{"id":5120,"date":"2025-11-26T23:21:43","date_gmt":"2025-11-27T04:21:43","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/?post_type=chapter&#038;p=5120"},"modified":"2025-12-07T23:08:38","modified_gmt":"2025-12-08T04:08:38","slug":"gestational-diabetes-mellitus-gdm","status":"web-only","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/chapter\/gestational-diabetes-mellitus-gdm\/","title":{"raw":"9p11 Gestational Diabetes Mellitus (GDM)","rendered":"9p11 Gestational Diabetes Mellitus (GDM)"},"content":{"raw":"<h1><strong>Overview:<\/strong><\/h1>\r\n<ul>\r\n \t<li>Occurs\u00a0<strong>during pregnancy<\/strong>.<\/li>\r\n \t<li>Usually develops\u00a0<strong>halfway through pregnancy<\/strong>.<\/li>\r\n \t<li>Often\u00a0<strong>disappears after childbirth<\/strong>.<\/li>\r\n \t<li>Women with GDM are at\u00a0<strong>increased risk<\/strong>\u00a0for developing\u00a0<strong>type 2 diabetes<\/strong>\u00a0later in life.<\/li>\r\n \t<li>Insulin production may be\u00a0<strong>normal<\/strong>,\u00a0<strong>slightly decreased<\/strong>, or\u00a0<strong>ineffective<\/strong>\u00a0due to\u00a0<strong>receptor resistance<\/strong>.<\/li>\r\n<\/ul>\r\n<h1><strong>Causes:<\/strong><\/h1>\r\n<ul>\r\n \t<li>The exact cause is\u00a0<strong>idiopathic<\/strong> (unknown), but may involve:\r\n<ul>\r\n \t<li><strong>Insulin resistance<\/strong>\u00a0due to placental hormones antagonistic to insulin.<\/li>\r\n \t<li>Pregnant females may <strong>not have enough insulin<\/strong> to support both themselves and the fetus.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n&nbsp;\r\n<ul>\r\n \t<li>Thought to be related to <strong>hormones produced by the placenta<\/strong>:\r\n<ul>\r\n \t<li>These hormones\u00a0<strong>impair insulin action<\/strong>.<\/li>\r\n \t<li>Can cause\u00a0<strong>hyperglycemia<\/strong>\u00a0by:\r\n<ul>\r\n \t<li>Impairing insulin activity<\/li>\r\n \t<li>Reducing insulin secretion<\/li>\r\n \t<li>Decreasing tissue response to insulin (<strong>insulin resistance<\/strong>)<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h1><strong>Risk Factors:<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>Age<\/strong>\u00a0(older age)<\/li>\r\n \t<li><strong>Family history<\/strong>\u00a0of diabetes<\/li>\r\n \t<li><strong>Overweight\/obesity<\/strong>\u00a0(BMI 30+)<\/li>\r\n \t<li><strong>Genetic predisposition<\/strong><\/li>\r\n<\/ul>\r\n<h1><strong>Diagnostic Blood Tests:<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>Glucose challenge test<\/strong>\u00a0(initial screening)<\/li>\r\n \t<li>Follow-up if high glucose:\r\n<ul>\r\n \t<li><strong>Oral glucose tolerance test<\/strong>\u00a0to confirm hyperglycemia.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li>Additional monitoring if risk factors are present.<\/li>\r\n<\/ul>\r\n<h1><strong>Treatment and Lifestyle Modifications:<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>Insulin injections<\/strong>\u00a0may be prescribed if needed.<\/li>\r\n \t<li>Lifestyle changes are crucial:\r\n<ul>\r\n \t<li>Healthy\u00a0<strong>diet<\/strong><\/li>\r\n \t<li>Regular\u00a0<strong>exercise<\/strong><\/li>\r\n \t<li><strong>Stop smoking<\/strong><\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h1><strong>Possible Complications:<\/strong><\/h1>\r\n<strong>For Mother<\/strong>\r\n<ul>\r\n \t<li><strong>Prolonged high blood pressure<\/strong>\u00a0can lead to\u00a0<strong>preeclampsia, eclampsia (hypertension<\/strong> and<strong> seizures),<\/strong> and<strong> organ ischemia<\/strong>.<\/li>\r\n \t<li>Increased risk of\u00a0<strong>type 2 diabetes<\/strong>\u00a0in the future (~5-10%).<\/li>\r\n<\/ul>\r\n<strong>For Baby<\/strong>\r\n<ul>\r\n \t<li><strong>Low glucose levels<\/strong>\u00a0in fetal cells can cause\u00a0<strong>seizures<\/strong>.<\/li>\r\n \t<li><strong>High blood pressure<\/strong>\u00a0may cause\u00a0<strong>organ ischemia<\/strong>.<\/li>\r\n \t<li>Higher\u00a0<strong>birth weight<\/strong>\u00a0(over 9 pounds) increases risk of\u00a0<strong>overweight<\/strong>\u00a0and type 2 diabetes later.<\/li>\r\n<\/ul>\r\n<h1><strong>Onset and Progression<\/strong><\/h1>\r\n<ul>\r\n \t<li>Usually\u00a0<strong>slow and insidious<\/strong>.<\/li>\r\n \t<li>Onset typically occurs\u00a0<strong>around 20 weeks<\/strong>\u00a0gestation, as placental hormone levels rise.<\/li>\r\n<\/ul>\r\n<h1><strong>Summary<\/strong><\/h1>\r\n<ul>\r\n \t<li>GDM is linked to hormonal changes during pregnancy impairing insulin action.<\/li>\r\n \t<li>It can be managed with\u00a0<strong>lifestyle modifications<\/strong>\u00a0and\u00a0<strong>insulin therapy<\/strong>.<\/li>\r\n \t<li>Close monitoring is necessary to prevent\u00a0<strong>maternal and fetal complications<\/strong>.<\/li>\r\n<\/ul>","rendered":"<h1><strong>Overview:<\/strong><\/h1>\n<ul>\n<li>Occurs\u00a0<strong>during pregnancy<\/strong>.<\/li>\n<li>Usually develops\u00a0<strong>halfway through pregnancy<\/strong>.<\/li>\n<li>Often\u00a0<strong>disappears after childbirth<\/strong>.<\/li>\n<li>Women with GDM are at\u00a0<strong>increased risk<\/strong>\u00a0for developing\u00a0<strong>type 2 diabetes<\/strong>\u00a0later in life.<\/li>\n<li>Insulin production may be\u00a0<strong>normal<\/strong>,\u00a0<strong>slightly decreased<\/strong>, or\u00a0<strong>ineffective<\/strong>\u00a0due to\u00a0<strong>receptor resistance<\/strong>.<\/li>\n<\/ul>\n<h1><strong>Causes:<\/strong><\/h1>\n<ul>\n<li>The exact cause is\u00a0<strong>idiopathic<\/strong> (unknown), but may involve:\n<ul>\n<li><strong>Insulin resistance<\/strong>\u00a0due to placental hormones antagonistic to insulin.<\/li>\n<li>Pregnant females may <strong>not have enough insulin<\/strong> to support both themselves and the fetus.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li>Thought to be related to <strong>hormones produced by the placenta<\/strong>:\n<ul>\n<li>These hormones\u00a0<strong>impair insulin action<\/strong>.<\/li>\n<li>Can cause\u00a0<strong>hyperglycemia<\/strong>\u00a0by:\n<ul>\n<li>Impairing insulin activity<\/li>\n<li>Reducing insulin secretion<\/li>\n<li>Decreasing tissue response to insulin (<strong>insulin resistance<\/strong>)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h1><strong>Risk Factors:<\/strong><\/h1>\n<ul>\n<li><strong>Age<\/strong>\u00a0(older age)<\/li>\n<li><strong>Family history<\/strong>\u00a0of diabetes<\/li>\n<li><strong>Overweight\/obesity<\/strong>\u00a0(BMI 30+)<\/li>\n<li><strong>Genetic predisposition<\/strong><\/li>\n<\/ul>\n<h1><strong>Diagnostic Blood Tests:<\/strong><\/h1>\n<ul>\n<li><strong>Glucose challenge test<\/strong>\u00a0(initial screening)<\/li>\n<li>Follow-up if high glucose:\n<ul>\n<li><strong>Oral glucose tolerance test<\/strong>\u00a0to confirm hyperglycemia.<\/li>\n<\/ul>\n<\/li>\n<li>Additional monitoring if risk factors are present.<\/li>\n<\/ul>\n<h1><strong>Treatment and Lifestyle Modifications:<\/strong><\/h1>\n<ul>\n<li><strong>Insulin injections<\/strong>\u00a0may be prescribed if needed.<\/li>\n<li>Lifestyle changes are crucial:\n<ul>\n<li>Healthy\u00a0<strong>diet<\/strong><\/li>\n<li>Regular\u00a0<strong>exercise<\/strong><\/li>\n<li><strong>Stop smoking<\/strong><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h1><strong>Possible Complications:<\/strong><\/h1>\n<p><strong>For Mother<\/strong><\/p>\n<ul>\n<li><strong>Prolonged high blood pressure<\/strong>\u00a0can lead to\u00a0<strong>preeclampsia, eclampsia (hypertension<\/strong> and<strong> seizures),<\/strong> and<strong> organ ischemia<\/strong>.<\/li>\n<li>Increased risk of\u00a0<strong>type 2 diabetes<\/strong>\u00a0in the future (~5-10%).<\/li>\n<\/ul>\n<p><strong>For Baby<\/strong><\/p>\n<ul>\n<li><strong>Low glucose levels<\/strong>\u00a0in fetal cells can cause\u00a0<strong>seizures<\/strong>.<\/li>\n<li><strong>High blood pressure<\/strong>\u00a0may cause\u00a0<strong>organ ischemia<\/strong>.<\/li>\n<li>Higher\u00a0<strong>birth weight<\/strong>\u00a0(over 9 pounds) increases risk of\u00a0<strong>overweight<\/strong>\u00a0and type 2 diabetes later.<\/li>\n<\/ul>\n<h1><strong>Onset and Progression<\/strong><\/h1>\n<ul>\n<li>Usually\u00a0<strong>slow and insidious<\/strong>.<\/li>\n<li>Onset typically occurs\u00a0<strong>around 20 weeks<\/strong>\u00a0gestation, as placental hormone levels rise.<\/li>\n<\/ul>\n<h1><strong>Summary<\/strong><\/h1>\n<ul>\n<li>GDM is linked to hormonal changes during pregnancy impairing insulin action.<\/li>\n<li>It can be managed with\u00a0<strong>lifestyle modifications<\/strong>\u00a0and\u00a0<strong>insulin therapy<\/strong>.<\/li>\n<li>Close monitoring is necessary to prevent\u00a0<strong>maternal and fetal complications<\/strong>.<\/li>\n<\/ul>\n","protected":false},"author":1370,"menu_order":17,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":["zoe-soon"],"pb_section_license":"cc-by-nc-sa"},"chapter-type":[],"contributor":[60],"license":[57],"class_list":["post-5120","chapter","type-chapter","status-web-only","hentry","contributor-zoe-soon","license-cc-by-nc-sa"],"part":63,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5120","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/users\/1370"}],"version-history":[{"count":6,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5120\/revisions"}],"predecessor-version":[{"id":5256,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5120\/revisions\/5256"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/parts\/63"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5120\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/media?parent=5120"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapter-type?post=5120"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/contributor?post=5120"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/license?post=5120"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}