Diabetes is a condition in which there’s high amount of sugar (glucose) in the blood. This is due to problems with the hormone insulin. Insulin allows sugar (mainly digested from the diet) to be taken up from the blood into the cells. This serves as the body’s main energy source. However, if insulin levels are too low, or the body does not respond normally to insulin, sugar accumulates in the blood (known as ‘glucose intolerance’), and diabetes occurs. So, what then is gestational diabetes?
What Is Gestational Diabetes?
Gestational diabetes mellitus (sometimes referred to as GDM) is a form of diabetes that occurs during pregnancy. Most women will no longer have diabetes after the baby is born. However, some women will continue to have high blood glucose levels after delivery. Diagnosis is when higher than normal blood glucose levels first appear during pregnancy.
Gestational diabetes can occur at any stage of pregnancy, but is more common in the second half. It occurs if your body cannot produce enough insulin – a hormone that helps control blood sugar levels – to meet the extra needs in pregnancy.
Gestational diabetes can cause problems for you and your baby during and after birth. But the risk of these problems happening can be reduced if it’s detected and well managed. Gestational diabetes is the most common pregnancy complication. There may not be much you can do to prevent it, but managing diet is key to controlling it.
What Causes Gestational Diabetes?
We don’t know what causes gestational diabetes, but we have some clues. The placenta supports the baby as it grows. Hormones from the placenta help the baby develop. But these hormones also block the action of the mother’s insulin in her body. Due to this insulin resistance occurs. Insulin resistance makes it hard for the mother’s body to use insulin. She may need up to three times as much insulin.
Gestational diabetes starts when your body is not able to make and use all the insulin it needs for pregnancy. Without enough insulin, glucose cannot leave the blood and utilized as energy. Glucose builds up in the blood to high levels (hyperglycemia) leading to GDM.
However, some factors can put you at higher risk of developing it.
What Are The Risk Factors For GDM
Any woman can develop gestational diabetes during pregnancy, but you’re at an increased risk if:
- you previously had a baby who weighed 4.5kg or more at birth
- you had gestational diabetes in a previous pregnancy
- one of your parents or siblings has diabetes
- you’re overweight
- have high blood pressure during pregnancy
- more than the age of 35years
How Is Gestational Diabetes Diagnosed?
Early detection is best to help you keep yourself and your baby healthy. That’s why between 24 and 28 weeks of pregnancy, you’ll have a screening test.
After fasting overnight, blood will be taken to check your fasting blood glucose level. After this, you’ll be given a sweet glucose solution to drink. In about an hour or two, your blood glucose level will be tested. If your level is too high, you’ll be asked to come back for a longer glucose tolerance test, which will determine whether you have the condition or not.
How Can I Manage Gestational Diabetes?
The main treatment of GDM is diet therapy, aimed at controlling blood glucose levels. By following a few guidelines for diet and exercise, you should be able to stay in control:
- Watch carbohydrates — choose whole grains and limit refined carbs
- Eat small meals every few hours
- Avoid extremely sugary foods and drinks, including fruit juice
- Add a healthy protein to every meal, such as nuts, avocado, lean meat, or eggs
- Eat foods high in fiber
In addition to diabetic diet therapy, simple physical activity such as a short daily walk will also help you manage diabetes. However, some women may need medication (metformin) and/or insulin injections to help manage gestational diabetes.
After the baby is born, an early blood test (via a heel prick) to check that the blood sugar levels have not dropped too low. Early breastfeeding (within half an hour of birth) will help to control the infant’s blood sugar levels.
Although your food choices may be a little more limited than you’d like, this is not the time to skip meals. If you don’t eat enough food, your body will still struggle to regulate your blood sugar. Due to that, you may end up with hypoglycemia, or low blood sugar. You will experience symptoms such as:
If you have these symptoms, check your blood sugar right away. The easiest way to bring it back up is to eat a small, sweet snack and then your next meal if you can.
What Complications Can Occur?
As long as you manage your diabetes, you’ll likely have a healthy pregnancy, normal delivery and a healthy baby. But, if not controlled, some diabetes complications can occur for you and your baby:
- High blood pressure leading to pre-eclampsia
- Preterm labor
- A large baby with extra fat, which could lead to Caesarean section
- Low blood sugar in the baby right after birth
- Mom and baby at higher risk for Type 2 diabetes later in life