Gestational Diabetes: Causes, Symptoms, Risk Factors & Treatment!
Gestational diabetes, also known as pregnancy diabetes, is a medical condition which is characterized by hyperglycemia (an increased level of blood glucose) found during pregnancy, usually in the second or third trimester.
Between 6% and 8% of pregnant women experience this type of diabetes.
In 90% of cases, this condition disappears a few weeks after birth. Still, an important number of affected women will develop, a few months or years later, type 2 diabetes, or more rarely, type 1 diabetes.
Gestational diabetes doesn`t represent a contraindication for breastfeeding. On the contrary, some studies proved that breast milk may offer a certain protection to the child when it comes to this affection. Babies born by mothers who experience this medical condition have a genetic predisposition for diabetes and, therefore an increased risk of developing this illness.
Table of Contents
- 1 Signs & Symptoms
- 2 Causes
- 3 Complications
- 4 Risk Factors
- 5 Prevention
- 6 Diagnosis
- 7 Treatment
Signs & Symptoms
Just as in the other types of diabetes, the pregnant women who experiences gestational diabetes doesn`t show any symptoms in general. In rare cases, the following signs may occur:
- Unusual fatigue;
- Intense thirst;
- Polyuria (the emission of a large urine amount).
Pregnancy & Glucose`s Metabolism
During the second or third trimester of pregnancy, the pregnant woman`s necessity of insulin is 2 or 3 times more increased. This is way is explained the progressive increase during pregnancy of the anti-insulin hormone production, which reduces the insulin`s effect on the organism. These hormones have an important role in the good development of the pregnancy, meaning in the health of the mother and fetus. Typically, this resistance to insulin stimulates the pancreas to produce a larger amount of insulin in order to compensate. Women with predisposition to insulin are those who`s pancreas cannot produce this surplus of insulin.
Gestational diabetes is the result of hormonal changes while pregnant. The increase of the hormonal level produced by the placenta prevents the insulin`s activity of regulating the amount of blood glucose. This condition is known as “resistance to insulin.”
While the pregnancy evolves, the placenta increases and produces a large amount of hormones, leading to an increase of resistance in insulin.
Typically, the pregnant woman`s pancreas produces more insulin (3 times the normal amount) to overcome the resistance to insulin.
If the pancreas doesn`t manage to produce enough insulin to suppress the effect produces by the increased amount of hormones during pregnancy, the level of blood sugar increases, leading to the occurrence of gestational diabetes.
This medical condition may affect both the mother and fetus. During the first stage of pregnancy, the affection may cause congenital abnormalities that affect organs like the heart or brain. Also, the illness is associated with an increased risk of miscarriage.
During the second or third trimester of pregnancy, gestational diabetes might lead to an excessive increase of size of the fetus, which represents a contraindication for normal births. Moreover, macrosomia (excessive development) is accompanied by hyperinsulinemia and hypoglycemia.
Possible Consequences for the Mother
- Urinary tract infections;
- Premature birth;
- Caesarean birth (due to the increased size of the baby);
- Increased risk of type 2 diabetes.
Possible Consequences for the Baby
- Neonatal hypoglycemia;
- More pronounced jaundice in the newborn;
- Blood calcium deficiency;
- Respiratory distress syndrome;
- Increased risk of diabetes, most often type 2 diabetes.
Obesity before pregnancy may be a major risk factor when it comes to gestational diabetes. Other risk factors may involve:
- 25+ years of age;
- Genetic predisposition for diabetes (family history of diabetes);
- The existence of gestational diabetes in a previous pregnancy;
- Hypertension, urinary tract infections, hydramnios (amniotic fluid in excess);
- Birth of a baby with congenital abnormalities, premature birth, stillbirth, or the birth of a baby with a weight of more than 4 kg;
- Belonging to an ethnic community with an increased risk: Hispanic, American, Afro-American, South East Asian women.
In principle, there isn`t a known method to prevent gestational diabetes, but it`s believed that a healthy diet and maintaining a normal weight might help reduce the risks (most pregnant women with diabetes, then develop type 2 diabetes).
Preventing the Complications for the Mother and Newborn
- Glucose Control – The complications of gestational diabetes may be relieved or prevented through a strict control of glucose. This control requires a proper nutrition and sometimes, the administration of insulin. A blood glucose meter is indispensable for the proper monitoring of blood glucose.
- Supplements of Multivitamins & Minerals – During pregnancy, the requirements of nutrients increase. A study shows that the deficiency of the following nutrients was noticed in women with gestational diabetes: vitamin B6, chrome, potassium and magnesium. These nutritional deficiencies may be attributed to glycosuria associated with diabetes. Moreover, they may accentuate the tendency of hyperglycemia as these deficiencies affect insulin production.
Preventing Type 2 Diabetes
The risk of occurrence of type 2 diabetes in women with gestational diabetes is very high – more than 50% of cases. Due to this reason, women need to take every measure of precaution required to prevent the occurrence of the illness.
Particularly, women with gestational diabetes need to observe obesity, follow a healthy diet and don`t neglect the physical activity. Moreover, these measures will prevent hypertension and hypercholesterolemia, 2 issues that sometimes accompany diabetes.
Women with an increased risk of gestational diabetes will perform specific investigations as early as possible during pregnancy. The other women will be tested between weeks 24 and 28 of pregnancy.
The test of detecting diabetes is known as the glucose tolerance test and consists in the administration of a liquid which contains 50 g of glucose. The body absorbs the glucose rapidly, leading to an increased blood sugar in 30 to 60 minutes. A sample of blood is taken in 1 hour after ingesting the solution. A blood sugar that is higher or equal with 140 mg/dl is considered to be abnormal.
In women with an increased risk of gestational diabetes, a screening test will be followed by another test at week 24 – 28 of pregnancy for diagnosis confirmation.
Some experts recommend adopting a healthy diet, which should follow the nutritional requirements of a pregnant woman. Moreover, there are some changes in the lifestyle to be made for the blood sugar to be maintained in acceptable limits. Most anti-diabetic drugs aren`t recommended during pregnancy. The treatment with insulin is reserved only in cases in which changing the lifestyle isn`t enough for a proper glycemic control.
Controlling Gestational Diabetes
- Monitoring the blood sugar 4 times per day (before breakfast and 2 hours after the meals);
- Monitoring the level of ketones in the urine
- Following some food recommendations – for instance, equal distribution of calories throughout the day;
- Physical activity – following the doctor`s recommendation;
- Weight control;
- Insulin administration, if the case requires. Insulin is presently the only treatment used during pregnancy.
- Hypertension control.
Blood Sugar Monitoring
Measuring the blood sugar a few times per day is useful for determining the efficiency that the lifestyle change has in controlling the blood sugar, or if the pregnant woman requires insulin administration to protect the fetus. The doctor will recommend keeping a daily food diary and measuring the blood sugar at home. Therefore, the measure in which the blood sugar can be controlled efficiently will be able to be evaluated and it will be made a decision regarding the necessity of performing some changes in the treatment plan. The purpose of monitoring is maintaining the blood sugar as close to normal as possible.
|The Time of the Test||Target Blood Glucose Values|
|Before breakfast||2 hours after your meal|
|Under 95 mg/dl||Under 120 mg/dl|
Fruits, vegetables and whole grains are recommended – fruits rich in nutritional substances and with a low number of calories. In turn, the consumption of animal products and sweets need to be reduced.
Physical exercises decreases blood sugar because it transports glucose to cells, where is used for energy production. Also, physical exercises increase the sensitivity to insulin, meaning that the organism requires a smaller amount of insulin to transport glucose to cells. Moreover, if practiced regularly, exercises may reduce some issues during pregnancy: constipation, insomnia, back pain and muscle cramps. Swimming, aerobic exercises and walking are recommended during pregnancy (depending on your case, the consultation of a doctor may be required).
If nutrition and physical exercises aren`t enough in controlling the blood sugar efficiently, insulin administration for decreasing the level of blood sugar is another option.