Gestational diabetes is the name of a condition that occurs when a woman develops high blood sugar (glucose) during pregnancy. Gestational diabetes is caused by pregnancy hormones or a shortage of insulin, which lowers glucose levels in your bloodstream.
Glucose comes from what you eat and drink. To keep it at safe levels, your pancreas releases insulin to move glucose into cells for energy or storage as fat, depending on whether you’re eating something or fasting for a while. Insulin also helps control your appetite by telling you when to feel hungry and when to stop eating so much.
If you have gestational diabetes:
- You may need more insulin than usual to help your body use glucose properly
- Your doctor will order tests each trimester (first three months) to check on how well-controlled those levels are
Normal blood glucose levels: Blood glucose levels for a non-pregnant person are considered normal if they fall between 70 and 130 mg/dL. For example, if your blood glucose level is 100 mg/dL, this is within the normal range for someone who does not have gestational diabetes.
Symptoms of Gestational Diabetes
- Increased thirst
- Increased tiredness
- Increased hunger
- Blurred vision or temporary loss of vision in one eye (no pain)
- Frequent urination, especially at night and first thing in the morning. This may be accompanied by a strong urge to urinate; it can also cause leakage and wetting accidents.
- Unexplained weight loss or gain of more than 5 pounds (2.27 kilograms). You should notice if you are losing weight because that means your body condition is getting worse, which means your baby is not getting enough nutrients from you during pregnancy. This can lead to preterm delivery and other complications and poor health for both mother and baby after birth.
You may have other symptoms such as yeast infections, slow healing cuts, dry skin, itchy skin, and leg cramps.
Causes of Gestational Diabetes
- Pregnancy hormones that cause Insulin resistance
- Your body’s pre-existing inability to produce enough insulin
- Unhealthy diet (high in sugar, carbohydrates, and salt)
- Lack of exercise or being overweight or obese
Tests for Gestational Diabetes
All women are mandatorily tested for GD during the 24-28th weeks of pregnancy. Apart from that, if you display any symptoms, several tests can be used to diagnose gestational diabetes.
- The most common is the Oral Glucose Tolerance Test (OGTT) which involves drinking a sugar solution and then having your blood sugar tested at intervals for two hours or longer (you may need to fast before this test).
- If you’re diagnosed with gestational diabetes, it may also be recommended that you have a fasting plasma glucose test and/or a random plasma glucose test. These involve taking blood samples at different times during the day when you’re not eating or drinking anything except water—this gives doctors a better idea of how much insulin your body needs.
- Another option is an HbA1c (also known as A1c) test; these measures average blood glucose control over three months by looking at red blood cells in your bloodstream. Urine tests are also sometimes used once pregnancy has been confirmed but aren’t very reliable on their own because some women without diabetes may show signs of high levels of sugar in their urine.
Treating Gestational Diabetes
If you have gestational diabetes, the first step is making lifestyle changes and blood sugar monitoring before resorting to medication. A dietitian can help you draw up a meal plan that accounts for your weight, activity levels, blood glucose results, and lifestyle. The meal plan should include:
- A variety of healthy foods
- Enough carbohydrate foods to keep you feeling full and satisfied (carbohydrates are the primary source of energy for your body)
Managing Gestational Diabetes
Managing gestational diabetes is a multi-faceted approach. There are no “one size fits all” strategies, but the following general guidelines can help you manage your condition:
- Eat well. Low-calorie, low-fat diets can help women with gestational diabetes control their blood glucose levels and lose weight if they need to. But you mustn’t cut out too many nutrients from your diet during pregnancy by following a strict diet plan without consulting your doctor first.
- Be physically active. Regular exercise helps women who have gestational diabetes control their blood sugar levels and helps them keep weight gain at a healthy level during pregnancy, both of which reduce complications for mothers and babies alike once the baby is born.
- Monitor blood glucose levels regularly using a home blood glucose monitoring device (called glucometers). This measures how much sugar is in your bloodstream at any given moment; and allows you to detect changes quickly so they can be addressed before they become dangerous or affect other aspects of health. Such as vision problems caused by retinopathy (when high amounts of sugar damage small blood vessels in the eyes).
Risk Factors Involved
You’re likely to be diagnosed with gestational diabetes if you have any of the following risk factors:
- Age older than 35 years old during pregnancy
- Age older than 25 years old at first pregnancy
- Family history of type 2 diabetes
- History of gestational diabetes (having had it previously) or polycystic ovarian syndrome (a hormonal disorder characterized by enlarged ovaries, irregular periods, and acne)
- Having had a large baby before
- Taking antipsychotic or steroid medications
If you already have a high blood pressure condition or are over 35 years old, your doctor will test your blood sugar more often during your pregnancy.
Risks of Untreated Gestational Diabetes to Your Baby
If you are diagnosed with gestational diabetes, your baby may also be at risk for health problems.
- Your baby may be born overweight or obese. This can make it harder for your baby to get into position during labour and delivery, which increases the risk of C-section delivery.
- The risk of respiratory distress syndrome (RDS) is higher in babies of mothers with gestational diabetes than in those whose mothers do not have gestational diabetes. RDS occurs when there’s too little surfactant—a substance that keeps lungs from collapsing—in the amniotic fluid surrounding a newborn’s lungs.
- Children who were born to women with untreated, gestational diabetes have an increased risk of developing type 2 diabetes later in life.
Risks of Untreated Gestational Diabetes to the Mother
Your risks of the following health problems increase if you do not get treated for gestational diabetes:
- Type 2 diabetes. You are at increased risk of developing type 2 diabetes later in life if you have pre-diabetes or gestational diabetes during pregnancy. Studies show that 50% to 70% of women with gestational diabetes go on to develop type 2 after they deliver their baby. The longer you have high blood sugar levels during pregnancy and the later it is caught, the greater your chances of developing type 2 after the birth. Women who had untreated, gestational diabetes during one pregnancy have up to a 60% chance of having another child with it during their next pregnancy.
- High blood pressure (hypertension). Having high blood pressure puts you at risk for complications such as heart attack, stroke, and kidney disease. However, research shows that women with either pre-existing hypertension or newly diagnosed hypertension during pregnancy may be able to reduce these risks by acting early on—before they give birth—to lower their blood pressure level before it becomes dangerous for both mother and baby.
- Heart disease/stroke/kidney disease.
- Nerve damage (neuropathy). A nerve disorder caused by high glucose levels in your bloodstream can affect any part of your body but most often affects nerves leading into muscles or organs such as those controlling digestion or bladder function.
Complications During Birth
The risks of complications during birth are higher if you have gestational diabetes. You’ll be closely monitored to try to prevent any problems. If you can have a vaginal birth, this is preferable because it’s easier for your body and baby to recover from.
If there are any difficulties during labour or delivery, your health care provider may decide that a cesarean section is necessary. This surgery involves cutting through the wall of the abdomen and womb with an incision to deliver the baby. While having surgery is not ideal, it does reduce some of the risks associated with natural vaginal delivery (for example, tearing). Cesarean sections also require less time spent inside an operating room than vaginal births, so they are often safer for both mother and child overall.
After birth – look after your baby if they have high blood glucose levels, low blood glucose levels, or jaundice.
After your baby is born, their blood glucose levels will return to normal. This usually happens by the second day after birth.
Breast milk is best for your baby. If your baby cannot breastfeed, they may need to be given formula milk instead.
If you notice that your newborn has jaundice (yellow colouring of the skin and eyeballs), this can be treated with light therapy using an infra-red lamp or special lights called biliblankets.
- A diagnosis of gestational diabetes means that you will have to monitor your blood sugar levels and diet during pregnancy closely.
- Your doctor may recommend a daily oral glucose tolerance test to check your blood sugar levels when you’re not pregnant after having a baby and again in the future. Your doctor might also recommend an eye exam before you become pregnant and other times during your life. This test can help detect retinopathy before it causes any problems with vision or blindness.
- If left untreated, gestational diabetes can cause serious health problems for both mother and child during pregnancy or birth (including preeclampsia). It’s essential to get treatment as soon as possible so that these complications do not occur.