Gestational Diabetes Mellitus (GDM): Risk Factors and Etiology

Gestational Diabetes Mellitus (GDM) is a type of glucose intolerance first recognized during pregnancy. It affects maternal and fetal health, increasing the risk of complications.

Risk Factors

• Obesity or excessive weight gain during pregnancy
• Family history of diabetes mellitus
• Previous history of GDM
• Polycystic Ovary Syndrome (PCOS)
• Advanced maternal age (>35 years)
• Ethnicity (higher prevalence among South Asian, African, and Hispanic populations)

Etiology

The primary etiology of GDM is insulin resistance, caused by placental hormones such as human placental lactogen. These hormones interfere with insulin signaling, leading to glucose intolerance.

Pathophysiology

During pregnancy, physiological insulin resistance increases to ensure glucose supply for fetal development. However, excessive resistance leads to hyperglycemia, requiring compensatory insulin secretion from pancreatic beta cells.

Complications

• Macrosomia (large birth weight babies)
• Neonatal hypoglycemia
• Increased risk of developing Type 2 Diabetes Mellitus postpartum
• Preeclampsia and hypertensive disorders

Prevention and Management

Preventive strategies include lifestyle modifications such as diet regulation, physical activity, and glycemic monitoring. Pharmacologic interventions like insulin therapy may be required in severe cases.