Gestational Diabetes: Causes, Risk Factors and Management

Gestational Diabetes Mellitus (GDM)  is a temporary condition that occurs during pregnancy. It is one of the top health complications that a mother may face during pregnancy. With gestational diabetes during pregnancy, there is an increased risk of developing diabetes for both mother and child.

What causes Gestational Diabetes? 

The exact cause of gestational diabetes is not known yet but there are certain clues and possibilities, why gestational diabetes occurs. The main risk factor is insulin resistance, so although the insulin is being produced by the mother’s body, it is not effective.

The baby, as it grows, is supported by the placenta and a multitude of hormones. While these hormones help the baby develop, they also block the action of the mother’s insulin in her body. The mother’s body finds it hard to use insulin, so her requirement of insulin goes up and gestational diabetes ensues. In other words, pregnancy hormones block the action of insulin, so the blood sugar levels remain high leading to this form of diabetes. This is why Gestational diabetes resolves after delivery, however, there is a risk of developing Diabetes in the future.

What are the risk factors for developing gestational diabetes?

  • being overweight,
  • previous gestational diabetes diagnosis
  • a family history of type 2 diabetes
  • having polycystic ovarian syndrome
  • maternal age of over 35
  • being a smoker

Are pregnant women screened for Gestational diabetes during pregnancy? 

  • Yes. Most women are screened for GDM between 24 and 28 weeks of gestation, if they are not at risk. For women who are at high risk, the testing is done sooner, possibly at the first prenatal visit.

How does Gestational diabetes affect the Mother? 

Mothers with Gestational diabetes may have a higher risk of pre-eclampsia(dangerously high blood pressure during pregnancy). There is also a higher risk of having a caesarian section or instrument-assisted delivery, mainly because of the macrosomia. Macrosomia means that the size of the baby is larger than normal. After pregnancy, mothers who had GDM have a higher risk of developing Diabetes millets in the future. The risk is highest in women

  • who needed insulin treatment
  • got antibodies associated with diabetes
  • women with more than two previous pregnancies
  • women who are overweight or obese

How does Gestational diabetes affect the Baby?  

Babies born to mothers with poorly treated GDM are at increased risk of

  • having low blood sugar after birth
  • being too large
  • jaundice
  • there is also a risk of stillbirth
  • in the long term, they may become overweight and develop diabetes

Management of  Gestational Diabetes

Once you have been diagnosed with gestational diabetes you will see an endocrinologist and develop a treatment plan. You may also see a nutritionist  or dietitian to help you develop a food plan that will meet the needs of you and
the baby and not be detrimental to your blood sugar level.

What you eat will have a major impact on your blood glucose levels. It is not only foods high in sugar that you have to avoid. A good meal plan will make use of the recommended food guide with several small meals spaced throughout the day.

Ideally, you should eat six times a day: breakfast, snack, lunch, snack,  dinner, and a bedtime snack. By eating frequent and small meals you can keep better control of your glucose level by trying to keep a slow and steady supply of energy for your body. Having a small amount of protein at each meal and snack is beneficial in maintaining a healthy blood glucose level.

Physical exercise is also very important. You can control and lower your glucose levels by getting active. Before you start any physical routine, be sure to consult with your doctor. The exercise you do does not have to be vigorous. You can take three small walks after breakfast, lunch, and dinner for 15-20 minutes to help burn off the extra sugar in your body.

A strict diet and physical exercise are going to be used for controlling gestational diabetes. In cases where higher insulin levels are needed (and the need for insulin is going to increase as the pregnancy progresses) your doctor will recommend additional insulin by way of injections. This isn’t as scary as it sounds and it is something you will get used to quite quickly. With the help of your doctor, you will learn how to adjust your insulin based on your blood sugar readings from your glucose monitor.

Utmost care is needed to combat gestational diabetes, as it concerns the health of the mother as well as that of the baby. Food choices are of paramount importance. This will have beneficial effects on the health of the baby’s growth. If you are fit and healthy, the risk of cesarean section birth will also be reduced. In many cases, it has been found that gestational diabetes leads to type II diabetes later. Do exercises regularly even during pregnancy, but only after consulting your doctor. This is the formative period for you as well as for the baby. Proper exercises provide strength to your body and act favourably for the growth of the baby within.

What does current research say about the optimal line of management for Gestational Diabetes?

Most current recent research shows that the optimal results are achieved with

  • Initial medical nutrition therapy with regular self-monitoring of blood glucose levels
  •  If optimal levels of blood glucose are not achieved, the treatment is intensified with adjunct insulin therapy
  • After delivery, an annual assessment for type 2 diabetes is recommended

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