CAIRO - 28 January 2018: While diabetes during pregnancy, known as gestational diabetes, is overwhelming at first, it is also a common pregnancy complication that should not prevent moms-to-be from enjoying a safe and healthy pregnancy.
Gestational diabetes is a form of diabetes that appears only during pregnancy and can be diagnosed by your doctor. Like any other form of diabetes, it means that you have high blood sugar (or blood glucose) levels that were normal before you were pregnant. Gestational diabetes can be managed through careful monitoring and treatment.
What causes gestational diabetes?
According to the Centers for Disease and Control Prevention (CDC), up to seven percent of pregnant women develop gestational diabetes. This form of diabetes usually starts between week 24 and week 28 of pregnancy as the hormones from the placenta block the insulin hormone, produced by the pancreas, from regulating the body’s metabolism of carbohydrates and fats to produce energy. As a result, the body is prevented from effectively regulating the increased blood sugar of pregnancy, leading to high levels of sugar in the blood stream that can damage the nerves, blood vessels and organs in the mother’s body.
What are the symptoms of gestational diabetes?
In most cases mothers do not notice any symptoms and consider any change in their bodies as a normal result of pregnancy. However, there are a few symptoms that mothers may experience:
Frequent urination in large amounts – different than the frequent but usually light urination of early pregnancy.
Feeling hungrier and eating more.
Sugar in the urine, which is detected at a routine prenatal care visit.
What are the risk factors?
There are some factors that can increase the woman’s chance of developing gestational diabetes, including:
Weight: Becoming pregnant when you have a BMI (body mass index used to measure body fat) of 30 or more is one of the most common risk factors for gestational diabetes, as the extra weight affects the insulin hormone’s ability to properly function and keep blood sugar at normal levels.
Abdominal fat: If you have higher level of tummy fat during your first trimester of pregnancy, you are more likely to have gestational diabetes later.
Age: If you get pregnant over the age 35, you have a higher risk of developing gestational diabetes.
Family history: You can be at higher risk of developing gestational diabetes if diabetes runs in the family.
Personal history of diabetes: If you had gestational diabetes during previous pregnancies, you are more likely to have it again.
If your blood sugar levels are slightly elevated before pregnancy.
If you were ordered to “bed rest” to prevent pre-term birth, this might lead to gestational diabetes as a result of gained weight.
If you have polycystic ovarian syndrome where you have high levels of male hormones and less female hormones, leading to irregular or rare ovulation.
If you are generally glucose intolerant.
If you take medications for asthma, autoimmune disease, high blood pressure, rapid heart rate or drugs for mental health problems.
If you have given birth to a large baby before – greater than 4 kilos or 9 pounds.
If you previously had certain birth defects, including delivering a stillborn baby.
How is gestational diabetes diagnosed?
In every prenatal care visit, your doctor will ask you for a urine sample to check for sugar in urine as a sign of gestational diabetes. The reason why your doctor repeats the test every month is because one positive screening of higher sugar levels in your urine does not necessarily mean that you have gestational diabetes.
Between week 24 and week 28 of your pregnancy, your doctor will ask you to drink a sugary drink and perform a blood screening test an hour later to see how your body handled the sugar. If the results show that you developed high sugar levels, your doctor will conduct a three-hour glucose tolerance test while fasting to determine whether you have gestational diabetes or not.
If your results are normal but indicate that you can develop gestational diabetes, your doctor may request a follow-up test later to make sure you still do not have it.
How does gestational diabetes affect you and your baby?
Gestational diabetes can be managed and is not harmful either for the mother or the baby with proper treatment and monitoring by a doctor.
However, the excessive blood sugar in the mother’s blood can enter the fetal circulation through placenta, leading to potential serious problems for the mother and the baby. In case gestational diabetes is not controlled, mothers would risk having too large a baby, leading to C-section, as normal delivery becomes more difficult. Also, in uncontrolled gestational diabetes cases, mothers also are at risk for preeclampsia (sudden high blood pressure) and stillbirth (a baby born dead after 24 completed weeks of pregnancy).
If the gestational diabetes is uncontrolled, it can also lead to potential problems for the baby after birth, including jaundice (a yellow discoloration of the skin), breathing difficulties and low blood sugar levels. The baby can also be at risk for developing type 2 diabetes and to be obese.
After giving birth, the mother’s blood sugar will most likely return to normal quickly. But, in some cases, the mother can develop type 2 diabetes in the future.
What can be done to prevent gestational diabetes?
Keep yourself aware of the risk factors discussed earlier and remember that some of these factors, like the family history or advance maternal age, cannot be prevented or controlled. However, if you are overweight, start to eat healthy and exercise to reduce your chances of developing gestational diabetes.
Here are some tips to help you prevent developing gestational diabetes before and during pregnancy:
Exercise: Exercise to burn glucose and produce energy even if the insulin in your body is blocked. Exercise can also help keep your blood sugar levels normal. The appropriate type of exercise should be advised by your doctor.
Healthy diet: Eat healthy and protect yourself and your baby during and after pregnancy. Include vegetables, fruits and healthy protein in your diet, and limit your fat intake. Also, avoid eating sugary and processed food.
Watch your weight: With the help of your doctor, try to maintain a normal weight and body fat. Make sure to watch that you are gaining the right amount of weight during pregnancy and plan to lose the extra weight after delivery.
Breastfeed as long as you can: Breastfeeding decreases the mother’s risk of developing type 2 diabetes after gestational diabetes by 50 percent, as it improves glucose metabolism and insulin sensitivity.
As for your baby, they should be tested for low blood sugar (hypoglycemia) with a simple blood test immediately after delivery. Apply the healthy lifestyle you are following to the whole family and make sure that your child is eating clean and exercising.
How is gestational diabetes treated?
In addition to diet and exercise, your doctor might give you supplementary insulin to control sugar levels in your blood. The supplementary insulin can be given as shots (up to three injections daily) or as oral drugs. Also, your doctor will do fetal monitoring in your third trimester to make sure that the baby’s heart rate and movement are normal.
In case of not feeling well between your regular check up visits or if you notice any unusual symptoms, contact your doctor immediately. These symptoms include: feeling very thirsty, peeing more than usual, fatigue, feeling nauseous and blurred vision.