Gestational diabetes is a type of diabetes that affects only pregnant women. A woman suffering from this condition has higher than normal blood sugar levels, not observed before the pregnancy. This happens due to hormonal changes that occur due to the growing fetus in the uterus. The placenta synthesizes hormones that trigger high blood sugar in the mother. The hormones also lead to insulin resistance, which means the mother is not able to utilize the glucose as needed. Women with gestational diabetes can have as much as three times higher blood sugar than normal levels.
How Risky is it?
Gestational diabetes occurs in an expectant mother only when the fetus is fully formed. Babies born to mothers with gestational diabetes are not at a risk of birth defects, unlike babies born to mothers who were already suffering from diabetes prior to conceiving the baby. However, there is the risk of giving birth to a bigger-than-usual baby. This is because the higher glucose level in the mother’s blood passes right through the placenta to the baby making it seem as if the baby were overeating. The baby’s blood glucose levels get affected. The baby’s body also reacts to high glucose levels by producing higher amounts of insulin. This leads to a drastic lowering of glucose at birth, lowering the baby’s physical functions like breathing. These babies have also been observed to be at a higher risk of developing type-2 diabetes later in life.
Who is at Risk of Developing Gestational Diabetes?
The US Center for Disease Control (CDC)1 released a report in 2014 that showed the prevalence of gestational diabetes to be around 9.2% around the world. In 2015, the Indian Journal of Endocrinology and Metabolism reported that there are an estimated 4 million Indian women suffering from gestational diabetes at different times. The gestational diabetes prevalence statistics provided by them were as follows;
- 3.8% in Kashmir
- 6.2% in Mysore
- 9.5% in Western India
- 17.9% in Tamil Nadu
- 35% in Punjab
- 41% in Lucknow
The study attributed the differences in prevalence to age and socioeconomic status differences among women from these different areas.
There are several risk factors that are associated with gestational diabetes:
- Asian, African-American and Hispanic women are more likely to develop gestational diabetes
- A woman who is overweight before pregnancy is at higher risk
- A history of diabetes and gestational diabetes in the family poses higher risk
- If a woman has had a larger-than-normal baby before, she is at higher risk
- If a woman has high blood sugar level before pregnancy, she is at higher risk
Symptoms of Gestational Diabetes:
In normal cases of gestational diabetes, the pregnant mother does not show any symptoms. The condition is usually diagnosed during routine maternal care checks. In more serious cases, symptoms may include;
- Frequent urge to urinate
- Constant hunger
- Elevated thirst
What Complications Come with Gestational Diabetes?
Gestational diabetes can cause the developing baby grow to a larger-than-normal size. This is likely to present complications at birth, needing C-section attention. A large sized baby is also at a risk of suffering shoulder damage from a prolonged normal birth.
The pregnant mother faces some level of risk from the higher levels of blood sugar. This is referred to as hyperglycemia. Just like in type-1 and type-2 diabetes, uncontrolled hyperglycemia places the mother at risk of complications including;
- Diabetic ketoacidosis: This happens when the body is unable to utilize blood sugar for energy and turns to break down fat. This leads to accumulation of toxic acids in the blood which can destabilize blood pH.s
- Hyperglycemic hyperosmolar state: This is a condition where excess dehydration occurs when the body starts flushing glucose through urine, leading to excessive urination. Elevated dehydration can also lead to a fatal coma.
How Can Gestational Diabetes Be Prevented?
It is possible to lower the risk of developing gestational diabetes. This involves making some lifestyle adjustments;
1) Healthy diet:
Cutting down on sugary foods should be a priority. Intake of sugar-rich pastries, confectioneries, sugary drinks, and beverages should be kept to a minimum or cut off completely. Calorie-rich foods including processed and fast foods should also be avoided. This is a good practice even for other people who are trying to eat healthily.
Increased intake of fiber is encouraged. It has been shown that an increase of 10 grams of fiber in food corresponds with a 26% decrease in risk of developing gestational diabetes. This is because fiber slows down the absorption of sugar while keeping hunger pangs at bay, which reduces the need to snack often. Lots of vegetables and fruits should also feature in a healthy diet.
2) Regular exercise:
Normally, exercising regularly comes with a variety of physical and mental benefits. It becomes even more important when you are pregnant. Physical activity helps the body prepare for pregnancy and helps stabilize the blood pressure and metabolic rate. It also helps improve and maintain cardiovascular function. It has been observed that women who engaged in at least 4 hours of exercise per week were at 76% lower risk of developing gestational diabetes.
3) Weight loss:
The UK diabetes community published a study showing that women with a Body Mass Index of 30 or more were three times more likely to develop gestational diabetes than women with a BMI lower than 25. Losing weight before pregnancy is hence highly encouraged. Your doctor is likely to ask you to do an oral glucose test if your BMI is over 30. Weight loss can be achieved through a variety of exercise and healthy dieting techniques.
How is Gestational Diabetes Treated?
If gestational diabetes is diagnosed, the doctor is likely to prescribe healthy dieting and exercises as a priority. Some of the exercises that are safe to do when pregnant include walking, swimming, and jogging. Nutritional experts recommend that this diet should be less than 35% of fat and 50% less of carbohydrates. Only in severe cases is the doctor likely to recommend insulin shots.
Countering gestational diabetes with lifestyle adjustments is unlikely to harm the baby. The doctor will also increase the monitoring of the pregnancy with ultrasound scans to check the effect of the condition on the baby.
The Way Forward:
It is very important for every woman who is planning to get pregnant or is already pregnant to get professional medical advice and consultation, preferably from a gynecologist or a counselor.
Infact, you can get expert advice and guidance without even having to step out of home. You can book an appointment online through Medlife e-consult and consult an experienced gynecologist right from the comfort of your home to guide you on prevention of gestational diabetes or ways to counter it.
Gestational diabetes is a condition which many pregnant women go through safely without facing any major complications and sometimes even without medical attention. The risks of developing it can be effectively reduced by making lifestyle adjustments such as taking healthy food and exercising. Taking these precautions also improves the overall health of the mother during and after pregnancy.
Also read: Gestational Diabetes and Pregnancy