Gestational diabetes refers to the high blood sugar or glucose that develops in the body of a woman during her pregnancy. It usually disappears after giving birth.

It can develop at any stage of pregnancy but most commonly it develops in the second or third trimester.

Insulin is a hormone that develops in your body to control the blood sugar levels to fulfill your body’s extra needs in pregnancy. When your body is not capable of producing enough insulin, gestational diabetes develops.

Gestational diabetes can create some problems for you and the baby during pregnancy and even after birth if the condition is not detected early and managed.

Factors determining the risk of gestational diabetes

You are at an increased risk of gestational diabetes if:

⦁ You are above 40 years of age

⦁ Your Body mass index (BMI) is above 30

⦁ You have a history of gestational diabetes

⦁ Your sibling or one of your parents has diabetes

⦁ You previously had a baby weighing 4.5 kg or more at the time of birth.

⦁ You had a weight loss surgery or a gastric bypass.

⦁ You are of south Asian, Black, African-Caribbean, or Middle Eastern origin.

Symptoms of Gestational diabetes

Generally, gestational diabetes does not cause any symptoms, but if the blood sugar level gets too high then some women may develop the following symptoms:

⦁ Genital itching

⦁ Unusual frequency of urinating

⦁ Increased thirst

⦁ A dry mouth

⦁ Blurred eyesight

⦁ Tiredness

These symptoms don’t need to be a sure sign of gestational diabetes because some of these symptoms are very common during the normal course of pregnancy. But if you are worried about any symptom that you are experiencing, it’s always better to consult your doctor.

Effects of gestational diabetes on your pregnancy

Most women with gestational diabetes have normal pregnancies and deliver healthy babies. But in some cases gestational diabetes may cause the following problems:

Baby growing larger than usual: It may create problems at the time of delivery and increases the chances of having induced labour or a Caesarean section.

Polyhydramnios: Excess of amniotic fluid in the womb causing premature labour or complicated delivery.

Premature birth: Giving birth before the 37th week of pregnancy.

Jaundice to the infant: Baby may develop low blood sugar or yellowing of the skin after birth.

Pre-eclampsia: A condition causing high blood pressure during pregnancy and leading to complications.

Stillbirth: Though it is rare there may occur chances of baby loss.

Screening for gestational diabetes

In the antenatal clinic, you after undergoing preliminary clinical examination will be given a 75 g oral glucose load, without regard to the time of the last meal. A venous blood sample is collected at 2 hours for estimating plasma glucose.GDM is diagnosed if 2 hr plasma glucose is ≥ 140 mg/dl (WHO criteria)

If 75 g glucose packet is not available, remove 5 level teaspoons (not heaped) of glucose from a 100 g packet that is freely available.

Advantages of the glucose tolerance test

The glucose tolerance test done to determine gestational diabetes has the following benefits:

⦁ You need not be fasting.

⦁ It causes the least disturbance in your routine activities.

⦁ It is served as both a screening and diagnostic procedure.

When you should be screened again

If you are found to have normal glucose tolerance (NGT), in the first trimester, you should be tested for GDM again around the 24th-28th week and finally around the 32nd -34th week.

Treatments for gestational diabetes

If you have gestational diabetes, there are chances of problems in your pregnancy but these can be reduced by controlling your blood sugar levels.

Excess blood sugar levels may be controlled by:

⦁ Changing your diet and being more active.

⦁ Doing gentle activities such as walking and swimming

⦁ Parental yoga can also help in controlling your blood sugar levels.

But, it is very important to consult your doctor before starting any activity that you have not done before.

However, you may need to take tablets or insulin injections if the above changes are not enough to lower your blood sugar levels.

Close monitoring during your pregnancy and birth will be done to check for any potential problems. You will be given a blood sugar testing kit also to monitor the effects of your treatment.

Long-term effects of gestational diabetes

Generally, gestational diabetes goes away after birth, but if you had it then you are more likely to develop:

⦁ Gestational diabetes again at the time of future pregnancy

⦁ A lifelong type of diabetes: Type 2 diabetes

After 6 to 13 weeks of giving birth, you should have a blood test to check for diabetes and if the result is normal, you should have a blood test once every year after that.

You shall not wait until your next test if you are developing any symptoms of high blood sugar such as increased thirst, unusual frequency of urination, and a dry mouth.

Generally, many people with diabetes do not have any symptoms; in that case, you should have the test even if you feel well.

Maintaining a healthy weight, eating a balanced diet, and exercising regularly are also advisable to reduce your risk of getting diabetes.

Planning future pregnancies

Make sure you get checked for diabetes if you have had gestational diabetes before and now planning for pregnancy.

If you do not have diabetes, you will be referred to a diabetes per-conception clinic for support to make sure that your condition is well controlled before you get pregnant.

It’s also very important to talk to your doctor if you have an unplanned pregnancy and had gestational diabetes in your previous pregnancy.

If you are expecting or have someone around who needs to know all about pregnancy, you can reach out to Dr. Shweta Wazir who can help you in getting a more clear vision of your problem.