Gestational Diabetes

Gestational diabetes is a type of diabetes that occurs during pregnancy.

It causes high blood sugar levels that can affect pregnancy and a baby's health. Blood sugar levels usually become normal after delivery.

However, it may increase the risk of some women developing type 2 diabetes.

Pregnant women can control gestational diabetes by eating a healthy diet, exercising and if required, medications which help to stabilize the levels of blood sugar.

Most women with gestational diabetes do not experience any symptoms.

The exact cause of gestational diabetes is unknown.

To understand how gestational diabetes occurs, it is important to understand how pregnancy affects the metabolism of glucose. Insulin, a hormone that is secreted by the pancreas, helps to regulate the amount of glucose in the blood after a meal. It achieves this by transporting glucose from the blood to the body's cells. In doing so, it also helps to deliver glucose which is required as a source of energy to the cells.

During pregnancy, the placenta, which connects the baby to the mother's blood supply, produces high levels of different types of hormones. These hormones pass into the mother's blood stream and impair the action of insulin on the cells of the mother's body. This leads to increased levels of sugar in blood. The more the baby grows, the more hormones the placenta produces. Increased blood levels can impair the growth and health of the baby. This condition usually develops in the last half of pregnancy, although it can occur as early as the 20th week.

Some doctors believe that all pregnant women should be screened for gestational diabetes for early diagnosis and appropriate treatment to be given. Women who are at a risk of developing gestational diabetes should have the blood sugar level carefully monitored regularly.

Tests that can be used in routine screening for gestational diabetes include:

• Initial glucose challenge test - in which a women is asked to drink a syrupy sugar solution and the blood sugar is measured an hour later. A blood sugar level below 130 to 140 mg/dL (7.2 to 7.8 mmol/L) is considered as a normal glucose challenge test. If it is higher, it indicates that a woman has an increased risk of developing gestational diabetes.
• Follow-up glucose tolerance test - in which a pregnant women is asked to fast overnight and the blood sugar level is measured on the next day. Before the blood sugar level is measured, the woman would be asked to drink a sweet solution and then the blood sugar level is measured every three hours. If at least two of the results indicate high blood sugar, then a woman will be diagnosed with gestational diabetes.

Frequent tests are required through out pregnancy to monitor the blood sugar level. After delivery, the blood sugar level should also be monitored to ensure the woman doesn't have type 2 diabetes.

Treatment strategies for gestational diabetes include:

• Monitoring blood sugar at least five to six times a day.
• Maintaining a healthy diet and avoiding excessive weight gain.
• Exercising regularly.
• Taking medications which help to normalize the amount of sugar in blood.
• Close monitoring of the baby's growth and development to prevent complications from developing.

The following can help prevent the development of gestational diabetes:

• Eating healthy foods rich in fiber and low in fats and calories, such as fruits, vegetables and whole grains.
• Exercising before and during pregnancy.
• At least 30 minutes of moderate activity per day.
• Losing excess weight before pregnancy.

Lifestyle modifications are necessary in order to cope with gestational diabetes.

Eating a healthy diet and exercising regularly can help women with gestational diabetes to reduce the risk of complications associated with this condition.

Knowing more about this condition and joining a support group can also be helpful.

There are several risks and complications associated with gestational diabetes.

The risk factors for developing gestational diabetes include:

• Being older than 25
• A family history or personal history of gestational diabetes.
• Having prediabets, a condition in which the blood sugar level is slightly elevated.
• Excessive weight
• Being African-American, Hispanic, American Indian or Asian.

If gestational diabetes is not treated, it can lead to several complications.

Complications that affect the baby, such as:

• Excessive birth weight (9 pounds or more).
• Early (preterm) birth
• Respiratory distress syndrome - a condition which makes breathing difficult due to immaturity of the lungs.
• Low blood sugar (hypoglycemia) which can lead to seizures.
• Type 2 diabetes later in life.

Complications in the mother include:

• High blood sugar
• Preeclampsia - Preeclampsia is a serious complication of pregnancy that causes high blood pressure and other symptoms that threaten the lives of both the mother and baby.
• Increased risk of developing type 2 diabetes in the future.