Also called as Gestational Diabetes Mellitus (GDM), Gestational Diabetes is a condition that usually affects women during pregnancy. Women in their third trimester are more prone to GDM which is characterized by abnormally high blood sugar levels in the mother’s body. If left untreated, the condition can lead to potential threats in the pregnancy, and in the worst case scenario, can endanger the life of both the mother and the child.
Gestational Diabetes and its Causes
The funny thing about GDM is that it can affect a pregnant woman who has never had any issues with her blood sugar levels in the past. That is why in most cases, the condition is left unchecked until it is pointed out by routine blood tests done during pregnancy.
One of the most common causes for gestational diabetes in women is dysfunctional insulin receptors that do not perform their regular duties of processing glucose and absorbing excess sugar from the blood stream. The reason for this dysfunction can be attributed to certain factors related to pregnancy (which explains why the condition is more prevalent in pregnant women). One particular factor is the human placental lactogen found in the womb that interferes with the function of the insulin receptors. When the insulin receptors fail to do their job well, excess sugar mixes with the blood stream causing extremely high blood sugar levels.
Risk Factors Associated with Gestational Diabetes
Not all pregnant women get Gestational Diabetes. Rather, the condition is known to be associated with certain risk factors during pregnancy. Some of these include:
- Family History of Diabetes (including GDM)
- History of GDM in previous pregnancies
- High blood sugar levels detected in urine samples
- Late pregnancy (age > 35 years)
- Existing conditions like high blood pressure
- Pregnancy complications during the previous pregnancy (including overweight baby at birth, still birth and birth defects etc.)
Noticing the Initial Symptoms of GDM
Gestational Diabetes has very few outwardly symptoms and remains undetected till it is diagnosed by a glucose screening test usually taken during the third trimester of pregnancy. In the case of GDM, the diagnostic test taken during pregnancy would show a sharp spike in glucose levels in the blood samples.
In case the patient in question has a family history of diabetes or had GDM during the previous pregnancy, the doctor would order for a couple of glucose screening tests during the initial prenatal visits (usually one during your first prenatal visit and then another test after the 24th week). In case the glucose screening test returns a positive result for GDM, the doctor would recommend a follow up test called the Glucose Tolerance Test (GTT) to confirm the condition.
Additional Tests for GDM
In case a patient tests positive for Gestational Diabetes, the doctor would recommend a series of follow up and precautionary tests to make sure that the mother and baby remain safe throughout the pregnancy.
Women with GDM would require more prenatal visits than others. They would also be asked to keep a close check on their baby’s movements inside the womb after the 28the week of pregnancy. Frequent ultrasounds (bio physical profiles) and fetal heart monitoring tests would also be conducted on the patient in question after 32 weeks to make sure that the fetus develops normally and does not get affected by the side effects of GDM.
Women with GDM need to be extra cautious during the last few weeks of the pregnancy. The doctor would also require them to visit the clinic more often for tests that would monitor the baby’s growth and activity levels. The frequency of these visits would depend on the severity of the condition.
Complications Arising from Gestational Diabetes
Gestational Diabetes can affect both the mother and the developing fetus.
Risks to the Mother
Women with untreated GDM can suffer from conditions like pre-eclampsia, miscarriage or delivery problems. In most cases, a woman with GDM would need to deliver her baby via a C- Section. Women with GDM can also contract type 2 Diabetes Mellitus after pregnancy and would need to be treated for the same.
Risks to the Baby
GDM can pose several health related risks to the baby before and after birth. The condition can lead to birth defects (in the major organs of the body) in the newborn, excess birth weight or obesity (both during and after pregnancy), low blood sugar levels, jaundice, seizures and even still birth.
Babies born to mothers with GDM have higher risks of developing Type 2 Diabetes later on in their life. They can also suffer from obesity and organ related ailments (pertaining to the heart, lungs and kidneys).
Precautionary Measures to Stay Safe from GDM
Women with GDM would be required to follow certain precautionary measures to make sure that they delivery their baby with minimum hassles. Some of these measures are described below.
Keeping a Check on Glucose Levels
Women with Gestational Diabetes would need to maintain a constant check on their glucose levels and rush to the doctor in case they notice even a slight spike in the readings. They would need to take regular glucose screening tests for the same purpose. These tests can be done at a local clinic or at home using home glucose strips or a home glucose meter.
Keeping a Check on the Diet
Women with GDM would need to consult with a qualified nutritionist to ascertain the best diet plan that would help them deal with the condition during pregnancy and afterwards. The chosen diet plan would need to be in par with their weight, height and activity level.
The best diet plan for women with GDM would be one that incorporates the correct amount of calories, fats, proteins, good carbs, minerals and vitamins. Women with GDM are usually urged to avoid skipping meals (especially breakfast) and to refrain from snacking on sugary items like cookies, cakes, candies, chocolates, sodas etc.
Keeping a Check on Exercises
Doctors usually recommend a 30 minute, moderate exercise program every day for women with Gestational Diabetes. It has been noted that exercises like walking, swimming or aerobics etc. can help the body process more glucose, thereby reducing elevated blood sugar levels. Women with GDM would need to check with a physical trainer to ascertain the best exercises for them during pregnancy.
Using Medications to Treat Gestational Diabetes
Although Gestational Diabetes can be treated with the help of proper diets and exercises, some women would still need additional help in the form of medications to thwart the side effects of the condition.
This usually happens in severe cases where the blood sugar levels remain high even after dieting and exercising. In these cases, the doctor would recommend the use of oral medications like anti-diabetic drugs or insulin injections to reduce the blood sugar levels in the body.
Dealing with Gestational Diabetes after Pregnancy
In most cases, GDM and its symptoms would disappear on their own after delivery. However, some women would continue to have GDM or Impaired Glucose Tolerance (glucose levels would be high but not in par with diabetic conditions) even after pregnancy.
Women who test positive for GDM after pregnancy would need to undergo additional glucose screening tests for the same. The tests are usually conducted between 6-12 weeks after the delivery. In addition to this, the women in question would need to undergo a glucose screening test once every three years after a pregnancy to make sure their blood sugar levels remain normal.
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