect, making the mother's cells more resistant to insulin. If the mother’s pancreas cannot produce enough extra insulin to overcome this resistance, blood glucose levels rise.
Clinical Implications
Unmanaged GDM can lead to macrosomia (excessive birth weight) and increases the risk of the mother and child developing Type 2 diabetes later in life. Management involves rigorous glucose monitoring, dietary modifications, and sometimes insulin therapy.