Gestational Diabetes Explained: Here's Everything You Need To Know - Dr Awadhesh Kumar Singh

Getting pregnant is the most incredible joy women experience, despite its share of highs and lows. However, some women suffer from pregnancy-related medical conditions of which gestational (pregnancy-related) diabetes and high blood pressure are common problems, especially if there is a family history of diabetes or high blood pressure.

What is Gestational Diabetes?

High blood glucose detected for the first-time during pregnancy is named gestational diabetes. Generally, it occurs after the first three months and during 3rd to 6th month or even late during pregnancy. High blood sugar detected before the first three months of pregnancy is commonly due to undetected diabetes (named pre-gestational diabetes) before the pregnancy. Gestational diabetes isn’t similar to other forms of diabetes, as it is caused by pregnancy hormones that lead to insulin resistance in the body and generally disappear after delivery.

What causes Gestational Diabetes?

Gestational diabetes is caused by an increase in pregnancy hormones such as estrogen, cortisol, and placental lactogen that may lead to insulin resistance in the expectant mother. As the pregnancy progresses, around the 20-28 weeks of gestation, the placenta produces additional hormones to sustain the pregnancy, thus heightening insulin resistance.

Although the expectant mother can produce extra insulin to overcome the insulin resistance caused by pregnancy hormones, when additional insulin isn’t made, the increase in insulin resistance levels causes gestational diabetes.

What symptoms indicate Gestational Diabetes?

Majorly, it is asymptomatic. However, like other types of diabetes, gestational diabetes may cause increased urination and thirst, especially when there is overt glucose in the blood. However, since these are normal during pregnancy, your doctor will look for other risk factors such as blurry vision, high body mass index, and significant weight gain.

The risk of gestational diabetes increases if the expectant mother has a family history of diabetes or has developed the condition during her previous pregnancy. In most cases of gestational diabetes, all diabetic symptoms disappear after the delivery. Still, there continues to be a risk of developing diabetes later in life if there is a positive family history.

How to diagnose Gestational Diabetes?

The Indian Council of Medical Research guidelines suggest screening for gestational diabetes should be done at the first prenatal visit to rule out pre-existing diabetes during pregnancy. During the second trimester, between 24 and 28 weeks of gestation, an Oral Glucose Tolerance Test should be done using 75 gm glucose to check the levels at fasting, after one hour, and after two hours. If the plasma glucose levels are ≥ 92 mg/dl, ≥ 180 mg/dl, and ≥ 153 mg/dl, respectively, the expectant mother is diagnosed with gestational diabetes.

This method is used worldwide and recommended by the International Association of Diabetes and Pregnancy Study Group (IADPSG). Another prevalent method used to diagnose gestational diabetes in India is a non-fasting Oral Glucose Tolerance Test with 75g of glucose with a cut-off of ≥ 140 mg/dl after 2 hours, recommended by the Diabetes in Pregnancy Study Group of India (DIPSI).

What are the ways to manage Gestational Diabetes?

The effects of gestational diabetes on a pregnant mother and her child depend on how the condition is managed during pregnancy. Expectant mothers with gestational diabetes can continue to enjoy a healthy and happy pregnancy with proper medical treatment and positive lifestyle habits such as following a nutritious diet, exercising regularly, maintaining pregnancy weight, and monitoring blood sugar levels.

Insulin is the gold standard treatment for gestational diabetes. In general, gestational diabetes does not produce any life-threatening complications if glucose is optimally controlled. However, if proper care or treatment is not taken during pregnancy, it could lead to some complications for both mother and child.