Diabetes can affect the developing fetus throughout the pregnancy. In early pregnancy, a mother’s diabetes can result in birth defects and an increased rate of miscarriage. Many of the birth defects that occur affect major organs such as the brain and heart.

During the second and third trimester, a mother’s diabetes can lead to over-nutrition and excess growth of the baby. This can lead to macrosomia, or a “fat” baby. Having a large baby increases risks during labor and delivery. For example, large babies often require planned or emergency caesarean deliveries, and if he or she is delivered vaginally, they are at increased risk for complications such as trauma to the baby. Babies with macrosomia face health problems of their own, including damage to their shoulders during birth.

When you have gestational diabetes, your pancreas works overtime to produce insulin, but the insulin does not lower your blood glucose levels. Although insulin does not cross the placenta, glucose and other nutrients do. So extra blood glucose goes through the placenta, giving the baby high blood glucose levels. This causes the baby’s pancreas to make extra insulin to get rid of the blood glucose. Since the baby is getting more energy than it needs to grow and develop, the extra energy is stored as fat.

Because of the extra insulin made by the baby’s pancreas, newborns may have very low blood glucose levels at birth and are also at higher risk for breathing problems. Babies with excess insulin become children who are at risk for obesity and adults who are at risk for type 2 diabetes.

Dr. Rajiv Kovil is a Consultant Diabetologist at Dr. Kovil’s Diabetes Care Centre, the first Preventive Diabetes Centre & Diabetic Foot Clinic in Mumbai, KLS Memorial Hospital and Holy Spirit Hospital among others. He is a founder member of United Diabetes Forum, a forum of practising diabetologists in India. He has also written various articles on diabetes for medical journals such as Asian Journal of Diabetology and Medical Image. His Preventive Diabetes Centre & Diabetic Foot Clinic is an initiative to provide preventive diabetic measures as well as to function as a specialized Foot Clinic for diabetic patients not only in terms of equipment but more importantly in terms of expertise.

BDST: 1722 HRS, FEB 28, 2015