Gestational Diabetes Symptoms, Causes, and Treatment

What is gestational diabetes?

Gestational diabetes (GD) is a kind of diabetes that occurs in women who develop high blood sugar levels during their pregnancy. The condition is also called gestational diabetes mellitus (GDM) and typically develops between the 24th and 28th weeks of pregnancy. While its cause remains unknown, the incidence of this form of diabetes is gradually increasing among Indian women. Gestational diabetes occurs during pregnancy alone and does not mean that the patient had diabetes before or will remain one throughout the rest of her life; it is temporary and dissipates with time. However, it can increase the risk of developing type 2 diabetes some years later. If left undiagnosed and unmanaged during pregnancy, gestational diabetes can increase the chances of your child developing diabetes, along with the risk of potential complications for both the child and mother during pregnancy and the time of birth

Causes of Gestational Diabetes:

While the exact cause of gestational diabetes remains unknown, most experts opine those hormonal changes during pregnancy are at the crux of the matter. During pregnancy, a woman’s body will produce higher quantities of certain hormones like the human placental lactogen (HPL), among other hormones that increase the body’s resistance to insulin.

While these hormones are made to protect the placenta, after some time, the levels of these hormones increase in the body, making it resistant to insulin, the hormone responsible for regulating blood sugar.

Insulin removes glucose from the blood and transfers it to the cells for energy. During pregnancy, the body naturally becomes insulin resistant to a certain extent, which means more glucose is available for the baby’s energy requirements. If the insulin resistance turns out to be far too severe, blood glucose levels can spike up abnormally, which can cause gestational diabetes.

Who is at most risk of developing gestational diabetes?

Gestational diabetes can develop in any pregnant woman, but it seems more prevalent in women aged over 25, who are at relatively higher risk. Other factors can also increase the chances of developing gestational diabetes, including high blood pressure, heart disease, a sedentary lifestyle, obesity, a family history of gestational diabetes, polycystic ovarian syndrome, and having had a baby earlier that weighed over four kilograms or so.

Women who are already overweight before they get pregnant, those who gain a lot of weight (more than average) while pregnant, those expecting multiple babies, or women who have had gestational diabetes in the past are also at risk of developing gestational diabetes. Having an unexplained miscarriage or stillbirth and using certain steroids like glucocorticoids are also potential risk factors.

Symptoms of Gestational Diabetes:

Gestational diabetes hardly ever causes any alarming symptoms; it is quite rare for this disease to cause any symptoms. And even if you face symptoms, they’ll most likely be very mild and manageable. Some fatigue, feeling thirst, blurred vision, yeast infections and a frequent need to urinate is the worst that can happen, and that too only temporarily.

Gestational diabetes- diagnosis:

Endocrinologists and Gynaecologists at Aakash Healthcare encourage regular screening of all pregnant women to look out for signs of gestational diabetes.

For women with no previous history of diabetes and who maintain normal blood sugar levels at the beginning of their pregnancy, most doctors will only try and screen them for gestational diabetes between the 24th to 28th week of pregnancy.

For others, specific tests can be run; these include simple tests called Glucose challenge tests. Patients are asked to drink a glucose-based solution, and after an hour of blood tests, the doctor may decide to perform a 3-hour glucose test if the blood sugar level is high. This is two-step testing.

On the other hand, some doctors go straight for a 2-hour glucose tolerance test, considered one-step testing.

Based on the test results, gestational diabetes is divided into two classes, namely

Class A1 is used to classify gestational diabetes that can be managed with a diet alone. In contrast, Class A2 is used for gestational diabetes that requires insulin or oral medications to manage the condition.

Treatment for gestational diabetes:

All treatment plans for gestational diabetes at Aakash Healthcare are formulated according to the patient's blood sugar levels throughout the day. You’ll most likely be asked to take your blood sugar before and after meals and follow a nutritious diet aided by regular exercise. Some women may need insulin injections until they give birth.

Feel free to ask your doctor about timing the insulin injections about your meals and how much exercise you’ll have to do to avoid low blood sugar.

Potential complications associated with gestational diabetes

If gestational diabetes is left unmanaged, a pregnant woman’s blood sugar levels can remain higher than they ideally should throughout pregnancy, which can cause complications and affect the child's health. Babies can be born with heavy birth weight, have low blood sugar, or shoulder dystocia when their shoulders get stuck in the birth canal during labour. These kids also face higher chances of developing diabetes later on in life.

Prevention of gestational diabetes:

Currently, it’s not possible to prevent gestational diabetes altogether, but healthy habits can help reduce any chances of developing the condition.

If you are pregnant and at any risk for gestational diabetes, try to eat nutritiously and keep to regular light activity.

If you are overweight and want to plan your pregnancy shortly, consider talking with a healthcare professional about ways to lose extra weight safely. Even losing a small amount can help reduce the risk of gestational diabetes.

This is why we always maintain that all pregnant women must seek prenatal care, follow all doctor-recommended advice, and come in for regular screenings and evaluations during their pregnancies.

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