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Diabetes in Pregnancy/Gestational diabetes

Overview

Diabetes associated with pregnancy or gestational diabetes, happens when your body has trouble managing blood sugar levels while you are expecting. While the condition usually develops in the second half of pregnancy, sometimes, pre-existing diabetes can complicate pregnancies. Nevertheless, regardless of whether the patient is dealing with this condition for the first time or managing pre-existing diabetes, controlling blood sugar levels is crucial to keep the patient and the baby safe and healthy. Gestational diabetes disappears soon after the delivery. However, gestational diabetes has been reported to increase the risk of developing type 2 diabetes; hence, consistent blood sugar monitoring of the patients is crucial.

The placenta, which supports the baby’s growth, produces hormones that can interfere with the action of insulin, a hormone that helps regulate the blood glucose levels. The blood sugar levels increase when the body cannot produce adequate insulin to maintain the blood glucose levels; this leads to gestational diabetes.

Certain factors that increase the likelihood of diabetes development during pregnancy include:

  • Obesity: Being overweight or obese before pregnancy increases the risk of developing gestational diabetes.
  • Age: Women over 35 have a higher chance of developing gestational diabetes.
  • Family history: If diabetes runs in your family, your chances are higher too.
  • Polycystic ovary syndrome (PCOS): PCOS has been reported to increase risk of developing gestational diabetes.
  • Previous history of gestational diabetes: If you had diabetes during a previous pregnancy, you are more likely to develop it again.

Gestational diabetes can sneak up on you because for many women, there are no noticeable symptoms. Hence, screening tests during pregnancy are very important. However, some women may experience: 

  • Unusual thirst
  • Frequent urination
  • Fatigue
  • Blurred vision

Approximately 24 to 28 weeks into pregnancy, a glucose screening test (OGTT) is performed. This involves drinking a sugary liquid; then, the blood sugar levels are measured after 1 and 2 hours.

Gestational diabetes is managed with a multidisciplinary approach involving an obstetrician, endocrinologist, dietician, and diabetes nurse. The major aspects that are focus upon are as follows:

  • Healthy diet: A well-balanced, nutritious diet, which includes fruits, vegetables, lean proteins, grains/cereals, and diary. Avoiding snacks, sweets, and foods that are processed helps too.
  • Monitoring blood sugar: Regular monitoring of blood sugar.
  • Exercise: Physical activities such as walking, jogging, swimming, or yoga are also beneficial for lowering blood sugar levels.
  • Medication: In some cases, lifestyle changes alone are not sufficient; medications or insulin injections are required to modulate the blood sugar levels.
  • Regular monitoring:  Closely monitoring the baby’s growth, usually with ultrasound imaging, can help ensure that everything is on track with regard to the pregnancy.

While you cannot always prevent gestational diabetes, one or more of the following steps may be taken to lower the risk of developing this condition:

  • Maintenance of healthy weight (obesity management or healthy weight gain) before pregnancy
  • Consumption of a balanced diet
  • Regular exercise
  • Regular check-ups
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