The causes of gestational diabetes are similar to other forms of diabetes, namely a problem at the cellular level getting the necessary energy from glucose (sugar). This usually involves an interaction between insulin (produced by the pancreas), glucose, and the liver.
However, gestational diabetes, unlike other forms of the disease, only occurs in pregnant women.
The placenta, which supplies the fetus with nutrients through the umbilical cord, produces hormones that prevent insulin from doing its job. These hormones, which include estrogen, cortisol and human placental lactogen, are vital to preserving pregnancy. Yet they also make the cells more resistant to insulin.
As the placenta grows larger in the second and third trimesters, it secretes even more of these hormones, further increasing insulin resistance. Normally, the pancreas responds by producing enough extra insulin to overcome this resistance, but up to three times as much insulin as normal may be needed, and sometimes the pancreas simply can't keep up.
When this happens, too little glucose gets into the cells and too much stays in the blood. This is gestational diabetes. It usually occurs about the 20th to 24th week of pregnancy and can be measured by the 24th to 28th week of pregnancy. After the baby is born and placental hormones disappear from the bloodstream, blood sugar levels should quickly return to normal.
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