Gestational diabetes
Gestational diabetes occurs when the body cannot produce the insulin it needs during pregnancy. People with this condition develop high blood sugar levels during pregnancy.
What is gestational diabetes?
During pregnancy, some people may develop high blood sugar levels. This condition is known as gestational diabetes mellitus (GDM) or gestational diabetes. Gestational diabetes typically develops between the 24th and 28th weeks of pregnancy.
If you develop gestational diabetes, it doesn’t mean you had diabetes before your pregnancy or will have it afterward. But developing it does raise your risk of developing type 2 diabetes in the future.
If poorly managed, gestational diabetes can also raise your child’s chance of developing diabetes. It can increase the possibility of complications for you and your baby during pregnancy and delivery.
What are the symptoms of gestational diabetes?
It’s rare for gestational diabetes to cause symptoms. A doctor may test for gestational diabetes if you have certain risk factors.
If you do experience symptoms, they’ll likely be mild. Diabetes symptoms may include:
· fatigue
· blurred vision
· excessive thirst
· excessive need to urinate
· yeast infections
What causes gestational diabetes?
Gestational diabetes occurs when your body cannot produce the insulin it needs during pregnancy. During pregnancy, your body produces larger amounts of some hormones, including:
· human placental lactogen (hPL)
· other hormones that increase insulin resistance
These hormones affect your placenta and help sustain your pregnancy. Over time, the amount of these hormones in your body increases. They may start to make your body resistant to insulin, the hormone that regulates your blood sugar.
Insulin helps move glucose out of your blood into your cells, where it’s used for energy. In pregnancy, your body naturally becomes slightly insulin resistant so more glucose is available in your bloodstream to be passed to the baby.
If the insulin resistance becomes too strong, your blood glucose levels may rise abnormally. This can cause gestational diabetes.
Who is at risk of gestational diabetes?
You may have a higher risk of developing gestational diabetes if you:
· have high blood pressure
· have a family history of diabetes
· were overweight before you became pregnant
· are not physically active
· gain a larger than typical amount of weight during pregnancy
· are expecting multiple babies
· have previously given birth to a baby weighing more than 9 pounds
· have had gestational diabetes in the past
· have had an unexplained miscarriage or stillbirth
· have been taking steroids
· have polycystic ovary syndrome (PCOS), or another condition associated with insulin resistance
Research data on race and ethnicity
The risk of gestational diabetes rises with an increase in body mass index (BMI) across racial and ethnic groups. But people with both high and low BMIs can get gestational diabetes. Still, in studies, it has been found that even in cases of low BMI among people who are Asian and Latin American, there is an increased risk of gestational diabetes.
Additionally, though People of Colour are disproportionately affected by type 2 diabetes, women of African and Afro-Carribean heritage have the highest risk of developing type 2 diabetes after gestational diabetes than all racial and ethnic groups.
Studies that discuss gestational diabetes and use race and ethnic differences for clarity can be limited. Additional research is still needed to consider environmental, behavioural, genetic, and socioeconomic factors as well as access to healthcare.
How is gestational diabetes diagnosed?
Routine screening of pregnant people for signs of gestational diabetes should be a default setting.
Should I be concerned about type 1 and 2 diabetes as well?
Many people who experience gestational diabetes will develop type 2 diabetes outside of pregnancy. There are two other types of diabetes:
· Type 1 diabetes: This occurs if the pancreas does not naturally produce enough insulin on its own.
· Type 2 diabetes: This occurs if the pancreas produces insulin but your cells don’t respond effectively to insulin, called insulin resistance. This causes your blood sugar to rise.
Your GP may screen for type 2 diabetes at the beginning of pregnancy. If you have risk factors for type 2 diabetes, a doctor will likely test you for the condition at your first prenatal visit.
These risks factors include:
· being overweight
· being sedentary
· having high blood pressure
· having low levels of HDL (good) cholesterol in your blood
· having high levels of triglycerides in your blood
· having a family history of diabetes
· having a history of gestational diabetes, prediabetes, or signs of insulin resistance
· having previously given birth to a baby who weighed more than 9 pounds
How is gestational diabetes treated?
If you receive a diagnosis of gestational diabetes, your treatment plan will depend on your blood sugar levels throughout the day.
A doctor may advise you to test your blood sugar before and after meals. They’ll also advise managing your condition by eating a nutrient-rich diet and exercising regularly. It’s recommended to perform 30 minutes of moderate-intensity aerobic exercise 5 to 7 days per week. If a doctor encourages you to monitor your blood sugar levels, they may provide you with a glucose-monitoring device.
A doctor may also prescribe insulin injections for you until you give birth. Ask them about properly timing your insulin injections in relation to your meals and exercise to avoid low blood sugar. A doctor can also tell you what to do if your blood sugar levels fall too low or are consistently higher than they should be.
What should I eat if I have gestational diabetes?
A balanced diet can help manage gestational diabetes. In particular, people with gestational diabetes can pay special attention to their carbohydrate, protein, and fat intake.
You may also need to avoid certain foods if you have gestational diabetes.
Carbohydrates:
Health-promoting carbohydrate choices can include:
whole grains
brown rice
beans, peas, lentils, and other legumes
starchy vegetables
low sugar fruits
Protein:
Good sources of protein can include:
lean meats
poultry
fish
tofu
Fat:
Healthy sources of fat can provide nutrients, such as vitamins and minerals. Health-promoting fats to incorporate into your diet include:
unsalted nuts
seeds
olive oil
avocado
What complications are associated with gestational diabetes?
If gestational diabetes is not managed well or left untreated, blood sugar levels may remain higher than they should be throughout your pregnancy. This can lead to complications that affect the health of you and your baby before, during, and after birth.
Complications that can affect you may include:
high blood pressure
preeclampsia
perinatal depression
preterm birth
stillbirth
caesarean delivery
Complications that can affect your baby can include:
high birth weight (macrosomia)
birth injuries, such as shoulder dystocia
breathing problems, including respiratory distress syndrome
low blood sugar (hypoglycaemia)
higher risk of developing diabetes later in life
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To avoid these complications, you can take steps to manage your gestational diabetes. For example, attend all of your prenatal care check-ups and follow a doctor’s recommended treatment plan.
What is the outlook for people with gestational diabetes?
Your blood sugar should return to typical levels after you give birth. But developing gestational diabetes raises your risk of type 2 diabetes later in life. Pre-determined check ups with your GP after your baby is born may well be encouraged. Taking steps to prevent type 2 diabetes can also help prevent associated complications.
Can gestational diabetes be prevented?
It’s not possible to prevent gestational diabetes entirely. However, changing your lifestyle can help reduce your risk of developing it. If you’re pregnant and have one of the risk factors for gestational diabetes, aim to eat a balanced diet and get regular exercise. Even light activity, such as walking, may be beneficial.
If you’re planning to become pregnant in the near future and have overweight or obesity, consider talking with a doctor about ways to safely lose weight while preparing for a pregnancy. Even losing a small amount of weight can help reduce the risk of gestational diabetes. Furthermore, it’s important to seek prenatal care and attend all doctor-recommended visits to get the necessary screenings and evaluations during your pregnancy.
Extracts taken from Brindles Lee Macon from https://www.healthline.com