Gestational diabetes

Being pregnant comes with many changes, and while most of them are welcome changes to be treasured, others need to be monitored or prevented, if possible. One such condition is gestational diabetes, which can cause abnormally elevated blood sugar, which can adversely affect your pregnancy and the overall health of your child1
Gestational diabetes is a complication that occurs during the latter stages of pregnancy. It’s influenced by genetic and lifestyle factors as well as hormonal changes.

When gestational diabetes occurs, hormones produced by the placenta increase insulin resistance, resulting in symptoms similar to type 2 diabetes, such as high blood glucose levels. Normally, most pregnant women can produce enough insulin to compensate for the increased insulin resistance caused by the placenta; however, in some cases, they cannot2.

Gestational diabetes can happen to anyone, even if you have no previous history of diabetes, but fortunately, gestational diabetes goes away after you give birth. Another upside of gestational diabetes is that it may be preventable with the right food, exercise and, if needed, medication1. So if you are at risk of developing gestational diabetes, you can take steps so that it doesn’t happen to you.

Who is at risk of gestational diabetes?
Women can monitor their chances of developing this condition, and take the necessary steps to prevent it. You may be at risk if:

  • Your body mass index (BMI) is above 30.
  • You have birthed a child weighing 4.5 kilograms (10 pounds) or more.
  • You have had gestational diabetes in past pregnancies.
  • One or both of your parents have diabetes3.

What are the symptoms to watch out for?
Gestational diabetes can be challenging to identify because it does not exhibit any outright symptoms. Some things to watch out for are increased thirst, a dry mouth, tiredness, and urination that is more frequent than usual.

The adverse effects of this condition can cause the child in the womb to grow bigger than usual, which can make for a difficult delivery. There is also a higher chance of needing induced labor or a cesarean section. In some instances, the baby’s growth becomes stunted or small for gestational age. Gestational diabetes can also lead to too much amniotic fluid in the womb which can lead to premature labor.

Preeclampsia is another possible effect of gestational diabetes. High blood pressure, which characterizes preeclampsia, can lead to severe complications if it goes untreated, such as preterm birth, organ damage, or cardiovascular disease.

Gestational diabetes can cause low blood sugar and jaundice in the baby, and increases the risk of type 2 diabetes in the mother later in life. The worst-case scenario, although rare, is a stillbirth3.

How will I know if I have gestational diabetes?
Gestational diabetes is diagnosed by a doctor with any of the following tests. 

There is the glucose challenge test, also known as a glucose screening test where you will be made to drink a sweet liquid and have your blood drawn after one hour. This test measures blood sugar levels in the body, and it requires no fasting.

The other test, the oral glucose tolerance test (OGTT) requires fasting for 8-10 hours. A blood sample will be drawn for a fasting blood sugar test, after which you will be asked to drink a sweet liquid. Blood will be drawn after 1 hour and after 2 hours from drinking the concentrated glucose. 

Hemoglobin A1c, also called glycosylated hemoglobin, evaluates your blood sugar control for the past 3 months. It does not require fasting. The idea is that the higher the level of sugar in the blood, the more glycosylated hemoglobin is formed. This can eventually determine if a person is diabetic or prediabetic6.

Depending on the values from any of the above tests, the doctor will determine whether or not you have gestational diabetes5.

Managing gestational diabetes
There is no cure for gestational diabetes, but gestational diabetes can be managed. With proper diet and exercise, most of the more harmful symptoms can be avoided.

A healthy diet is essential for those with the condition. As every woman is different, it is best to have meal plans that are created by a dietitian. 

Regular exercise goes hand-in-hand with healthy food because it lowers blood sugar levels. At least 30 minutes of moderate-intensity workouts, whether it be brisk walking, yoga or swimming, is adequate. 

In addition to diet and exercise, a woman with gestational diabetes should regularly have her blood sugar monitored with guidance from her doctor. If necessary, they should take insulin to control the condition.

Close monitoring of the baby is critical during this time. And this will be done regularly through ultrasounds or other tests.

Even though gestational diabetes goes away after childbirth, mothers should still be on the lookout for type 2 diabetes, which can develop later on. New mothers need to get checked for diabetes 6 to 12 weeks after delivery, and afterwards, every 1 to 3 years. It is important to continue exercise and maintain a healthy diet during this crucial period4.

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1 Gestational diabetes. Accessed 14 Sept. 2020
2 Symptoms & Causes of Diabetes. Accessed 14 Sept. 2020
3 Gestational diabetes. Accessed 14 Sept. 2020
4 Gestational Diabetes and Pregnancy. Accessed 14 Sept. 2020
5 Tests & Diagnosis for Gestational Diabetes. Accessed 14 Sept. 2020
6 Hemoglobin A1c. Accessed 21 Sept. 2020