Gestational Diabetes
Gestational diabetes is a condition that can arise during pregnancy causing an increase in blood sugar levels. Typically, this condition is diagnosed by running several blood tests between the 24th and 28th weeks of pregnancy. The good news is that gestational diabetes can be effectively treated and managed. Simple lifestyle changes such as adopting a healthy diet and engaging in regular physical activity can often manage it, though some women may require insulin or other medications. Fortunately, this condition typically resolves itself after delivery. However, if left untreated, it can lead to severe health issues for both the mother and the baby.
What causes gestational diabetes?
The glucose (sugar) from food is broken down by the hormone insulin, which is released by the pancreas, and sent to our cells for energy. Our blood glucose levels are maintained at a healthy level by insulin. If insulin function is impaired or inadequate, blood sugar levels can increase resulting in diabetes.
Hormonal changes during pregnancy cause increased levels of certain hormones produced in the placenta. These hormones can hinder the pancreas from producing and releasing insulin, or make it difficult for insulin to regulate blood sugar levels effectively leading to the development of gestational diabetes.
Who is at risk of developing gestational diabetes?
There are several risk factors that increase a woman’s possibility of developing gestational diabetes, including:
- Being overweight or obese
- Having a sedentary lifestyle with little physical activity
- Having a history of prediabetes (history of higher-than-normal blood glucose)
- Experiencing gestational diabetes during a previous pregnancy
- Having polycystic ovary syndrome
- Having a family history of diabetes
- Having previously delivered a baby weighing more than 9 pounds (4.1 kg)
These factors can increase the chances of developing gestational diabetes, but it can occur in anybody during pregnancy.
What are the symptoms of gestational diabetes?
Most of the time gestational diabetes does not cause any symptoms and most women find out about it during their regular checkups. Some women may notice
- Frequent urination
- Increased thirst
- Tiredness
How is gestational diabetes diagnosed?
A glucose screening test is often used to identify gestational diabetes between the 24th and 28th weeks of pregnancy. This involves drinking a sugary drink and having blood drawn one hour later to measure blood glucose levels. If the blood glucose level is high, a more comprehensive diagnostic test known as the glucose tolerance test will be recommended. This test involves fasting overnight, drinking a sugary drink, and having blood drawn every hour for three hours to measure blood glucose levels. High blood sugar levels at any two or more blood test times—fasting, 1 hour, 2 hours, or 3 hours are indicative of gestational diabetes. (If two or more of the glucose values are above the normal range, gestational diabetes will be diagnosed). High-risk women may be tested during their initial prenatal appointment and may need more frequent testing throughout their pregnancy.
Target Blood Glucose Readings
The American Diabetes Association recommends the below-mentioned targets for pregnant women who test their blood sugar:
- Before a meal: 95 mg/dL or less
- An hour after a meal: 140 mg/dL or less
- Two hours after a meal: 120 mg/dL or less
What are the effects of gestational diabetes on the baby and mother?
Gestational diabetes, if left untreated, can cause complications for both the mother and the baby.
The mother’s risk of cesarean birth (C-section) increases if the baby is big, as well as the risk of preeclampsia, which is characterized by high blood pressure and protein in the urine during pregnancy. Gestational diabetes also increases the mother’s risk of developing type 2 diabetes later in life.
On the other hand, gestational diabetes puts the baby at risk of having an increased birth weight (weighing 9 pounds or more), breathing problems at birth, hypoglycemia (low blood sugar), obesity, premature birth, and type 2 diabetes later in life.
Fortunately, controlling blood glucose levels during pregnancy and labor can reduce the risk of complications for both the mother and the baby.
How is gestational diabetes managed?
Gestational diabetes is managed by
- Blood sugar monitoring: The mother will need more frequent checkups during pregnancy.
- Healthy diet and regular exercising
- Weight gain monitoring
- Taking oral medications or insulin, if necessary, per the health care provider’s advice.
How can I prevent gestational diabetes?
Gestational diabetes cannot be completely prevented but the risk can be lowered by eating a healthy diet, staying active, and losing extra weight.
- Eating healthy food – Focus on consuming foods high in fiber and low in fat and calories and avoiding junk processed food and sugary drinks. Eat smaller meals more often. Eat more fruits, vegetables, and whole grains.
- Regular exercise: Being physically active will help to control sugar levels. Aim to engage in 30 minutes of moderate activity on most days of the week such as brisk walking.
- Continue with prenatal vitamins and supplements as prescribed by the healthcare provider
- Use of medications or Insulin to help maintain stable sugar levels. Talk to your healthcare provider about low blood sugar levels and how to deal with them.
- Start pregnancy at a healthy weight – If a woman plans to conceive, it is advisable to eliminate excess weight and reach a healthy weight beforehand
- Avoid gaining more weight than advised – While weight gain during pregnancy is normal and healthy, excessive weight gain can increase the possibility of developing gestational diabetes. Consult your healthcare provider to find out how much weight gain is appropriate for you.
To summarize, while most women who develop gestational diabetes have healthy successful pregnancies and healthy babies but occasionally it can cause serious problems, especially if it is not recognized or treated. In many cases, gestational diabetes can be managed with diet and exercise though medications may be necessary for some women. Women who have had gestational diabetes have a 50% increased risk of developing type 2 diabetes later in life. So, it is important to keep up with a healthy lifestyle by eating a balanced diet, exercising, and maintaining proper weight. Additionally, women with gestational diabetes during one pregnancy have a higher chance of developing diabetes in the subsequent pregnancy. If a woman with gestational diabetes during one pregnancy is planning to get pregnant again, she should speak with a healthcare provider so that necessary lifestyle modifications can be made before the next pregnancy.
