Gestational diabetes affects between 2% to 5% of pregnant women. Data shows that increase in plasma glucose levels is associated with birth weight above the 90th percentile, cord blood serum C-peptide level above the 90th percentile, and, to some extent, primary cesarean deliveries and neonatal hypoglycemia. Risk factors for gestational diabetes include a history of delivering a baby with abnormally high birth weight, strong family history of diabetes, and obesity.
Gestational diabetes usually begins when a woman is halfway through her pregnancy. It is advised that all women should have an oral glucose test done between the 24th and 28th week of pregnancy to screen for prediabetes. If gestational diabetes is not diagnosed or if left untreated, it can lead to high blood suagr levels. In pregnancy, glucose crosses the placenta from the mother to the baby in order to meet the energy needs of the growing baby.
If the mother’s blood sugar levels get higher than normal, the extra glucose will cross the placenta to the baby. To cope up with the extra glucose coming from the placenta, the baby starts making more insulin. This can lead to increased risk of your baby weighing more than 4 kg. This may cause difficulty during delivery of the baby. Gestational diabetes may also increase the risk of your baby being overweight and the chance of subsequent development of type 2 diabetes in the future.
The cornerstone of management of gestational diabetes is glycemic control. Quality nutritional intake is necessary to treat it. Patients with gestational diabetes who cannot control their glucose levels with diet alone will require insulin. Women with gestational diabetes experience twice the number of urinary tract infections than women who do not have the condition. This increase in the incidence of infection is thought to be due to the increased amount of glucose in the urine beyond the normal glucosuria that is present in pregnancy. There is also an increased risk of pyelonephritis, asymptomatic bacteriuria, and preeclampsia.
There is reportedly an increased incidence of stillbirth when control over elevated blood glucose levels is poor. There is also a 10% per year risk of developing type II diabetes after the pregnancy in which gestation diabetes occurred, with the greatest risk within the first 5 years following the index pregnancy.
Management of Gestational Diabetes
Gestational diabetes is managed by:
- Monitoring your blood sugar levels 4 times per day i.e. before breakfast and 2 hours after meals.
- Monitoring urine for ketones, an acid that indicates your diabetes is not under control
- Following dietary guidelines
- Exercising after obtaining your doctor’s permission
- Monitoring weight gain
- Taking insulin, if necessary. Insulin is currently the only diabetes medication used during pregnancy.
- Controlling high blood pressure
At Lifespan, you can learn how to manage your Gestational diabetes and avoid the complications associated with diabetes. If you have had gestational diabetes, you run the risk of developing type 2 diabetes in the future. Come to Lifespan if you have had gestational diabetes and we will help you avoid/delay the onset of type 2 diabetes.