What is Gestational Diabetes? Causes, Symptoms, and Management

What is Gestational Diabetes Mellitus (GDM)?

Diabetes is a condition characterized by high blood sugar levels. Here your body is unable to convert glucose, a sugar from the food you eat, into energy. As a result, your blood sugar level increases, giving rise to a number of health complications.

GDM is a type of diabetes that occurs in pregnant women who have never been diagnosed with the condition earlier. The condition develops in pregnant women if their blood sugar levels become too high. Gestational diabetes usually occurs during the middle of your pregnancy, at around 24 to 28 weeks.

Getting diagnosed with gestational diabetes does not indicate that you have had diabetes before pregnancy. This condition occurs due to hormonal changes during pregnancy. If not managed well, high blood sugar levels can affect both the mother and the baby.

What Causes Gestational Diabetes?

During pregnancy, the placenta (an organ that develops in the uterus during pregnancy) supplies the growing fetus with nutrients. It also produces a variety of hormones, some of which can interfere with the action of insulin (a hormone that helps regulate blood sugar levels).

Hormones such as estrogen, cortisol, and human placental lactogen have blocking effects on insulin. This is called the contra-insulin effect and occurs after the 20th week of pregnancy.

As the amount of these hormones increases, your cells become more resistant to insulin. Normally your pancreas produces enough insulin to overcome insulin resistance.

However, in some women during pregnancy, the amount of insulin is inadequate due to the effect of the placental hormones resulting in gestational diabetes.

What are the Risk Factors of Gestational Diabetes (GDM)?

Some factors are found to increase the risk of gestational diabetes, such as:

• Having a family history of diabetes
• Being overweight or obese
• Physical inactivity
• High blood pressure
• Polycystic ovarian syndrome (PCOS)
• Having a history of gestational or prediabetes
• Previous birth of an infant weighing more than 4.1 kgs

What are the Symptoms of Gestational Diabetes?

Gestational diabetes might not cause symptoms in every woman. Some may experience the following:

• Frequent urination (polyuria)
• Excessive thirst (polydipsia)
• Fatigue
• Nausea

How is Gestational Diabetes Detected?

Your doctor will perform a routine blood test to measure your blood glucose levels around 24 to 28 weeks of your pregnancy. It may include two parts:

Glucose Challenge Test:

This test is done half an hour after having a glucose solution. If the blood glucose levels are higher than normal you will need another test to confirm the diagnosis.

Glucose Tolerance Test:

This test is usually done to confirm the diagnosis after a glucose challenge test. Here you need to fast for 8 hours, and your blood sugar levels will be checked before and after you have a sweet drink.

How to Manage Gestational Diabetes?

Management of gestational diabetes includes:

A Healthy Diet

Having a healthy diet helps manage your blood glucose levels. You can include fruits, vegetables, whole grains, low-fat, and high-fiber food in your diet. Avoid junk food, processed foods, and foods that are high in sugar. Try to have smaller portions multiple times a day and have your meals at the same time each day.

Regular Exercise

Staying physically active can benefit your overall health. Exercise helps your body use more glucose and helps in managing healthy blood sugar levels. It also helps you maintain an ideal body weight.

Regular Glucose Monitoring

Your healthcare provider will advise you on how and when to monitor your blood sugar levels during pregnancy. It is usually done twice a day, once in the morning before food and once again in the evening. This will help you keep a check on your glucose levels.

Medications

In cases where diet and exercises are not enough to control your blood sugar, your doctor might prescribe oral medications or insulin injections.

What are the Complications Expected from Gestational Diabetes?

Complications arising out of gestational diabetes can be managed as well as prevented. The important part is to control your blood sugar levels once the diagnosis of Gestational Diabetes mellitus (GDM) is made. If not managed well, gestational diabetes can lead to complications that can affect both the baby and the mother.

Complications That Can Affect The Baby

Increase in Size of the Baby:

High blood sugar during pregnancy can cause the babies to be bigger in size than normal babies.

Hypoglycemia:

In some cases, there are chances of the baby’s blood sugar levels dropping shortly after birth. Prompt feeding and sometimes intravenous glucose can bring back the blood sugar levels to normal.

Breathing Problems:

Babies born to mothers with gestational diabetes experience respiratory problems.

Obesity or Type 2 Diabetes:

Babies of mothers with gestational diabetes have a higher risk of developing obesity or Type 2 Diabetes in the future.

Still Birth:

Untreated gestational diabetes can pose a threat to the baby’s life and can result in stillbirth or death shortly after birth.

Shoulder Dystocia:

It is a rare condition where the baby’s shoulder or shoulders get stuck inside the pelvis during childbirth. This can cause nerve damage, leading to weakness or paralysis of the affected side.

Complications That Can Affect The Mother

High Blood Pressure:

Having high blood sugar levels during pregnancy can increase your risk of developing high blood pressure.

Preterm Birth:

Having gestational diabetes increases your chances of delivering early or before your due date.

Chances of a C-Section:

Most mothers with gestational diabetes undergo a C-Section to avoid complications during delivery due to the baby’s weight.

Risk of Type 2 Diabetes:

Having gestational diabetes can increase your risk of developing Type 2 diabetes later in life.

Perinatal Depression:

It is an emotional disorder that occurs during pregnancy or during the first year after childbirth. With perinatal depression, you may feel anxious, overwhelmed, worthless, irritated, or sad most of the time.

Can Gestational Diabetes be Prevented?

A few minor healthy lifestyle changes before and during your pregnancy can help you prevent gestational diabetes. This includes:

Having a healthy diet:

Having food that is high in fiber and low in fat and carbohydrates.

Staying active:

Regular exercise before and during pregnancy can reduce the risk of gestational diabetes.

Maintaining a healthy weight:

Losing extra weight while planning for pregnancy will help you have a healthier pregnancy.