Gestational diabetes is diabetes that occurs only in pregnancy. It usually occurs in the second half of pregnancy. It resolves after the woman has given birth and blood sugar levels return to normal.
In some women, pregnancy hormones make it harder for the body to use insulin hormone for control of blood sugar levels. They are unable to produce the extra insulin which is required. Therefore a higher than normal amount of sugar stays in the blood circulation. This causes gestational diabetes to develop.
This condition may occur without the woman having any noticeable symptoms. In women with risk factors, screening for gestational diabetes with a special blood test called the oral glucose tolerance test is carried out around 24 to 28 weeks of gestation. Urine is checked for sugar at antenatal visits.
Risk Factors for Gestational Diabetes
Certain factors increase a woman’s risk of developing this condition. They include:
- previous history of gestational diabetes
- history of having had a big baby of 4.5kg or more
- family history of diabetes (sibling or a parent)
- history of previous, unexplained stillbirth
- being pregnant at an older age
- being obese or overweight
- smoking
Gestational diabetes is associated with the following problems for the mother and her unborn baby
Risks to the mother
- More infections during pregnancy, some of which may be severe.
- miscarriage or stillbirth
- having to give birth by Caesarean section
- association with other pregnancy-related problems such as high blood pressure and bloods clots in leg veins and lung veins
- sustaining birth canal injuries during childbirth, as the baby is often big
- blood sugar may be too high or too low, leading to serious illness
- having to give birth by Caesarean Section
- Recurrence of gestational diabetes in future pregnancies.
- Developing type 2 diabetes in later years.
Risks to the baby
- too much fluid around the baby in the womb, which can cause complications to both mother and baby
- being born prematurely
- being born with abnormalities
- higher birth weight, which causes difficult delivery and possibly cause make giving birth harder and may result in birth injuries
- distress during labour and delivery ,with difficulties in breathing after birth
- being unwell with low level of blood sugar at birth
Prevention and Treatment
If a woman is overweight and obese, lifestyle changes that promote a healthy weight before pregnancy will reduce the risk of gestational diabetes. Stopping smoking is also recommended. Treatment of gestational diabetes may involve dietary management and medications to control blood sugar. Regular check-ups are required to check the health of the mother and unborn baby
Specialist care may be required.
