Gestational Diabetes

What is Gestational Diabetes?

Gestational diabetes is a form of diabetes which affects pregnant women and is a common health problem of pregnancy. It affects about 2% - 5% of expecting moms.

A hormone Insulin regulates the amount of sugar in blood. When the body is not able to produce enough insulin Diabetes develops. During pregnancy a woman’s body has to produce extra insulin to meet the needs of the baby, especially around middle of pregnancy, second trimester. If the woman’s body is not able to do this she may develop Gestational Diabetes.

The hormones produced during pregnancy interfere with the insulin functionality which can lead to rise in the blood sugar level.

Hormones involved in development of placenta, which helps the baby to develop also blocks, the action of the mother's insulin in her body. This problem is called insulin resistance. During pregnancy a mother may need up to three times more insulin for glucose to leave the blood and transform to energy. When body is not able to use insulin due to insulin resistance it develops into Gestational Diabetes. Glucose builds up in the blood to high level, it is called hyperglycemia.

How does Gestational Diabetes affect the mother and the baby?

In Gestational Diabetes there is extra blood glucose which passes through the placenta to the baby, which increases the blood glucose level of the baby. While as Insulin does not cross the placenta like glucose so baby’s pancreas has to make extra insulin to get rid of the extra blood glucose.

Gestational diabetes affects the mother in late pregnancy and the baby too. Extra blood glucose passes through the placenta that gives the baby a high blood glucose level. Insulin does not cross the placenta, as glucose and other nutrients do. It results the baby's pancreas to make extra insulin to get rid of the blood glucose. The extra blood sugar and insulin can cause the baby to gain extra weight leading to Macrosomia.

If the baby is too large woman may have problems in delivery and may have to go for Cesarean delivery. And woman with Gestational Diabetes have an increased risk of Preeclampsia.

Some of the risks for babies born to moms with gestational diabetes are:

  • Babies who are large due to high blood sugar level in mom mostly continue to be overweight in childhood and as adults.
  • Baby may develop hypoglycemia due to over production of insulin due to increased glucose level before birth.
  • Newborn Jaundice
  • Low blood calcium (Hypocalcemia)
  • Breathing problems
  • Stillbirth

How is Gestational Diabetes diagnosed?

If some sugar is found in the urine during antenatal check up doctor suggests to get the blood glucose test done. If the sugar level is found higher then doctor will ask you to go for Glucose Tolerance Test which confirms Gestational Diabetes.

Almost all pregnant women have to go through Glucose Screening Test between 24 and 28 weeks of pregnancy. Some cases when one has already had gestational diabetes or if the doctor thinks that she is at a higher risk then he might recommend the test to be done before the 13th week and a follow up between 24th to 28th week.

How is Gestational Diabetes treated?

Gestational Diabetes can be treated by keeping the blood sugar level in control. Few things which will help in keeping the blood sugar level in control are:

  • Changes in Diet: Mostly doctor will suggest the changes that are needed in the diet. First thing that one needs to do is avoid eating food that contains simple sugar like cake icecream etc. and eat food that contains natural sugar like fruits. Another thing that you have to make sure is that you do not skip meals.
  • Exercise: Exercise as suggested by doctor. Moderate exercise helps keep the blood sugar level in check as exercise improves body’s capability to process sugar. Walking and swimming are some of the easy exercises which are good and helpful. Start with 5 to 10 minutes of exercise and you can increase it to 30 mins slowly. Make sure not to exercise too hard.
  • Insulin Injection: For few women who have severe gestational diabetes which cannot be controlled with diet and exercise may be asked to take insulin shots.

What happens after baby is born?

Most women will not have Gestational Diabetes after delivery. The blood sugar level gets back to normal within few hours of delivery. But for some women the sugar level may not go down immediately and doctor may suggest some diet and exercise and get the tests done again after 3 months.

Woman with Gestational Diabetes have high chances of having diabetes later in life. Obese woman have still higher chances of having diabetes.