What you need to know about gestational diabetes

It is called gestational because it develops during pregnancy. Gestational diabetes causes high blood sugar levels that can affect your pregnancy and your baby’s health.

Eating healthy foods, exercising and, if necessary, taking medication will control your blood sugar and thus prevent a difficult birth and keep you and your baby healthy.

In gestational diabetes, blood sugar usually returns to normal soon after delivery. But if you’ve had gestational diabetes, you’re at risk for type 2 diabetes. It is therefore important that you continue working with your healthcare team to monitor and manage your blood sugar.

It is advisable that as soon as you think about trying to get pregnant, you should see a doctor to evaluate your risk of gestational diabetes.

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To make sure your blood sugar level has returned to normal after your baby is born, your healthcare team will check your blood sugar right after delivery and again in six weeks. Once you’ve had gestational diabetes, it’s a good idea to have your blood sugar level tested regularly.

For most women, gestational diabetes does not cause noticeable signs or symptoms. It is not known why some women develop gestational diabetes. To understand how gestational diabetes occurs, it can help to understand how pregnancy affects your body’s glucose processing.

During pregnancy, the placenta, which connects your baby to your blood supply, produces high levels of various other hormones. Almost all of them impair the action of insulin in your cells, raising your blood sugar.

Modest elevation of blood sugar after meals is normal during pregnancy. As your baby grows, the placenta produces more and more insulin-counteracting hormones. In gestational diabetes, the placental hormones provoke a rise in blood sugar to a level that can affect the growth and welfare of your baby.

Gestational diabetes usually develops during the last half of pregnancy — sometimes as early as the 20th week, but generally not until later. Your doctor will likely evaluate your risk early in your pregnancy.

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Risk factors

Any woman can develop gestational diabetes, but some women are at a far greater risk than others. Risk factors for gestational diabetes include:

• Age greater than 25. Women older than age 25 are more likely to develop gestational diabetes.

• Family or personal health history. Your risk of developing gestational diabetes increases if you have pre-diabetes, have had gestational diabetes in previous pregnancies or if a close family member, such as a parent or sibling, has type 2 diabetes.

• Big baby. If you had delivered a baby who weighed more than 4.1kg at birth or if you had an unexplained stillbirth.

• Excess weight. You’re more likely to develop gestational diabetes if you’re significantly overweight, with a body mass index (BMI) of 30 or higher.

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Complications

These factors may affect your baby:

• Excessive birth weight. Extra glucose in your bloodstream crosses the placenta, which triggers your baby’s pancreas to make extra insulin. This can cause your baby to grow too large.

• Early (pre-term) birth and respiratory distress syndrome. A mother’s high blood sugar may increase her risk of early labour and delivering her baby before the baby’s due date. Or her doctor may recommend early delivery because the baby is large. Babies born early may experience respiratory distress syndrome – a condition that makes breathing difficult.

• Low blood sugar (hypoglycemia). Sometimes babies of mothers with gestational diabetes develop low blood sugar (hypoglycemia) shortly after birth because their own insulin production is high.

• Type 2 diabetes later in life. Babies of mothers who have gestational diabetes have a higher risk of developing obesity and type 2 diabetes later in life.

• Stillbirth. Untreated gestational diabetes can result in a baby’s death either before or shortly after birth.

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Other and related risks

• High blood pressure and preeclampsia. Gestational diabetes raises your risk of high blood pressure, as well as preeclampsia — a serious complication of pregnancy that causes high blood pressure and other symptoms that can threaten the lives of both mother and baby.

• Future diabetes. If you have gestational diabetes, you’re more likely to get it again during a future pregnancy. You’re also more likely to develop type 2 diabetes as you get older.

Treatment

• It’s essential to monitor and control your blood sugar.
• Eating the right kinds of food in healthy portions.
• Exercise.
• Medication. If diet and exercise aren’t enough, you may need insulin injections.
• Close monitoring of your baby.

Prevention

There are no guarantees but to live a healthy life.

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