Gestational Diabetes: Diabetes in Pregnancy

Gestational Diabetes Mellitus (GDM) is a condition that occurs during pregnancy. Even women who have never had diabetes before can later be diagnosed with GDM. High levels of blood sugar can be found circulating in the system of the expectant mother in this condition. Gestational Diabetes occurs in about 7% of all pregnancies!

Gestational diabetes is usually symptomless

Gestational diabetes doesn’t cause any symptoms as such. It may vary from woman to woman but some women may experience:

• Recurrent urination
• Vomiting
• Dehydration
• Fatigue

Extra care is a mandate during pregnancy and it is a must for all women to get tested between 24 to 28 weeks. But on the upside, most women with gestational diabetes don’t remain diabetic after the baby is born. However, they can run a risk of contracting it again during future pregnancies and be more susceptible to developing diabetes when they age.

Why Gestational Diabetes Mellitus Happens?

Insulin is the hormone that is required to metabolize glucose in the body. During pregnancy, the mother’s body has to produce extra insulin to meet the needs of the baby. Usually, a pregnant woman produces 3 times more insulin than a normal person would. At the same time, due to the production of a lot of extra hormones in the body, there is a lot of insulin resistance too.

GDM results when the mother’s production of insulin is not enough to overcome the effect of these hormones. It usually develops during the latter half of pregnancy.

Risk Factors:

• Obesity- Overweight women with a body mass index of more than 25
• High blood pressure- If the expecting mother already has hypertension
• Antenatal checkups-If you’ve been told that you might develop prediabetes or if you ever tested positive for sugar in the urine previously, you should be more vigilant.
• Age-related causes- Women who get pregnant after 25 years of age are more likely to develop gestational diabetes.
• Family health history- If someone in your family has or had diabetes (type 1, type 2, or gestational diabetes), you might be at a higher risk.
• PCOS- Polycystic Ovarian Syndrome can put the pregnancy and the baby in danger, and lead to gestational diabetes in the future.

What makes it difficult to control blood sugar during pregnancy?

While it is not the particular condition of pregnancy that makes it difficult to manage diabetes, it all happens due to poor lifestyle and eating habits which makes it uncontrollable. Multiple people will probably give you mixed advices during pregnancy but please do not start following anything without professional consultation. Just because someone said- “Hey chill, try this, it worked really well for me” doesn’t mean it will turn out to be in your favor. Take care cautiously.

Test for gestational diabetes

In order to diagnose gestational diabetes, your health professional will ask you to do an oral glucose tolerance test (OGTT). You’ll have to prepare for the test as per their instructions like you shouldn't eat anything for 8 hours before the test. This test is often done on empty stomach in the morning.

Before the test, some medical professionals will tell you to do a glucose challenge test. You will be told to drink a sweet liquid. A blood test will then be done about an hour later to check your blood sugar. If your blood sugar is high or results are uncertain, your doctor will do a glucose tolerance test.

According to ADA (American Diabetes Association), if you have above the below-stated level, it might be gestational diabetes:

Fasting:  92 mg/dL or more

1 Hour: 180 mg/dL or more

2 Hour:  153 mg/dL or more

Consult a doctor on The Wellness Corner to reduce the risk of diabetes-related problems for you and your baby.

How is Gestational Diabetes Treated?

Gestational Diabetes can be treated by keeping the blood glucose level within the target range. Proper diet, physical activity, and insulin (if required) play an important role in maintaining blood glucose levels.

Dietary Tips

• Have small frequent meals (at least six meals a day).
• Limit sugary foods and beverages
• Include more fiber in your diet in the form of fruits, vegetables, whole grain bread, and cereals.
• Carbohydrates should be 40 to 45% of the total calories with breakfast and a bedtime snack containing 15 to 30 g of carbohydrates.
• Stay hydrated and have at least 8 to 10 glasses of liquids every day.
• Avoid trans fats and fried foods.

It's important to eat a variety of nutritious foods every day for a healthy pregnancy. A meal plan specially curated for pregnancy can ensure good brain development, and can reduce the risk of many birth defects. Sticking to a balanced diet during pregnancy also reduces the risk of anemia and other bothersome pregnancy symptoms such as lethargy and morning sickness.

Physical activity

• Be fit and maintain a reasonable weight.
• Be physically active for at least 30 minutes a day.

Physical activity can help the mother reach her blood glucose targets. If it still proves unhelpful, take insulin as directed, if your doctor prescribes it. Insulin is not harmful to your baby.

How Gestational diabetes affects pregnancy?

• Excess growth: Extra glucose will cross the placenta, triggering your baby's pancreas to produce extra insulin. According to a study, it causes weight gain, which means the baby will grow larger, and therefore, there will be a chance of a C-section.
• Jaundice: The baby may develop jaundice and have breathing problems if he has to be birthed surgically.
• If a woman's diabetes is not controlled during pregnancy, her baby may get affected after birth or there is a good chance your child may contract type 2 diabetes later in life.
• Babies of mothers who have gestational diabetes have a higher risk of being obese later in life.

Bottom line

Gestational diabetes usually goes away after the baby is born. But if you do get it, you are more likely to develop diabetes in the future. To minimize this risk, ensure to maintain a healthy weight, make healthy food choices, and exercise regularly. Later, breastfeeding may also help lower the risk.