Gestational Diabetes - Symptoms, Treatments and Diagnoses

What Is Gestational Diabetes?

The type of diabetes that affects pregnant women is called gestational diabetes. It affects how the cells use glucose in the body. It also results in hypertension (high blood pressure), which can affect the health of the mother and her baby. Most pregnant women can control blood sugar by eating healthily, exercising, and taking medicines.

Here, blood sugar generally returns to normal after delivery, but it increases the risk of type 2 diabetes. So women who had gestational diabetes are advised to keep monitoring their blood glucose levels every three years after delivery. Gestational diabetes if left untreated, can cause complications for your baby during pregnancy or delivery. It affects women between the 24th and 28th week of pregnancy.

What Are the Symptoms of Gestational Diabetes?

Generally, pregnant women do not show any sign of gestational diabetes. It is diagnosed during routine prenatal screening. But when the sugar levels are too high, some women experience the following symptoms:

• Increased thirst.

• Dry mouth.

• Frequent urination.

• Fatigue.

• Snoring.

• Blurred vision.

If a pregnant woman experiences unusual symptoms, she should get immediate medical help. The doctor will diagnose and treat the condition promptly.

What Are the Warning Signs of Gestational Diabetes?

• Presence of Sugar in the Urine: Blood sugar levels may be higher than usual in pregnant women with gestational diabetes. Typically, this is found during regular prenatal screening exams.

• Unusual Thirst: Pregnant women with gestational diabetes experience increased thirst

• Frequent Urination: With increased thirst frequent urination is also experienced by pregnant women.

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• Nausea: High blood sugar levels can cause nausea in pregnant women with gestational diabetes.

• Vaginal, Bladder, and Skin Infections: With the increase in blood sugar levels, frequent skin infections also occur and it could be a warning sign of gestational diabetes.

What Causes Gestational Diabetes?

Normally, glucose is produced and released in the blood when the food gets digested. When the pancreas detects glucose in the blood, it produces insulin to move sugar from the blood to the cells. The cells use this glucose for energy.

But in pregnancy, the placenta produces high levels of human placental lactogen (hPL) and other hormones, which cause insulin resistance. These hormones impair the action of insulin and raise blood sugar levels. As these hormones are produced more as the baby grows, gestational diabetes usually develops during the second or third trimester.

What Are the Forms of Gestational Diabetes?

There are two forms:

1. Class A1 - Gestational diabetes that can be controlled through diet.

2. Class A2 - Gestational diabetes that needs insulin or oral medications.

What Are the Risk Factors for Gestational Diabetes?

The factors that increase the risk of gestational diabetes are:

• Mother over 25 years of age.

• Hypertension.

• Family history of diabetes.

• Overweight before pregnancy.

• Gain a lot of weight during pregnancy.

• Multiple pregnancy.

• Previous gestational diabetes.

• Unexplained miscarriage.

• Previous stillbirth.

• Women on glucocorticoids.

• Polycystic ovary syndrome (PCOS).

• Prediabetes.

• Acanthosis nigricans.

What Are the Complications of Gestational Diabetes?

If the blood sugar level is too high, and if it is left uncontrolled, it can result in complications.

Baby’s complications

• Baby can grow too big - As glucose level is high in the mother’s blood, more glucose reaches the baby through the placenta. This makes the baby’s pancreas produce more insulin. As a result, the baby grows too big, which is called macrosomia.

• Respiratory distress syndrome - Babies born early have breathing difficult, as the lungs are not mature. Such babies need breathing assistance until the lungs mature.

• Low blood sugar - Shortly after birth, some babies develop hypoglycemia (low blood sugar). Severe hypoglycemia can result in seizures.

• Risk of type 2 diabetes and obesity - Later in life, babies have a higher risk of developing obesity and type 2 diabetes.

• Sudden death - In rare cases, untreated gestational diabetes can result in the unexpected death of the baby during pregnancy or delivery.

Mother’s complications

• C-section - If the baby weighs more than 9 pounds, C-section might be required.

• Early labor - High blood sugar causes preterm delivery.

• Preeclampsia - High blood sugar results in high blood pressure and preeclampsia. Preeclampsia is a condition caused by high blood pressure, which can be fatal for both the mother and her baby.

• Type 2 diabetes - Women with gestational diabetes are at risk of developing type 3 diabetes as they age.

How Is Gestational Diabetes Diagnosed?

Screening for gestational diabetes is done between the 24th and 28th week, if you are not a known diabetic or if your blood sugar level was normal during early pregnancy tests. The tests done are:

• Glucose challenge test - Here, the pregnant woman is made to drink a glucose solution, and the blood sugar level is tested after an hour. A blood glucose level below 130 to 140 mg/dL is considered normal.

• Glucose tolerance test - If the result of the glucose challenge test is abnormal, then the doctor performs glucose tolerance test every three hours. Firstly, blood glucose is checked after fasting overnight, and then after drinking a sweet solution, which contains a higher concentration of glucose than in glucose challenge test. Then the doctor takes blood glucose readings every hour for three hours. The normal readings at every hour are:

1. Fasting blood sugar level equal to or more than 95 to 105 mg/dL.

2. One-hour blood sugar level equal to or more than 180 to 190 mg/dL.

3. Two-hour blood sugar level equal to or more than 155 to 165 mg/dL.

4. Three-hour blood sugar level equal to or more than 140 to 145 mg/dL.

Amongst these readings, even if two readings show high blood glucose, the diagnosis of gestational diabetes is made.

How to Treat Gestational Diabetes?

Keeping the blood sugar level under control is crucial for the mother’s and baby’s health. The treatment options include:

• Continuous Testing of Blood Sugar - During pregnancy, blood sugar is checked four to five times a day. It has to be checked early in the morning and after meals. Mothers can use a home blood glucose meter to monitor their blood glucose levels.

• Healthy Eating - Eating a healthy diet, which is low in refined carbohydrates and high in fiber and protein can help control blood sugar. Consume a lot of fruits, vegetables, and whole grains. Consult a dietician or a nutritionist online to create a personalized diet plan.

• Exercise - Exercising daily helps lower blood pressure and blood glucose by making the glucose move into the cells, which is then used as energy. It also increases insulin sensitivity. Apart from these benefits, regular exercise can help relieve back pain, cramps, swelling, and constipation. Try walking, cycling, and swimming during pregnancy.

• Medicines - If the blood glucose levels are not controlled even after maintaining a proper diet and exercise, the doctor might prescribe antidiabetic medicines (Metformin) or insulin shots.

How Is Gestational Diabetes Prevented?

Although gestational diabetes cannot always be avoided, there are precautions that women can take to lower their chances of contracting the condition. The following approaches could aid in preventing gestational diabetes:

1. Keep a Healthy Weight: Pregnant women who are overweight or obese have an increased risk of getting gestational diabetes. This risk can be decreased by maintaining a healthy weight both before and during pregnancy.

2. Exercising: Regular physical exercise can aid in enhancing insulin sensitivity and blood sugar management. It is recommended that women try to exercise for at least half an hour at a moderate intensity on most days of the week.

3. Eating Balanced Diet: Maintain healthy blood sugar levels by eating a balanced diet that is high in fruits, veggies, whole grains, and lean proteins while being low in processed foods and added sugars.

4. Monitoring Blood Sugar Levels Regularly: Women who have previous instances of gestational diabetes or who are at high risk of developing it may profit from keeping track of their blood sugar levels at home.

Conclusion:

To conclude, gestational diabetes can make a pregnancy complicated if not controlled well. Therefore, every woman should be aware of this condition and be cautious of the risk factors. A healthy lifestyle can help prevent gestational diabetes to some extent. One should be active and eat healthily to avoid complications.