Gestational diabetes is a condition that develops during pregnancy. It occurs when the hormone produced by the placenta prevents the body from using insulin effectively (insulin resistance), as a result of which glucose accumulates in the blood instead of being absorbed by the cells.
Unlike other types of diabetes, in gestational diabetes blood glucose goes back to normal after childbirth. It usually appears during the middle phase of pregnancy, between 24 and 28 weeks.
Gestational diabetes can affect the mother as well as the health of the baby. Pregnant mothers can manage gestational diabetes by consuming healthy foods, doing regular activity, regular blood glucose monitoring, and if required by injecting insulin.
Gestational diabetes doesn't usually cause any symptoms. But some women experience:
Excess weight gain before pregnancy often plays a vital role in the development of this condition. Generally, several hormones work to maintain blood glucose levels. Once food breaks down to glucose, insulin delivers the glucose to the cells. But during pregnancy, altered hormone levels cause insulin resistance, making it difficult for the body to utilize the blood glucose efficiently. This leads to gestational diabetes.
Previous history of delivering a baby weighing more than 4.1 kgs.
Race: Black, Hispanic, American Indian, and Asian American women have a higher risk of developing gestational diabetes.
All pregnant women should undergo screening tests during their second trimester between 24 and 28 weeks of pregnancy.
If a pregnant woman has high risk of gestational diabetes, the doctor may test for diabetes early in pregnancy, likely at their first prenatal check-up.
Routine screening for gestational diabetes:
Screening tests may vary marginally depending on the health care provider but generally include:
Initial glucose challenge test. They will be required to drink a syrup containing glucose solution. After a gap of 1 hour, they will undergo a blood test to measure their blood sugar. A level of 140mg/dl or more indicates gestational diabetes.
Blood sugar below 140 mg/dL is usually considered normal on a glucose challenge test. If the blood sugar level is higher than normal, patients will need another glucose tolerance test to determine gestational diabetes.
Follow-up glucose tolerance testing (OGTT): Measures blood glucose after 8hrs of fating. Post which lady is required to drink liquid containing glucose and blood sample is drawn every hr for 2 to 3 hrs.
Treatment for gestational diabetes includes:
Blood sugar monitoring
Medication, if necessary
Lifestyle modifications play a vital role in managing blood sugar levels in a healthy range. The doctor can help the person set weight gain goals based on the weight before pregnancy.
A healthy diet includes intake of fruits, vegetables, whole grains, and protein foods which are rich in nutrition and fibre and subsequently low in fat. A dietitian can help to create a diet plan based on certain factors like the present weight, pregnancy weight gain goals, and levels of blood glucose, exercise regimens, food choices, and financial support.
Regular and disciplined physical activity plays a vital role in every woman's wellness plan before, during, and after pregnancy. Exercise helps to lower the levels of blood glucose and also helps to reduce some common discomforts resulting from pregnancy, including back pain, muscle cramps, swelling, constipation, and trouble sleeping.
Walking, cycling and swimming are the most recommended activities during the phase of pregnancy. Day to day activities such as housework and occasionally gardening also helps a lot.
Blood Glucose Monitoring
While being pregnant, the doctor may recommend checking the blood sugar levels four or more times a day in a phased manner, such as early in the morning, followed next after consumption of meals to make sure the level stays within a healthy range.
Gestational Diabetes Medication
If diet and exercise aren't adequate to control this condition, the patients may need insulin injections to lower their blood sugar levels. Women with gestational diabetes require insulin to achieve their blood sugar goals and maintain them as well.
If the person has gestational diabetes, the baby may be at an increased risk of:
Excessive birth weight
Early (preterm) birth
Serious breathing difficulties
Obesity at a later stage in life
There are no specific factors that contribute to the prevention of gestational diabetes but adopting healthier habits before pregnancy surely helps a lot. If the patient had a previous history of gestational diabetes, these measures might also reduce the risk of having it again in the future during pregnancy.
Eat Healthy Foods
Select food materials which are high in fibre content and low in fat and calories. Emphasis should be on fruits, vegetables and whole grains. Patients should try to look for variety to help achieve their goals without compromising taste or nutrition.
Exercising on a daily, regular basis, especially before and during pregnancy, can help protect the patients from exhibiting gestational diabetes. Target should be of at least half an hour of a walk along with a few activities on most days of the week. Riding a bike and swimming are other activities that help the patients to stay active.
Start Pregnancy at a Healthy Weight
If the patient is planning to conceive, shedding extra weight before planning pregnancy helps to have a normal and healthier impregnation.
It is Recommended
Not to gain additional weight than advised as too much weight gain and too quickly can increase the risk of developing gestational diabetes.
Most women's blood sugar levels come down after they give birth and hormone levels return to normal. But about 50% of women with gestational diabetes develop Type 2 diabetes later in life. Diet and exercise can help lower the risk. The doctor may suggest blood glucose tests every six to 12 weeks after pregnancy to check for diabetes.