By. Raashid Ehsaan Hyderi
Gestational diabetes is diabetes, or high blood sugar levels, that develops during pregnancy. It occurs in about 4% of all pregnancies. It is usually diagnosed in the later stages of pregnancy and often occurs in women who have no prior history of diabetes.
What causes gestational diabetes?
Gestational diabetes is thought to arise because the many changes, hormonal and otherwise, that occur in the body during pregnancy predispose some women to become resistant to insulin. Insulin is a hormone made by specialized cells in the pancreas that allows the body to effectively metabolize glucose for later use age as fuel (energy). When levels of insulin are low, or the body cannot effectively use insulin (i.e. insulin resistance),blood glucose levels rise.
What are risk factors for gestational diabetes?
Some degree of insulin resistance and impaired glucose tolerance is normal in late pregnancy. However, in some women, this is enough to produce diabetes of pregnancy, or gestational diabetes. There are several risk factors that can increase your risk of getting gestational diabetes. Risk factors include:
• Obesity;
• A history of gestational diabetes in a previous pregnancy;
• Previous delivery of an infant with a high birth weight (over 9 pounds);
• A parent or sibling with type 2 diabetes;
• A personal history polycystic ovary syndrome (PCOS);
What are the symptoms of gestational diabetes?
Gestational diabetes typically does not cause any noticeable signs or symptoms. This is why screening tests are so important. Rarely, an increased thirst or increased urinary frequency may be noticed.
How is gestational diabetes diagnosed?
Gestational diabetes is diagnosed with blood tests. Most pregnant women are tested between the 24th and 28th weeks of pregnancy, but if you have risk factors, your doctor may decide to test earlier in the pregnancy.
Blood testing confirms the diagnosis. A screening glucose tolerance test involves drinking a sugary beverage and having your blood drawn an hour later to test the glucose levels an hour later. If the screening test is not normal, you may need additional testing will generally be necessary. Another type of test is an oral glucose challenge test (OGTT). For this test your baseline blood glucose level is checked and then measured at 1, 2, and sometimes 3 hours after consuming a sugary drink.
Glycosylated haemoglobin, or haemoglobin A1C, is another test that may be performed. This test is used to monitor long-term blood glucose levels in people with diabetes. The hemoglobin A1c level offers a measure of the average blood glucose level over the past few months.
What are the consequences of gestational diabetes for the baby and mother?
Women with gestational diabetes who receive proper care typically go on to deliver healthy babies. However, if you have persistently elevated blood glucose levels throughout pregnancy, the fetus will also have elevated blood glucose levels. High blood glucose can cause the fetus to be larger than normal, possibly making delivery more complicated. The baby is also at risk for having low blood glucose (hypoglycemia) immediately after birth. Other serious complications of poorly controlled gestational diabetes in the newborn can include an greater risk of jaundice, an increased risk for respiratory distress syndrome, and a higher chance of dying before or following birth. The baby is also at a greater risk of becoming overweight and developing type 2 diabetes later in life.
If diabetes is present in an early pregnancy, there is an increased risk of birth defectsand miscarriage compared to that of mothers without diabetes.
Women with gestational diabetes have a greater chance of needing a Cesarean birth (C-section), in part due to large infant size. Gestational diabetes may increase the risk ofpreeclampsia, a maternal condition characterized by high blood pressure and protein in the urine. Women with gestational diabetes are also at increased risk of having type 2 diabetes after the pregnancy.
What is the treatment for gestational diabetes?
It is important to receive proper treatment for gestational diabetes because research studies have shown that the incidence of problems and complications is decreased when blood glucose levels are normalized. Treatment for gestational diabetes involves attention to maintaining a proper diet. Regular exercise can also contribute to tight glucose control. Nutritional modification is the mainstay of therapy, and many women will achieve adequate glucose control by following a nutritional plan.
Testing your blood glucose levels at home at specific times or after meals will be recommended to determine if your glucose levels are within acceptable limits. Testing at least four times per day is typical. You may also be asked to test your urine for ketones, substances that are produced when your body metabolizes fat. Ketones are elevated when the body is unable to use glucose for energy.
If diet and exercise are not sufficient to maintain tight control of your blood glucose levels, it may be necessary to instityte insulin therapy. Insulin is the only officially approved medication for treating gestational diabetes in the U.S.; however, oral agents are used by many cliniciant to control the blood sugar in selected patients. As the pregnancy progresses, insulin requirements may change, and insulin doses may need to be adjusted.
Is there a special diet for a woman with gestational diabetes?
While there is no one specific diet that is recommended for all women with gestational diabetes, following a meal plan can help keep your blood sugar levels under control and avoid complications.
• Many women with gestational diabetes will be advised to eat fewer carbohydrates than in their normal diet and to eat complex carbohydrates that contain fiber. It’s important to limit consumption of foods containing large amounts of simple sugars.
• High-fiber foods like fresh fruits and vegetables, as well as whole-grain products, are not only nutritious but also effective in keeping blood sugar levels stable.
• Skipping meals is not recommended because this leads to undesirable fluctuations in blood sugar levels.
