Gestational diabetes: Causes, symptoms, risk factors, and treatments
Detecting Gestational Diabetes Mellitus during the early stages of pregnancy will help avoid complications. Read on to know more about GDM, its effects, who's at risk for it and how to manage it.
What is Gestational Diabetes: Gestational Diabetes Mellitus (GDM) is a condition wherein a high blood sugar level is present in the mother during pregnancy. Pregnant women are often screened for gestational diabetes in the latter part of their second trimester as a standard obstetrical practice.
The United for Diabetes Philippines 2011 report states that gestational diabetes mellitus complicates at least 14% of pregnancies. If left unmanaged, it has the potential to harm both mother and child.
What is gestational diabetes?
Gestational diabetes refers to a condition where the body cannot produce the needed insulin during pregnancy. If you are an expectant mom and you have this condition, you are most likely at risk to develop high blood sugar levels during pregnancy. Gestational diabetes usually disappears after giving birth.
It is important that this condition is detected early to manage it before getting worse and to prevent other complications in pregnancy. Gestational diabetes may cause a problem for both the mom and the baby.
This condition typically occurs between the 24th to 28th weeks, so, it’s important to monitor your blood sugar level during this time of pregnancy.
According to Healthline, having gestational diabetes during pregnancy may raise your risk of developing type 2 diabetes in the future. In addition, gestational diabetes if left untreated, can also raise your baby’s chance of developing diabetes. It may also pose a risk of experiencing complications during pregnancy and delivery.
Who is at risk for Gestational Diabetes?
WebMD, lists the following factors that increase the chances of developing Gestational Diabetes Mellitus during pregnancy. Here are some risk factors for gestational diabetes:
- High Body Mass Index (BMI)
- Family history of diabetes
- History of contraceptive pill use
- History of polycystic ovarian syndrome (PCOS)
- The mother’s age is 25 or older
- Coming from a high-risk ethnic group (Asian, Hispanic, Black, Native American)
- Having too much amniotic fluid during pregnancy (polyhydramnios)
- Previous history of having given birth to big babies or a stillborn
- GDM in a previous pregnancy
Causes of Gestational Diabetes
However, the body has a harder difficulty adequately digesting blood sugar during pregnancy due to changing hormone levels. A blood sugar rise result from this.
Risk factors for gestational diabetes associated with pregnancy include:
- Being overweight or obese
- Having no physical activity
- A pre-diabetic state
- Previous pregnancy with gestational diabetes
- Diagnosis of polycystic ovary syndrome
- Having a close family member with diabetes
- Having recently given birth to a child that weighed more than nine pounds (4.1 kilograms)
- Being a member of a certain racial or ethnic groups such as Black, Hispanic, American Indian, or Asian
Gestational diabetes symptoms
Due to the similarities between many changes and those that occur during pregnancy, GDM may not always show any overt signs or symptoms.
However, a few Gestational Diabetes symptoms could be:
- fuzzy vision
- severe thirst
- recurring vaginal, or bladder infections
- excessive urination
- Sugar in urine
- Yeast infections
Any pregnant woman who has new or unusual symptoms should consult their physician. If she has developed GDM or any other disease, the doctor may be able to tell more accurately. Thus, giving proper medication and treatment as well.
Most symptoms of gestational diabetes are similar to normal pregnancy symptoms. That is why it is essential to consult your doctor if there’s any sign or symptom that brings you to worry.
Risks on baby
The mother’s inability to produce the right amount of insulin during pregnancy puts the baby at risk in many ways. If GDM presents in the first trimester, this may mean birth defects affecting major organs or an increased risk of miscarriage.
According to the National Health Service UK website, the following may occur when GDM is observed in the second or third trimester:
- Macrosomia – The fetus grows so big (8 pounds and above) that its presents problems during labor and delivery. This may result in shoulder dystocia or other birth injuries as well as increased risks for cesarean delivery.
- Hypoglycemia – While a low blood sugar level in the baby is pretty common in newborns for the first two hours or so after birth, an extended period in this condition may result in neurological problems, developmental delays, and seizures.
- Jaundice – Baby’s skin and eyes are yellow. Though common in newborns, especially among Asian babies, and does not usually indicate a problem, jaundice remains a cause for concern for medical practitioners since it can potentially result in neurological, behavioral, and developmental issues.
- Respiratory Distress Syndrome (RDS) – A baby has trouble breathing and may need medical intervention.
Risks on mother
According to mayoclinic.com, the following conditions may occur in mothers with GDM:
- High blood pressure, preeclampsia, and eclampsia – The latter two cause high blood pressure. All 3 pregnancy complications can pose a fatal threat to mom and baby.
- Future diabetes – Gestational diabetes has a great chance of occurring in the next pregnancy. The mother is also likely to develop type 2 diabetes as she gets older.
How is it diagnosed?
It is highly encouraged by professionals that pregnant women routinely undergo screening for any signs of gestational diabetes. According to Healthline, if a woman has no history of diabetes and has optimal blood sugar levels at the beginning of pregnancy, then her healthcare provider will most likely order a gestational diabetes screening when she is 24 to 28 weeks pregnant.
Here are some tests that your doctor may recommend you to rule out gestational diabetes:
Oral glucose challenge test
In doing an oral glucose challenge test, you need to drink a glucose solution, first. Your blood will be tested after an hour. If the result of your blood test shows that you have a high level of blood sugar then your healthcare provider may perform a 3-hour oral glucose tolerance. In addition, this process is also known as two-step testing.
However, there are doctors who skip the glucose challenge test and perform the 2-hour glucose tolerance test instead. This process is considered one-step testing.
What are 1-step and 2-step testing?
In one step test, you need to fast before your blood is tested. Your doctor will start testing your fasting blood sugar levels. Next, you will ask to drink a solution with 75 grams of glucose. Afterward, your blood sugar levels will be tested again after 1 hour and 2 hours.
On the other hand, in a 2-step test, you are not required to fast. And instead of drinking a solution with 75 grams of glucose, your healthcare provider will ask you to drink a solution containing 50 grams of sugar. Afterward, they will test your blood sugar after an hour.
Treatment of Gestational Diabetes
Catching and managing the condition early during pregnancy will help avoid complications. A mother will have to be monitored closely. A physician may insist on a regular glucose tolerance test from when the condition is diagnosed to close to birth.
Treatment of gestational diabetes: Gestational diabetes diet
The right diet and exercise will keep GDM from getting worse, but so will controlling the weight gain of the baby inside. Medications may be necessary to control insulin levels and avoid further complications like preeclampsia.
In cases of neonatal hypoglycemia, immediate and proper breastfeeding is encouraged. In cases where this might not be possible, glucose water is sometimes given to newborns.
Treatment of jaundice also requires a mother to breastfeed more since breastmilk has laxative properties that facilitate the excretion of bilirubin.
It has to be stressed that most IDMs (infants of diabetic mothers) grow on to become healthy babies. However, to reduce the risks of their children growing up obese or developing Type 2 Diabetes, decisions on child feeding, lifestyle, and habits should be made a priority by mothers with gestational diabetes. Working with experts and healthy choices should ease a mother’s worries.
Gestational Diabetes Diet: Meal plan for gestational diabetes
Meal plan for gestational diabetes: Here’s what you can eat to help with your Gestational diabetes mellitus:
- Lean Protein
- Low-fat dairy
- Healthy Fats
- Olive Oil
- Peanut butters
- Non-starchy vegetables
- Green Beans
- Complex Carbohydrates
- Whole-wheat bread
- Sweet potatoes
- Brown Rice
Here’s what to avoid when you have Gestational diabetes:
Steer clear of highly processed foods like white bread and anything that is generally high in sugar like:
- Fast food
- Alcoholic beverages
- baked goods such as cakes and muffins
- Fried food
- Sweetened liquids, such as soda, juice, and other sweetened liquids
- Starchy meals, such as white pasta, and rice
- Sweetened cereals, sweetened oatmeal, and sweetened granola bars
If you are unsure, consult your doctor about the typical foods you consume. They can provide you with suggestions on what to stay away from and alternatives that will gratify you.
Take better care of yourself when you have Gestational diabetes mellitus
If you have gestational diabetes, your health may depend on more than just food. You can do the following things to have a healthy pregnancy in addition to eating a gestational diabetes diet:
- Make an effort to exercise consistently for at least 30 minutes every day, five days per week. Just keep in mind to consult your doctor before beginning any new exercises.
- Avoid skipping meals. Try to have a nutritious snack or meal every three hours to manage your blood sugar levels.
- Take your prenatal vitamins and any other medication prescribed by your doctor
- Consult and visit your doctor as often as needed.
Additional information from Margaux Dolores and Jobelle Macayan
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