Gestational Diabetes that occurs during pregnancy is called gestational diabetes. It usually affects women during the 24th week of pregnancy. Similar to the other type of diabetes (type 1 and type 2) gestational diabetes also lead to an increase in the blood sugar level.
The digestive system breaks down the food into a sugar called glucose. This glucose goes into the bloodstream where it is used as fuel for energy. The pancreas produces a hormone called insulin. If the body cannot produce enough insulin, or if the cells fail to respond to insulin, the glucose, instead of converting into energy, remains in the blood.
During pregnancy, the body naturally becomes resistant to insulin. This increases blood glucose. This increased glucose level provides nourishment to the baby. When the body needs extra insulin to deal with the extra blood sugar, the pancreas secretes more insulin.
However, if the pancreas fails to keep up the supply of the insulin in demand with the blood sugar during pregnancy, the blood sugar level rises up too high as the cells are not using glucose. This leads to gestational diabetes.
Gestational diabetes is a temporary condition. The blood glucose returns to normal after the baby is born.
The risk factors of gestational diabetes are:
- Age over 25 years
- African American, Native American, or Hispanic descent.
- Obesity (Overweight)
- Presence of glucose intolerance
- Certain medicines, such as glucocorticoids, or medicines for high blood pressure
- A history of gestational diabetes
- A family history of gestational diabetes
Usually women do not show any symptoms. Therefore, diagnostic tests are performed. In rare cases, women may show symptoms of increased urination and increased thirst.
A thorough medical history with a detailed medical examination can be helpful in determining the presence of gestational diabetes in pregnant woman.
The health care provider usually performs the screening test for gestational diabetes during early pregnancy.
Tests done may include:
- Initial glucose challenge test: The pregnant woman is asked to drink a glucose containing solution. The physician performs a blood test after an hour to measure the blood sugar level. A level below 130 to 140 milligrams per deciliter (7.2 to 7.8 millimoles per liter) is considered normal on a glucose challenge test. An increased blood sugar level indicates an increased risk for gestational diabetes.
- Follow up glucose tolerance testing: The pregnant woman is asked to fast all night, followed by measurement of blood sugar level. The physician asks the woman to drink glucose containing solution, after which the blood glucose level is checked again after 3 hours. An increased reading of at least two of the blood sugar levels indicates the presence of gestational diabetes.
The aim of treatment is to monitor and control the blood sugar, and to prevent any complications during pregnancy. Managing blood sugar mainly includes:
- Regular blood sugar monitoring.
- Diet: A healthy diet is one of the best ways to control gestational diabetes. Women should be advised to maintain an optimal weight. A healthy diet mainly comprises of fruits, vegetables, and whole grains, and less of refined carbohydrates along with sweets. A woman should always consult a dietician prior to starting any diet plan.
- Exercises: Exercising on regular basis during pregnancy is the key to wellness. Exercise decreases the level of glucose in the body by moving glucose in the blood cells, where they are utilized as energy.
Walking, cycling and swimming are the best choice of exercises during pregnancy.
- Medicines: The physician may prescribe insulin injections to lower the level of glucose in blood. Insulin can also be given in oral form. However, research is still going on to study the effects of oral medicines.
- Monitoring the baby: One of the most important steps in management of gestational diabetes is regular close monitoring of the baby. This is mainly done via ultrasound.
Around 30% to 80% women may have the risk of developing gestational diabetes again in future pregnancy. The risk is ever more if there is less than one year of gap between two successive pregnancies.
If left untreated, gestational diabetes can cause uncontrolled blood sugar, which can further cause problems to the baby. Other complications may include:
- An increased birth weight
- Premature delivery
- Breathing difficulty in the new born baby (called respiratory distress syndrome)
- Low blood sugar (hypoglycaemia) in women
- Increased risk of type 2 diabetes in later life
- High blood pressure and preeclampsia in pregnant women
Diabetes can be prevented by:
- Eating healthy food
- Exercising regularly
- Maintaining an optimal weight before and during pregnancy