Gestational Diabetes: Causes, Symptoms, and Treatment

Gestational diabetes is a common issue among pregnant women, with the incidence rate worldwide ranging between 14-17%. In the following article, we will highlight the most important details related to it.

What is Gestational Diabetes?

Gestational diabetes is a type of diabetes that first appears during pregnancy due to hormones produced by the placenta, which affect the body’s ability to use or produce insulin, causing elevated blood sugar levels.

This condition typically develops during pregnancy, specifically between weeks 24-28, and it does not mean the woman had diabetes prior to pregnancy.

What Causes Gestational Diabetes?

The actual cause of gestational diabetes is not fully understood, but several theories have been proposed, including those related to the placenta.

The placenta primarily develops to supply the fetus with nutrients and water during pregnancy. At the same time, it produces several hormones to maintain the pregnancy, such as cortisol, estrogen, and human placental lactogen. All of these hormones may have a blocking effect on insulin. As the placenta grows, more hormones are produced, increasing the risk of insulin resistance.

Although the pancreas can normally produce extra insulin to counteract insulin resistance, in the case of gestational diabetes, insulin production is not enough to overcome the effect of the placental hormones.

Risk Factors for Gestational Diabetes

Certain groups are more likely to develop gestational diabetes, including those who:

1. A sedentary lifestyle and do not engage in physical activity.
2. Have prediabetes or had gestational diabetes in previous pregnancies.
3. Gave birth to a baby weighing more than 4.1 kilograms in the past.
4. Have polycystic ovary syndrome (PCOS).
5. Are obese.
6. Have a direct family member with diabetes.

What are the Symptoms?

Often, gestational diabetes does not cause noticeable symptoms, and even when symptoms appear, they are typically mild and may not be recognized by the patient until testing is done. These symptoms may include:

1. Increased thirst.
2. Frequent urination.
3. Fatigue and nausea.

How is Gestational Diabetes Diagnosed?

Doctors usually perform a test between weeks 24-28 of pregnancy, but may do so earlier if there are risk factors.

Diagnosis typically involves a blood test to measure blood sugar levels. Depending on the results, the doctor may request further tests, such as:

• The glucose challenge test, where the pregnant woman drinks a liquid and waits for an hour before having her blood sugar measured.
• The glucose tolerance test, which may be requested if the glucose challenge test shows abnormal results. In this test, the patient fasts for 8 hours before a blood sample is taken to measure blood sugar levels, then drinks a glucose solution and undergoes regular blood sugar tests for two to three hours.

Blazma provides all the necessary tests that a doctor may require to diagnose gestational diabetes, including Glucose - Random Test and Glucose - Fasting Test.

How is Gestational Diabetes Treated?

Treatment is usually selected based on the woman's age, general health, medical history, the severity of the condition, and her tolerance to medications and other treatments.

In general, treatment focuses on maintaining blood glucose levels within the normal range to protect the health of both the mother and the baby, and to avoid serious complications during pregnancy and delivery. Treatment may include one or more of the following:

• Lifestyle changes to maintain healthy blood sugar levels, such as adjusting the diet and reducing carbohydrate intake, and engaging in physical activity.
• Monitoring blood sugar levels 4 or more times a day: first thing in the morning and after each meal.
• Monitoring fetal growth and development through regular ultrasound checks to ensure the baby does not grow too large.
• Insulin injections if diet and exercise are not sufficient to control blood sugar levels.

After delivery, the doctor will monitor blood sugar levels and may recheck them after 6-12 weeks to ensure they have returned to normal.

When is Gestational Diabetes Dangerous for the Baby?

Gestational diabetes can pose a risk to the baby if not well-controlled. Elevated blood sugar increases the risk of the following complications:

1. Excessive birth weight (Macrosomia): Larger babies are at greater risk of getting stuck in the birth canal, sustaining injuries during delivery, or requiring a C-section.
2. Preterm birth: The doctor may recommend delivering the baby early due to its large size.
3. Respiratory problems: Gestational diabetes increases the risk of the baby developing respiratory distress syndrome.
4. Hypoglycemia: Newborns may experience low blood sugar shortly after birth.
5. Other complications: Gestational diabetes may increase the risk of obesity and type 2 diabetes later in life for the child.

Can Gestational Diabetes Be Prevented?

Yes, the risk of developing gestational diabetes can be reduced before pregnancy by making lifestyle changes, such as losing excess weight through physical activity and modifying the diet.