Gestational Diabetes

Understanding Gestational Diabetes

Understanding Gestational Diabetes

Gestational diabetes is a specific type of diabetes that develops only during pregnancy in women who did not previously have diabetes. Gestational diabetes typically appears in the second or third trimester and usually goes away after the delivery, but it does increase the risk of developing Type 2 diabetes later in life for both the mother and child.

Development of Gestational Diabetes

Why certain women develop gestational diabetes is not fully understood, but hormonal changes during pregnancy causing insulin resistance seem to be the likely cause. Insulin is a hormone that helps to metabolise glucose for energy. When the body becomes resistant to insulin, blood sugar levels increase, leading to gestational diabetes. While most pregnant women have some degree of insulin resistance during late pregnancy, those who cannot produce enough insulin to overcome this resistance develop gestational diabetes.

Development of Gestational Diabetes

Risk Factors for Gestational Diabetes

Several factors can raise a woman’s risk of developing gestational diabetes, including:

 

  • Age: Women over the age of 25 are at higher risk.
  • Family History: Having an immediate close family member with diabetes.
  • Weight: Being overweight or obese before pregnancy.
  • Previous Gestational Diabetes: Having had the condition in a previous pregnancy.
  • Polycystic Ovary Syndrome (PCOS): Women suffering from PCOS have a heightened risk of developing gestational diabetes.

Signs and Symptoms of Gestational Diabetes

Gestational diabetes is often  asymptomatic; however, some women may experience:

  • Increased Thirst and Urination: Due to the excess glucose in your bloodstream, your body may respond by trying to flush out the excess sugar, leading to more frequent urination and, subsequently, greater thirst.
  • Fatigue: Energy levels might dip because your body isn’t using glucose for energy efficiently.
  • Blurred Vision: High blood sugar levels can induce fluid levels in the body to fluctuate, leading to swelling in the tissues of your eyes. This can temporarily change the shape of the lens and the eye, leading to blurred vision.
  • Nausea: Nausea refers to the feeling of discomfort in the stomach that is often accompanied by an urge to vomit. The physical and metabolic demands of pregnancy, exacerbated by the challenges of managing gestational diabetes, can also play a role in the onset of nausea.
Signs and Symptoms of Gestational Diabetes

Indicators that You Need to See an Endocrinologist for Gestational Diabetes

It is best if the endocrinologist manages the sugar levels during gestational diabetes to achieve pregnancy-specific glucose levels to prevent complications during pregnancy for both the mother and the baby. Especially in certain conditions, you should seek help as soon as possible if you have the following circumstances :

  • Uncontrolled Blood Sugar Levels despite optimising treatment. Complicated Medical or Obstetrical History: Patients with a pre-existing history of diabetes or gestational diabetes
  •  If required use oral medications or insulin to achieve glucose goals
  • Planning Future Pregnancies: Those planning future pregnancies may seek an endocrinologist’s advice to manage risks and improve outcomes in subsequent pregnancies.

Seeing an Endocrinologist for gestational diabetes ensures specialised care that can better address specific or severe aspects of the condition.

Indicators that You Need to See an Endocrinologist

Screening for Gestational Diabetes

Screening for gestational diabetes is a routine part of prenatal care. 

Gestational diabetes is diagnosed by an oral glucose tolerance test.

How is it done?

  • Fasting: Before the test, you’ll be asked to fast for at least 8 to 12 hours (no food or drink except water).
  • The morning blood sample is taken to measure your fasting blood glucose level.
    Drinking the glucose solution: After the initial blood draw, you’ll drink a sugary solution containing glucose (75 grams).
  • Blood draws at 2 hours: Blood samples are taken at intervals of 2 hours to see how your body responds to the glucose challenge. 
Screening for Gestational Diabetes

Complications of Gestational Diabetes

If not properly managed, gestational diabetes can lead to several complications, which can affect both mother and baby:

 

  • For Mothers: Women with gestational diabetes are at a 2 to 3-fold risk of developing diabetes in the future. It’s also associated with an increased risk of hypertension during pregnancy and delivery complications.
  • For Babies: If not correctly managed throughout the pregnancy, there can be a higher risk of being born large for gestational age, which can result in complications during delivery. Additionally, these babies may face higher risks of obesity and type 2 diabetes later in life.

Treatment and Management of Gestational Diabetes

Effective management of gestational diabetes is crucial to prevent complications such as high birth weight, premature delivery, prolonged delivery, avoiding cesarean section and respiratory difficulties for the baby. 

 

  • Medication: Medication may be needed if lifestyle modifications aren’t enough to control blood sugar levels.
  • Dietary Changes: Eating a balanced diet is critical. Consuming foods low in simple sugars and high in fibre contributes to better management of the condition.
  • Exercise: A physically active lifestyle can help lower blood sugar levels. Activities such as walking, swimming, and prenatal yoga can be beneficial.
  • Monitoring Blood Sugar Levels: To manage your condition, it is essential to monitor your blood sugar levels several times a day or use a continuous glucose monitoring device.

Follow up after Delivery

  • After delivery, follow-up care is crucial for women who have gestational diabetes because they are at a higher risk of developing Type 2 diabetes in future and may also experience gestational diabetes in future pregnancies. 
  • 6 to 12 weeks after delivery, they should undergo another glucose tolerance test (OGTT) to check if their blood sugar levels have returned to normal.

 

Women who have had gestational diabetes are advised to undergo regular diabetes screening, particularly before planning another pregnancy or as part of their routine postpartum care.

Treatment and Management of Gestational Diabetes
Harmony Thyroid, Endocrinology and Diabetes Centre

If you or your loved ones are suffering from gestational diabetes, you can schedule an appointment with our Medical Director and Senior Consultant Endocrinologist, Dr Vikram Sonawane, from Harmony Thyroid, Endocrinology, and Diabetes Centre.

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