H O R M O N E

Gestational Diabetes – distress during your pregnancy

Pregnancy

Pregnancy is a wonderful journey that every woman looks forward for. The best part is when you get extra care and love from your husband and family, where nobody stops if you want to have a delicious dessert. But, if you get carried away, you may increase your risk of gestational diabetes.

Gestational diabetes can add to your worry and make you anxious. Inthis condition, awoman develops high blood sugar levels for the first time during her pregnancy. If left untreated, it mayraise concerns for both the mother and the baby.The consequences can be serious, and sometimes even fatal.

The conditionoften develops between 24th and 28th week of pregnancy, but sometimes it may occur as early as in 20th week.The blood sugar levels in the woman with gestational diabetes return to normal after pregnancy. However, they are at an increased risk of developing diabetes later in their life.

Research says that gestational diabetes is the major cause for still births and also responsible for neonatal deaths. Children whose mothers suffered from gestational diabetes during pregnancy are also at a higher risk of obesity and diabetes.

Are there any factors that increase my tendency to develop gestational diabetes?

Gestational diabetes can occur in any woman, but there are some factors that increase your risk of developing the condition. They include:

  • Age (above 25 years)

  • Obesity

  • Excessive central body fat deposition

  • Smoking

  • Sedentary lifestyle

  • Family history for type 2 diabetes

  • Other conditions like high blood pressure and PCOS (polycystic ovarian syndrome).

How can I know that I have gestational diabetes?

Usually, you may not experience any symptoms due to the condition. Even if they occur, they are mild and usually identified during routine screening.

It is always better to undergo routine screening tests and watching out for symptoms like being thirstier, or hungrier than normal, or having to urinate more often.

What are the complications of gestational diabetes?

If the elevated blood sugar levels during pregnancy are left untreated, it mayraise concerns both for both you and your baby. It may lead to high blood pressure and also severe health conditions such as pre-eclampsia. Itaffects the blood flow through placenta leading to premature babies. Preeclampsia also leads to blood clotting problems, damage to organs such as liver and kidneys in unborn babies and may also lead to maternal or infant death in severe cases.

It may increase your chances of undergoing a C-section for delivering your baby, gestational diabetes in future pregnancies, and diabetes in the future. Many women with a history of gestational diabetes are a greater risk of developing type 2 diabetes later in their life.

How does gestational diabetes affect my baby?

Your baby is at a risk for several health issues if your gestational diabetes is poorly managed or left untreated. Normally, during gestational diabetes your pancreas work overtime to produce more insulin in order to regulate the increased blood sugar levels. Additionally, your baby’s pancreas also produces extra insulin in response to the additional glucose passed down from your body. The extra insulin and high blood glucose levels may make your baby significantly larger than average, a condition known as fetal macrosomia. Larger babies are at a risk for birth injuries due to shoulder dystocia (infants’ shoulder get stuck in the mother’s pelvis). Moreover, your baby is at a risk of developing hypoglycemia (lower blood sugar levels) immediately after birth. Gestational diabetes also increases the risk of the baby to develop type 2 diabetes and obesity later in life.

Gestational diabetes also increases the risk of preterm deliveries. The babies born early have lungs that are still immature that may lead to respiratory distress syndrome.Although, respiratory distress syndrome happens more often in preterm deliveries, it may also affect full term babies if you have gestational diabetes.

How is the condition treated?

The treatment for gestational diabetes focuses onmaintaining blood sugar levels within normal range. Depending on your blood glucose levels at the time of diagnosis, your doctor decides the type of treatment that is needed to control your blood sugar levels. Often, lifestyle changes such as healthy diet and exercise may help to control blood sugar levels. If your blood sugar levels are still high, your doctor may recommend insulin to control your blood sugar levels. It is considered as a first-choice drug as it does not cross the placenta and cannot affect your baby. So, its use is considered to be safe during pregnancy. However, other medications such as metformin and glyburide may also be considered to be acceptable and safe to be used during pregnancy.

Will gestational diabetes go away after my delivery?

In majority of cases, the diabetes that occurs during pregnancy goes away soon after delivery. It important to get tested for diabetes six to twelve weeks after your baby is born, to make sure that your blood sugar levels has returned to normal. Though your testresults are normal you will have to check your blood sugar levels for everyone to three years, as half of the women with gestational diabetes are at an increased risk to develop type 2 diabetes later.

What is the 75g glucose tolerance test?

Pregnant women between 24- 28 weeks of gestation must undergo the 75gm GTT for assessment of gestational diabetes for women who have not been previously diagnosed with diabetes. This test is done after an overnight fast (8-14 hours). First, the fasting plasma glucose is tested. Then, the patient receives 75gm of oral glucose. After consumption of sugar, the blood sugar is tested again at 1 hour and 2 hours respectively.

  • The fasting sugar level should be less than 92mg/dL,

  • 1 hour blood glucose level should be less than 140mg/ dL

  • 2 hour blood glucose level should be less than 120mg/dL.