Gestational Diabetes is also called Gestational Diabetes Mellitus (GDM) or Diabetes during pregnancy. Gestational diabetes is a form of an elevated (high) blood sugar level that is noticed in an index (current) pregnancy.
That is, the pregnant woman must have developed diabetes before getting pregnant but it wasn’t noticed, after doing the sugar level test, she found out she has gestational diabetes.
A pregnant woman that develops gestational diabetes is at a higher risk of developing a type of diabetes known as type 2 diabetes or obesity later in life.
A type 2 diabetes is an adult onset diabetes that affects the way the body processes blood sugar (glucose). With type 2 diabetes, the body either doesn’t produce enough insulin, or it resists insulin.
Gestational diabetes and insulin are related because all types of diabetes are related to the hormone insulin. Insulin is a hormone that regulates carbohydrate breakdown i.e, it regulates the amount of glucose in the body by allowing sugar to move from the blood into the cells.
A pregnant woman placenta produces insulin blocking hormones. This makes sugar stay in the blood long after a meal because the baby gets nutrients from the mother’s blood.
In gestational diabetes, the placental hormones provoke a rise in blood sugar to a level that can affect the growth of the baby.
Diabetes in pregnancy usually develops during the last half of pregnancy, sometimes as early as the 20th week if she doesn’t have diabetes before getting pregnant.
Causes of Gestational Diabetes
The causes of gestational diabetes Mellitus (GDM) is unknown. Nobody knows what causes it but there are some common risk factor of Gestational Diabetes.
Risk factors of Gestational Diabetes are
1. Liver Problem
If a pregnant woman has a liver problem, there is a tendency of her having gestational diabetes. This is because a liver help to store glucose to power the cells during periods of low sugar.
By storing glucose, the liver makes sure that blood glucose levels remain steady between meals and during sleep.
2. Over age 28
The risk of getting diabetes increases with age. Women older than age 25 are more likely to develop gestational diabetes.
3. Genetic Tendency
If one or more members of the family have a history of diabetes, there is a high tendency that the pregnant woman will develop gestational diabetes because of the sugar level problem.
4. Over weight
A pregnant woman can develop diabetes during pregnancy if she is significantly overweight, with a body mass of 30 or higher.
If the pregnant woman had a baby in a past pregnancy who weighed more than 9 pounds or was still born, it can lead to gestational diabetes.
There is also a higher risk of gestational diabetes if a pregnant woman had gestational diabetes in her previous pregnancy.
Pregnancy increases blood sugar level naturally, this is because pregnancy is stress on its own (stressful event). When there is stress, there are some hormones that are usually released in a stressful situation.
7. Racial factor
For reasons that are not clear, women who are black (people of colour) e.g Hispanic, American Indian, Asian or Pacific Islander are more likely to have gestational diabetes.
8. Other risk factors are
- Short Stature( 1.50m)
- Hypertension or high blood pressure
- Recurrent miscarriage
- Offspring malformation
- Sedentary lifestyle.
Symptoms of Gestational Diabetes
For some women, gestational diabetes is not noticeable. That is, they usually have no signs nor symptoms. Most learn they have it during the blood sugar level test, while some may experience some mild symptoms which are mostly related to abnormal blood sugar level.
These mild signs are similar to those of other forms of diabetes and also common symptoms in all pregnant women. That is why doctors do screen expectant mother, usually between the 24th and 28th week of pregnancy. Some of these symptoms are:
Fatigue means feeling overtired, with low energy and a strong desire to sleep that interfere with normal daily activities. So if a woman has diabetes during pregnancy, she might have symptoms of excessive tiredness.
2. Excessive Thirst:
Diabetes during pregnancy, can make a woman have excessive thirst. Though it is normal for a pregnant woman to always drink water, but if she feels excessive thirst even when she has not eaten something salty, or have not done something else that would make her want an extra glass of water, she should see her doctor for a blood sugar level test.
3. Increased Urinary Urgency and Frequency:
This can be a sign of uncontrolled blood sugar levels. The need to urinate during pregnancy at night is normal but when it is frequent, you should see a doctor to run a blood sugar level test.
Some other mild symptoms are:
- Excessive snoring during pregnancy
- Increased weight gain.
Effects of Gestational diabetes On The Mother And Baby
Diabetes during pregnancy can affect both the mother and the baby in different ways.
Effects on the baby
Macrosomia is a condition in which the baby grows too big. Extra glucose in the bloodstream crosses the placenta, which triggers the baby’s pancreas to make extra insulin.
This means the baby weighs more than 9 pounds, 13 ounces (4,000 grams) at birth. That may hurt the baby during birth and the mom will have to undergo the c- section (Caesarean section) delivery to keep the baby safe.
2. The baby will have breathing problems including Respiratory Distress Syndrome( RDS).
This is a breathing problem when babies don’t have enough surfactant in their lungs. Surfactant is a protein that keeps the small air sac in the lungs from collapsing.
This is when a baby’s eyes and skin look yellow. A baby does have Jaundice when his liver isn’t fully developed or isn’t working well.
4. Low blood Sugar (hypoglycemia):
Gestational diabetes can also lead to the baby having hypoglycemia at birth.
5. Type 2 diabetes:
This type of diabetes occurs later in life because as a pregnant woman that had diabetes during pregnancy, the baby is at a higher risk of developing type 2 diabetes when they are older.
6. Obesity later in Life:
Babies of mothers who had gestational diabetes have a higher risk of developing obesity later in life.
Effects on the mother
1. High Blood Pressure and Preeclampsia
Gestational diabetes increases High blood pressure and Preeclampsia risk. High blood pressure is also known as hypertension.
This is when the force of blood against the walls of the blood vessel is too high. Preeclampsia is when a pregnant woman has high blood pressure and signs that some of her organs (kidney, liver) may not be working properly. Preeclampsia causes high blood pressure.
2. Future Diabetes
If you have gestational diabetes, you are likely to have it again during a future pregnancy. You are most likely to develop type 2 diabetes as you get older.
This is a birth before 37 completed weeks of pregnancy. A mother with gestational diabetes is likely to deliver before the baby’s estimated due date.
4. Shoulder dystocia
This happens when a baby’s shoulder gets stuck inside the mother’s pelvis during birth. Through that, the mother might have Postpartum haemorrhage ( heavy bleeding).
5. Still Birth
Stillbirth is the death of a baby in the womb after 20 weeks of pregnancy. GDM can cause stillbirth.
6. Perinatal depression
It is the depression that happens during pregnancy. It is also called Postpartum depression. It is a medical condition that causes feelings of sadness.
Treatment and Prevention of Gestational Diabetes
Treatment of Gestational Diabetes Mellitus (GDM) can help reduce the risk factor for pregnancy problems / Complications.
And the best way to lower the risk of GDM is to stay healthy and as a woman, always prepare your body for pregnancy.
Some treatments are:
- Monitoring your blood sugar levels by eating a healthy, balanced diet. Your diet should contain more vegetables, protein and the right mix of carbohydrate and fats. Too many carbohydrate can increase the blood sugar level.
- Regular Exercise: Speak to your doctor before doing any exercise. Aim for at least 30 minutes of exercise, at least three days a week because regular exercise can keep the sugar level stable.
- Regular Eating: To regulate the blood sugar level, never skip meals. Skipping meals can fluctuate the blood sugar levels.
- Always go to all the Prenatal care checkups and always take your prenatal vitamins.
- Always follow the instructions/directions of your doctor how often to check your blood sugar and how often or exactly when to take insulin. Don’t start or stop medication without consulting your doctor. Take Oral medication if necessary. Oral medication such as metformin or injectable insulin to lower the blood level.
- Check your weight gain during pregnancy because gaining too much weight can make it harder to manage blood sugar level if it is high.
Gestational Diabetes comes with a lot of risks that can be life-threatening for the mother and baby. It is only wise to prevent or treat it at all cost.
Pregnant mothers should endeavour to go regular checkup. This is because, the presence of gestational diabetes can increase the risk of diabetes later in the future,
A healthy lifestyle is also highly encouraged. After all, we all love to have healthy mothers and babies.